CPR ?

CPR?

by Dave H - 2020-03-27 12:52:19

I take it you have a total heart block (like me) and are PM dependent (like me).  CPR? a good question.............Seems like it would have to be performed non-stop until PM was replaced.  Regarding your ablation  ------ care to say when, where, and who performed it?

Survivor

by Theknotguy - 2020-03-27 12:59:40

I'm a survivor of CPR so your question is a good question.  

First, the pacemakers/ICD units rarely fail.   It took a while for me to get my brain wrapped around that idea.  

Second, a lot of people, even without the pacemaker/ICD, have a minimum heartbeat.  It may keep you alive until help can arrive.  You won't be in too good of shape but you can survive.  You'll have to talk with your heart specialist to see what you have and what could possibly happen.  

The CPR mimics the heart action of a full heartbeat.  However it is very physically rough on your body.  

Most of the ambulance services (at least in the eastern part of the USA) have a lot of medical equipment on hand including the shock paddles and an external pacemaker that can keep you alive until you get to a hospital.  They can call into a hospital and get a doctor's approval to use the equipment on route.  That was done for me when I had my event.  

The good thing about CPR is, if you do have to have it, you'll be unconscious and won't know it's happening.  I survived two sessions of CPR and didn't know I had them until I was in the heart rehab rest home getting treatments.  That was several weeks after everything happened.  

I know the mind races and goes into dark areas sometimes especially after having to get a pacemaker/ICD.  It's really hard at first to relax and just let things go but there isn't too much you can do about it anyway and you can't spend the rest of your life in constant fear.  

I was walking the dogs on a trail, turned to go on the exit trail when everything went black.  Woke up six days later in the hospital after everything happened. Spent the next two years recovering and putting all the pieces back together. Wasn't anything I could do about it as it all was in the past. 

If your mind does keep going into the dark places, I encourage you to work with a psych type person.  I worked with a psychologist who specialized in trauma and heart problems. (There are people like that out there!)  She helped a lot.  

Otherwise I hope your adjustment to your ICD goes well.  
 

Pacemaker Dependent

by AgentX86 - 2020-03-27 17:24:44

Wrapping your head around: Would you rather be dead now? That's the choice.  Note that I made the choice of having an AV/His ablation willingly (enough of that flutter crap, already).  I needed a pacemaker anyway and for a little bit more (becoming dependent) I could sleep again and not lose things like a thyroid or kidneys.

If the pacemaker: Pacemakers are incredibly reliable (leads, not so much), it's not worth worrying about that.  Learn not to worry about things  you have no control over.  If you can't change the outcome, the energy is better spent on something else more useful.

Yes, CPR would work.  CPR relies on mechanical pumping by thumping on the chest and squishing everything inside.  It has nothing to do with the electrical system.  As noted, there are external pacemakers that can be used in an emergency but CPR would have to be performed until one of them gets to you.

There are several natural pacemakers in the heart.  In theory, any nerve in the heart could become a pacemaker.  The pacemakers operate from the fastest to the slowest.  The fastest, of course, is the SI node.  This is what the healthy heart uses as its pacemaker.  After that is usually the AV node, (or bundle of HIS).  This generates what's called a "junctional rhythm",  Since your AV node has been severed, it's unclear if you have this beat (I don't).  Then there all sorts of "ectopic" (meaning come from somewhere else ;-) beats.  These cause things like PVCs (premature ventricular contractions) and PACs (premature atrial contractions) but PACs wouldn't help you since your AV node is no more).

The bottom line is that since you're "dependent", if someone swiped your pacemaker, your heart might not stop but it's unlikely it would beat fast enough to keep you consious.  It might beat fast enough to keep you alive until help can arrive. During your pacemaker clinic visits they will test this response (the elevator ride) down to 30bpm.  You'll probably fail the "dependency test" but they're not allowed to go further to see if there is any beat at all.

Test tomorrow.

CPR

by Tracey_E - 2020-03-27 17:30:46

First of all, they don't just fail.  Second, as KnotGuy said, even if it were to happen, odds are our own heart would kick in and beat at least some on its own. That said, if we were to need CPR, it's just like anyone else needing CPR.  Having a working pacer doesn't stop us from arresting. All the pacer does is tell the heart to contract, the heart muscle has to respond and contract.  If it should stop beating, either on its own or because the pacer is no longer sending signals, CPR will manually circulate the blood until help gets there. Ambulances carry external pacemakers, most public places have AED now to jump start the heart until help arrives. 

Have you done a CPR/AED class to get certified? It might make you feel better to understand how CPR works. Also, it's just plain good to be CPR certified, you never know when you might save someone's life.

Complete Heart Block

by Selwyn - 2020-03-28 06:49:21

Let me tell you a story:

A colleague left a lady in complete heart block ( pulse of 30 per minute) as she declined hospital admission due to the fact she wanted to see her family visit her ( it was New Year).

I came round to her house, the following day,  to see her on a doctor's home visit as she was short of breath on activity and dizzy.  After quite a while, I persuaded her that she needed urgent hospital admission. I went down stairs and was on the phone to the hospital when I heard a shout from upstairs. Dashing upstairs I found the lady in cardiac arrest and proceeded to do CPR. Luckily, she responded and lived to tell the tale with a pacemaker having been inserted. 

Complete heart block is associated with significant risk of cardiac arrest.  The ventricles of the heart have their own inherent  rhythm ( at about 30 beats per minute). This will sustain life.  If you can get from asystole ( no heart  beat) to 30 bpm with CPR then you will save life. 

Always try CPR.

There are a few people walking around today due to my CPR efforts. The aforementioned incident resulted in a bottle of wine and thank you letter to me!   You can have external pacemakers ( transcutaneous pacing)  slapped onto your chest wall as an emergency procedure. This can keep you going until a permanent PM is implanted. Although retired 7 years from medical practice, I still carry a functional defibrillator in the car. I have told all the neighbours that this is their nearest defibrillator. Sadly, one of my medical mates, who lives within 1/2 mile, had his medical Dad collapse at home in cardiac arrest ( just at the top of his road)- his medical Mum called the medical son. In spite of CPR the Father died ( He did not think to phone me). All the evidence on surviving a cardiac arrest points to early defibrillation having a better outcome than late defibrillation- hence the use of ICDs!

All public buildings should have defibrillators. My fitness centre has a defibrillator. The social centre we dance at has a defibrillator. My table tennis place has a defibrillator.  Do you know where your nearest defibrillator is? Can you do CPR?

( see https://en.wikipedia.org/wiki/Transcutaneous_pacing) .

It is interesting how we look on our pacemakers

by LondonAndy - 2020-03-28 18:10:49

You say about coming to terms with being dependent on your pacemaker.  I am totally dependent too, and yet my question to my technician at first checkup was: how do I die?  The pacemaker keeps me going, and going, and going .... :) 

"how do I die?"

by AgentX86 - 2020-03-28 22:52:52

I would have answered "by asking stupid questions."  ;-)  Well, my wife would have anyway.

going and going and going

by Tracey_E - 2020-03-29 11:13:40

The pacer keeps sending out signals to beat. One day the heart muscle will decide it's not going to respond to those signals.