ICD improvement timeline

Cardiac Resynchronization Therapy (CRT)

by Gemita - 2024-08-29 03:00:00

Gwyn, firstly welcome to the Pacemaker Club.

Looking at your Bio you have stated you have a CRT device although from your comments it seems you have a defibrillator also.  A defibrillator won’t improve your ejection fraction (EF).  A defibrillator is there to stop a dangerous arrhythmia and to save your life.  The CRT part is the part that will hopefully help to improve your EF, although this can sometimes take in excess of three months before some patients start to see real results.  It has to be said that it will be a combination of treatments, perhaps lifestyle changes, CRT therapy, medication to help improve our EF.  Sadly in some cases, EF may not improve, for example with advanced heart failure.

In your case I see that your EF has already improved since you received your CRT device, so this is a very good sign that synchronised pacing is helping you.  I would feel reassured.

It is difficult to say how long the shortness of breath will last because they need to find the cause - like an arrhythmia, continuing infection, damage to either your lungs or heart from whatever cause - ?Covid.  They are clearly still investigating and I see you are due to have a pulmonary stress test which will give them more information about the condition of your lungs and if this is adversely affecting your heart function?

I hope with time your symptoms continue to improve.  You have already stated that you feel better overall, so that is real progress and reassuring.  Additionally your EF has already increased, so things are going in the right direction, wouldn’t you say?  I hope for the very best for you 

bio pull-down

by PaceCahr - 2024-08-29 13:59:51

@Gemita

I just checked the bio page, and there isn't a pull-down option for an ICD. 

Current options are only:  pacemaker, defibrillator, CRT.  

If @admin would update that pull-down to include a write-in, or a much larger list of device types, that would help new folks who want to identify their device correctly, do so. 

Does @ mentioning work here?   🤗     (I remember reading another post where there was no response from the admin, about the new site, so 🤷 

Bio pull-downs and other menus

by Gemita - 2024-08-29 14:36:51

Hello PaceCahr, you did make me smile when I saw your comments, and no @ doesn’t seem to work here because we are not receiving notifications of any messages received at the moment and even when we did, to my knowledge @ never worked to alert the named member.  Hopefully when the new site is up and running we will have more in the way of options, like bumping any new comments, even when left on old messages, to the top of the New Message board.  Perhaps if Admin sees this message they might consider an option like the @ sign?  

Tracey_E and I frequently check the forum, so we will usually see questions addressed to ourselves or to Admin and will either respond personally or publicly to a member, or contact Admin on behalf of the member, if required.  

At the moment to join the Club, new members are not required to complete Device Type, Manufacturer, Model and additional info like Implant year, Country of residence etc. which fall under the heading “Optional Information”.  I and many others would ideally like this info to be given to help us to answer members' posts, although clearly the Serial Number identifying the member's own device should never be given for security reasons.  However if we ask for too much info, it might put some new members off from joining the Club so it can be a difficult balance.

In answer to your specific question, Device Type under Optional Information, already includes a Defibrillator (also known as an implantable cardioverter defibrillator (ICD)).   I believe the previous owner of this site wanted to keep the menus as simple as possible and not to have too many categories.  There is a lot of work that still needs to be done in this area but once this site is re-launched, with new software, we should all benefit.  This should happen October time I believe.  In the meantime, thank you for your thoughts which I will pass on to Admin to see where improvements could be made.

It would be helpful to see Manufacturer specific devices included in our drop down menus, including for Leadless Pacemakers/CRT pacemakers although to include "all" possible manufacturer Models and keep these updated would be quite a challenge.  For this reason we always refer a member to their device Manufacturer's website where they can ask questions and also ask for a copy of their specific device manual

Cardiac Resynch. pacing for heart failure.

by Selwyn - 2024-08-30 16:45:34

Studies have demonstrated that biventricular pacing in patients with moderate to severe heart failure and ventricular dyssynchrony can improve their quality of life, NYHA functional class status, exercise tolerance, and morbidity and mortality. One of these studies, the Multicenter InSync Randomized Clinical Evaluation (MIRACLE) trial, was the first study that measured therapeutic benefits of CRT in patients with advanced systolic heart failure and ventricular dyssynchrony. The study was designed to measure therapeutic benefits as determined by changes in NYHA functional classification, distance walked in 6 minutes, and patients' perceptions of improvement in quality of life. This study demonstrated that many patients responded positively to CRT. Sixty-nine percent of patients experienced improvements in their NYHA functional status by one or more class, and 50% demonstrated improvement in exercise capacity, as evidenced by an increase in 6-minute walk distance of 50 meters or greater and improvement in quality of life as measured by the Minnesota Living With Heart Failure Questionnaire. The assessment was after 6 months of therapy.

A fair number of patients with heart failure never receive proper medical treatment. This should be continued along side the pacemaker therapy.

Ref: https://www.nejm.org/doi/full/10.1056/NEJMoa013168

https://pubmed.ncbi.nlm.nih.gov/30025570/