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ICD & stenuous activity
My question is about the icd and temporary exertion, cold water shock and adrenaline rush.
I just had an icd implanted. I am an outdoor adventure guide leading canoe and walking trips based in Vermont. We live in rural Nicaragua for 6 months where we are 3 hours away from the nearest basic hospital, 12/15 hours from a professional city hospital. We understand and accept that risk and actually that was the factor that tipped in favor of getting the icd.
We did not explore this question fully before getting the implant. Although I have not had a shock yet, I think I will be OK with that...but my concern is how debilitating is it? For example, I am guiding/running a whitewater river, and am thrown into cold water...how is that "gasp take my breath away, racing heartbeat" going to affect/effect the icd? I am not referring to cold water hypothermia, since if I am in that state, I am simply trying to save myself and I have no other responsibilities. Or another more likely situation is for an event to trigger my adrenaline in a rescue situation
working hard under some pressure.
I understand these new units are programmable. Is it possible to set the icd differently when I am leaving for a cold water trip where it is likely that I might be shocked unnecessarily? I understand there would be some risk to changing that setting, but it seems to me in my situation, it is worth it.
Nothing is perfect all the time, and there are risks to life
but it seems to me that if the icd can be reprogrammed to anticipate such a situation, it would be beneficial. I have a meeting with the docs next week and will discuss it with them, but wanted to try and get some background before that.
Thanks in advance, and appreciate the detailed information you have on the site.
4 Comments
Minimise the shock.
by johng - 2008-05-25 04:05:41
JW,
may I suggest that you wear a 6mm.wetsuit top.
This might provide a window of opportunity for you to get clear of the cold, before it has a chance to affect you.
Please keep us posted on what your doctors say. It may help others make a better decision.
Best wishes,
John
followup to activity
by jw101 - 2008-05-26 05:05:23
Thanks to both...Smitty first. No I have not thought about changing vocations. I am not going to let any little heart problem change my life...but, seriously, this is what I do, and want to do. Rarely are we guiding solo, so the full responsibility is not only with me.
Wetsuits and drysuts protect, but don't necessarily prevent to cold water shock. To be clear, I am 61 and no longer paddle with the icebergs like we used to, but rather using that as an example of something else might be affecting my heart rate.
I was trying to explore how the settings are decided on.
what triggers the zap and it seems to me that since the the sensitivity for the zap be changed a bit, yes I might be a bit more 'at risk', but the tradeoff might be acceptable to me.
As I mentioned, I am going to the doc next Fri and trying to educate myself to be able to ask the right questions.
Thanks to all.
Hey JW..
by joy1 - 2008-05-27 01:05:45
Your smart to educate yourself before going to see your doctor. It's unfortunate you weren't able to ask these questions before you received the implant; not that circumstances which made you a candidate for one would have been any different.
I fully understand wanting to maintain your lifestyle because we identify ourselves by the things we do but you really need to be prepared to trim back some of your activities atleast until you can get your device programed right for what you want to do. It's one thing to put yourself at risk it's quite another if other peoples lives might be at stake. There was a post response written by a man named "electric frank" He is 78, has an ICD, and is mt climbing and doing all sorts of things. You might want to send him a pm and ask your questions of him. He seems to be quite knowledgeable about the kind of questions you are asking.
Joy.
You know you're wired when...
You have a new body part.
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ICD & Activity
by SMITTY - 2008-05-25 03:05:24
Hello JW,
I'm not certain that I understand you question, but here goes anyway. If I understand you correctly, you have an ICD and you are concerned that in your activities which can cause you to be exposed to very cold water, which you think may lead to a need for ICD may to fire to keep your heart beating. You are further concerned that the shock from that ICD may compound your problems.
I take it you have an ICD because your doctor has reason to believe you may be at risk of having Ventricular Tachycardia (V-Tach) and Ventricular Fibrillation (V-Fib). Both can lead to cardiac arrest, so the doctor implanted an ICD.
I'm certainly no expert in this field and have only a pacemaker. However, since my doctor keeps bringing up the subject that I may need an ICD in the future I'm always interested in how and what they can do.
I have not seen anything about sudden exposure to cold causing Vetch or V-Fib, I know from experience, many years ago, that stepping into really cold water makes me feel that my heart is going to stop because of the shock, but just how real that is I don't know. But it is my understanding that V-Tach and V-Fib are the result of an internal problem with our heart's natural pacemaker and impulse conduction. I have seen nothing abut either of these being caused by external forces.
Your ICD functions in the following ways:
Pacing: If you have ventricular tachycardia that isn't too severe, the ICD can deliver several pacing signals in a row. When those signals stop, the heart may go back to a normal rhythm.
Cardioversion: If the pacing doesn't work, cardioversion can be used. In cardioversion, a mild shock is sent to the heart to stop the fast heartbeat.
Defibrillation: If ventricular fibrillation is detected, a stronger shock is sent. This stronger shock can stop the fast rhythm and help the heartbeat go back to normal.
Pacemaker: The ICD can also see when your heart beats too slowly. It can act like a pacemaker and bring your heart rate up to normal.
The defibrillator shock is the strongest treatment. Many people say it feels like being kicked in the chest. It usually comes suddenly and lasts only a second, although you may feel upset for a short time after a defibrillator shock. To me this says even if the defibrillator did shock you at the least desirable time, it would not necessarily be a disaster.
All this leads me to a question that I will admit is none of my business. Since you have what can be a very serious heart problem at times, have you thought of switching vocations? What you describe doing not only puts you at risk, but also puts at risk those people that are depending on your expertise. Sometimes life deals us a crappy hand and we must make some changes.
Good luck,
Smitty