6 week Post Op Check Up

Hi, yesterday I had my 6 week check up of my CRT-D implant. I thought I'd share my experience with you on this forum so that others will know what to expect although I'm sure other hospitals do things differently. Also I'd like to hear your comments if you have them.

I was seen on time and after checking that the wound was fine, the 'header' was placed on my shirt above the implant. ECG type stickers and leads were placed on my body at various locations. The technician and the assistant carried out checks on the computers and said all was working well and the remote monitoring was working correctly with no red flags raised. I was told that there had been no shocks, AF, tachies or arrhythmias. This was good news. 
The settings of 55bpm for pacing and 130 for the high limit were not altered. I am pacing 97% right atria and 1.2% RV. The LV lead is still switched off as the LV is working fine and does not need it at present. The DDD was 55 and now I have a DDDR of 55 which I am told means my heart rate can climb more when on the move and should help prevent breathlessness and being light headed. They sped up my heart rate using the computer to do some tests, this was quite unreal and more than a little stressful. They then slowed it down for a while. Afterwards they asked if I was anxious, I said I was was but why do you ask? He told me my HR was 110 but not to worry as it was my adrenaline causing this. They were very helpful, answered all my questions and said, see you in six months time! I was in the room for 45 minutes. My HR was a bit high in the evening but it was back at 55 at bedtime. Once again well done to Derriford Hospital staff in Plymouth, they were terrific. 

I'm going to see my cardiologist on Monday, I will let you know what he says.

Hope this is of interest. 
Graham

3 Comments

Such good news

by Gemita - 2023-10-27 16:09:31

Graham, I was very interested to hear about your device check yesterday and even more interested to hear that in the 6 weeks following your implant, there had been no shocks, AF or other tachy arrhythmias recorded.  That is more than good news and should reassure you that you will be fit and well for your Thailand trip.

I note that you are pacing almost completely in the right atrium, like me, with very little right ventricle pacing, hence they feel reassured that you do not need your LV lead turned on at the moment to provide synchronised pacing.  I see that you now have Rate Response turned on to help you feel more comfortable when you exert yourself.   Be patient, since Rate Response can take a little while to get it fine tuned to suit your requirements.

45 mins of checking was certainly not a rushed appointment and I agree completely, well done to Derriford Hospital staff in Plymouth, they were terrific.  My device appointments usually last 30 mins which I feel is excellent too.

I hope you have a similar positive experience on Monday when you see the cardiologist and that he will confirm that all is well and you will be more than fit to travel to Thailand in January.  I hope you continue to make good progress and that they will watch you closely, especially your ejection fraction to make sure that it remains at a safe level.  Thank you so much for sharing your experience.  The NHS at its very best

Follow up consultation

by Graham Harry - 2023-10-31 08:31:26

Yesterday I went to see my cardiologist in Truro. We went through the implant report and he answered my questions. He was very pleased with how things are going and advised I increase the bisoprolol if and when my heart rate goes high again. The pm setting of 55 is fine and shouldn't need to be altered and the upper limit is 130. He said that the ongoing 'palpitations' are ectopic heart beats which he explained and that is something I just have to live with. The next step is an ablation which will enable me to get off the amiodarone. He said I am I fine to travel so I was very pleased with that! This week I have started doing steady 30 min walks which is the first exercise since the implant. Hopefully I am going in the right direction now. Fingers crossed. 
 

Thank you for the update Graham

by Gemita - 2023-10-31 12:01:14

I am so pleased that your cardiologist is happy with how things are going.  My doctors also tell me that if my heart rate increases, I can take an additional dosage of a beta blocker (also on Bisoprolol).  Ectopic beats can be forerunners to other heart rhythm disturbances, but in themselves if they are not too numerous or prolonged, we may not even feel or notice them.

It sounds as though the Amiodarone is working well for the moment.  Certainly from your earlier pacemaker check, no high heart rate episodes or any events/shocks were seen/given, so that tells me that what you are doing or taking in the way of medication is the right treatment for you.  Hopefully with pacing you will slowly notice an improvement and better control of your rhythm disturbances in general and that you will never need an ablation in the future (as has been the case for me).  Hopefully you will slowly be able to wean yourself off the Amiodarone too and remain on Bisoprolol only which would be a lot safer.

You are certainly going in the right direction Graham and you and the family must be getting very excited about your trip now.   

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