My fathers last pacemaker readout. Possible vfib?

VT more likely

by crustyg - 2023-06-08 12:59:03

I hesitate to comment as I suspect you're looking for someone to blame - which is natural and human.

I would interpret VT as Ventricular Tachycardia - possibly not sustained, lasting 25s.  Depending on a number of factors that's going to make most folk lie down or collapse onto a bed.  I get the occasional non-sust VT (usually around 180BPM for 12-15s) and they make me feel terrible and I stop what I'm doing immediately.

VF - it's a killer and no amount of calling 911 will make any difference.  There are only two things that get you out of VF: a pre-cordial thump (and that's not certain) or a defib shock, internal or external.  Without either of those death is certain within 3min.

I can imagine going into non-sustained VT and back out and then having another episode, and after each episode blood pressure will rise, the brain gets a decent blood supply and you can talk and think.

My commiserations on your loss.  No matter how long expected, it's always an emotional blow when it happens.

My condolences

by Gotrhythm - 2023-06-08 13:11:26

I'm sorry for your loss. The death of a parent at any age is a profound event. The changes it makes in our own lives are both obvious and subtle--and long-lasting. When the death was sudden and unexpected, all the effects are magniified.

Sorry, I don't know anything about vfib. I do know about loss of parents. Been there. I urge you to be gentle with yourself. Recognize that you have had a shock to your entire system and it will be a while before "things make sense" again.

In the meantime, continue to look for facts and knowledgeable opinion. Something in us needs to know how a loved one died. What caused it. Did they suffer? What if anything could have been done differently. Asking these questions, coming to terms with the answers, or lack of answers, is part of the grieving process.

Complicating our search for answers is the question of our own guilt and sense of having failed our parents. Even when we consciously know that the guilt is irrational, the guilt nags at us. Please be gentle with yourself, and forgive yourself as often as you need to.

You are in my thoughts and prayers.

End of life

by Selwyn - 2023-06-08 20:24:51

Hello BDOGG,

You certainly are rendered unconscious by ventricular fibrillation. The ventricles are fibrillating and not pumping. You will die without a fairly immediate change of circumstances.

Clearly, your source of information is incorrect concerning  the opinion ( If machine generated they are notoriously unreliable). 

The best way to send a picture in Pacemaker Club is with a Drop Box link ( free for small articles, the app is downloaded free of charge). In that way all anonymity is ensured. Do take off any personal ID. An EKG can be sent as a .pdf link. 

I can't make any sense of the information enclosed. Sorry.

Wisdom is great with hindsight.

My condolences for your loss. My mother-in-law collapsed and died last October. She had a pacemaker. I was there within 3 minutes. Although the pacemaker was initially functioning ( as shown on the paramedics EKG - they arrived after me), it gradually stopped as death is not just about the heart stopping or having an arrhythmia, it is a breakdown of body function, specifically leading to loss of brain function.  My Mother also died with a functioning pacemaker.

I hope your Dad  lived well, was a good age, and did not suffer.  The end of life can be rather a mess. The less suffering the better.

I am so sorry for your loss

by Gemita - 2023-06-09 02:12:19

BDOGG, Firstly I am so very sorry to hear this news.  It is devastating to lose a family member and there are always so many unanswered questions and whether we could have done more and prevented this from happening.  

I experienced this with my mother and on behalf of the family I fought hard to get answers.  I wrote to those concerned with my questions and received a full explanation of the circumstances leading up to her death and a copy of the Post Mortem.  Once I had the answers, I could see that it was futile to continue my search for "why" her life had to end and "why" I needed to blame someone for her death, including myself.  I slowly forgave myself for not being there when she most needed me, knowing in my heart that her death must have been such a release for her.  I hope you will soon find your peace as I did.

Now to your dropbox information.  Thank you so much for doing this.  It does help.   Based on what you have provided, my observations are:

From what I can see, Page 1 shows therapies (parameters) set up that have to be met before treatment of an unstable heart rhythm or high heart rate is provided, but this doesn't confirm the cause of your father’s death on the 8th June 2023.  Furthermore, Pages 2 and 3 appear to relate to an event which occurred on 25 August 2021, not the day of your father’s death (see Encounter Date at top of these pages). You need to ask why you were given these old records and their relevance to your father’s date of death?  Looking at the short rhythm strip, it does look like VF "to my untrained eye" but again the Encounter date doesn't match the actual date of death.  

Page 4 is useful because it gives a lot of information on what was set up in your father’s device, although I don't see the period Page 4 covers?  I see your father had an ICD, a three lead CRT device and the battery status was still good with 6+ years to run.   No other arrhythmia other than NSVT (non sustained ventricular tachycardia - 25 detections) appear to have been recorded under Counters (since last reset) although VF therapies appear to have been given on the 25th August 2021?

I would respectfully ask for more recent pacemaker data leading up to the day of your father’s death and for a full explanation of the cause of your father's death.  If the cause of death was definitely VF, you could ask if there is any evidence of the ICD having delivered shock therapy on the day of his death and if not, why not?

I see your father had a Cardiomyopathy, Code I42.8.  The code is "I"42 .8 not "1"42.8.   You could look up this Code for further information on his particularly type of Cardiomyopathy.  Your father was taking Metoprolol, a beta blocker to help control his heart rate and to calm any arrhythmia.  From his need for an ICD and CRT device it would appear he was suffering from heart failure although I don't know how severe this was or whether it ultimately led to VF and to his death and this is a question you need to ask his doctors?   I am sorry I cannot help more based on what you have provided. 

ECG Ventricular fibrillation

by Selwyn - 2023-06-10 14:55:21

Thank you for the drop box link.

Yes, the ECG provided shows venticular fibrillation on 25 August 2021.

I see there are 5 episodes and shocks delivered on the patient information sheet.

His ICD was functioning normal. 

What relevance this has  is another matter

Ventricular fibrillation (VF)  causing collapse, ICD correcting the arrhythmia,  wake up, and get up,  as survival from the `VF has taken place. 

I am unsure how this helps as the ECG is some 2 years ago.

My sympathy 💐

by Lavender - 2023-06-11 07:53:25

My dad was alone in his boat and somehow drowned.  Boat found swirling in water, upright. Healthy 66 yr old. 
You can imagine the consternation of wanting to know what happened that took this most beloved man out of this earth. 
 

Mom wouldn't allow an autopsy. He only had one small mark on his temple. 
 

In time, the family has reconciled ourselves to the theory that:

The water was shallow enough to wade in with hip boots. The boat motor had a small stone stuck in the propeller. 
 

Perhaps it caused the boat to suddenly stop, throwing dad out, hitting his temple and rendering him unconscious under water. (He was a great swimmer-(had medals for it from local competitions) and could've just stood up in the water. )

Perhaps dad knew a stone was stuck and somehow got out, went under there to release it and passed out. 
 

We will never know for sure but it was certain that dad was gone. We can't go backwards only forwards. We will see him again in paradise. We will find out then the exact manner of death. Til then, we try and find peace. 
 

May God comfort you in this temporary loss. May your mind know that your dad is with you in spirit not wanting you to be anguished about this or any matter. Your dad had heart trouble and he stayed as long as he could. Don't let your dad's entire span of years be defined by a moment in time where he passed onto eternity. We are all one heartbeat away.