Upgrading my PM to ICD on 3/19

My EP and Cardiologists discussed my case after the cardiac MRI (which was normal) and decided to put an ICD and extract out a lead couple of days from now.I am 46 years old, male living in Dallas TX and had my dual lead Medtronic PM for 6.5 years which I got due to Atrial flutter plus bradycardia back in 2014. Couple of vtac episdoes over 30 secs sealed the decision in favour of an ICD.I did not feel any symptoms during those episdoes. My last months echo showed a drop of EF to 45% but the MRI and stress tested showed it around 55 which was normal. Not sure how life's gonna be with ICD. As I understand If I dont get any shocks its same as having a PM and ICD will try to pace my heart out of vtac before sending a shock.Anyways gotta suck it up and play the cards life dealt me.  


Suck it up...

by AgentX86 - 2021-03-16 21:35:06

It seems you have your arms firmly around the problem.

I might ask why the different LVEF numbers but you're not going to get an answer (maybe a shrug).  I'd like to know if it were really 45% or 55%.  As long as they're going to be tinkering around in there, it would seem to be a good time to put in a CRT now, rather than play catch-up next year.

<removed the stuck key>

It is what it is

by Gemita - 2021-03-16 21:53:14

and acceptance can be the beginning of healing.  With your attitude I am sure your heart will stay calm and so will your ICD and life will go on as normal.  

You mention the atrial flutter and that they are going to extract a lead.  I am assuming the flutter is continuing and the atrial lead is redundant and will come out?  If this is the case, I would agree with AgentX86 that it might be the perfect opportunity to upgrade to a CRT device to give your heart synchronised pacing to help protect your ejection fraction, although perhaps you are getting a CRT/ICD device?  If not, might be worth speaking to your doctors about this.

I send my best wishes to you for a successful procedure and speedy recovery.


Thank you Agent and Gemita

by seenu302 - 2021-03-17 21:43:24

As per my cardiologist , echo based EF is subjective to the measurements the tech takes their skill.I did not have any flutter episodes. I had a-flutter ablation during my first PM placement. Looks the the 2 leads from the ICD will go to my ventricles (one for pacing and other for shocking) and the shocking lead can also pace if needed. It could be controlled by the software switch.My cardiologist is a big fan of bi-V pacing and my EP is not.Having a software option to turn it on later is a plus without going through another surgery.

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