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Largehearted I miss living in Europe, specifically Munich, GermanyI like to think out loud. Some of my ruminations can be found at beinganddoing.wordpress.com. I love to cook and eat, but hate to clean up. I tend to be confident in my opinions, but will change when presented with a compelling enough reason/argument. Find out more about Largehearted
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  • Defib test

    Hello everyone.

    Does anyone else have to do the 18 month defib test where they put you out and screw up your rythm to see if your device will fire? My EP doc wants me to do it on Valentines day of all days. The last time I did this I went into a-fib and was hospitalized for 4 days. To say the least I am not so hot on the idea.

    So tell me. Is there any other way of testing the device other than firing it? The EP guy said, "We're betting your life that it will fire so we need to test it and make sure it will"

    I am open to other suggestions.

    Peace,

    Leon
    God Squad co-moderator
    Nothing is as gentle as strength and nothing is as strong as gentleness

  • #2
    Hi Leon,

    My EP doc prefers to induce an arrythmia to test my devise also. I have this done yearly. Her feeling is that my implant was set up for this to occur and I have always had it done yearly since 2001 when it was implanted. She said until she has an alternate method of assurance , she will continue to do this. It is technically called, NIPS( non invasive programmed stimulation).

    Her theory is that mine has never fired and she would rather have regular yearly assurances that it is working and will fire if needed. The first couple of years she noted that each time an arrythmia was induced , my devise would fire and get me out of it but I would also go into A-fib and she would have to externally convert me to get the A-fib to go away. She has over the last 2 years realized there is a method to this maddness and she must induce the arrythmia at a precise moment on the rise of my QRS complex. I no longer need that extra jolt to convert me back to NSR( normal sinus rhythm) .

    Additionally , the last time I was in A-fib, they were able to use my devise to convert me and spared me the burn from external cardioversion.

    Hope this helps, it really is a very benign experience on the scale of 1-10 in severity. It is more of an inconvenience for me. Overall I think for my EP and me it is important for her to stay abreast of any changes that may occur and this keeps her a part of the bigger picture that my cardiologists at Boston see and are aware of. She affiliates at a completely different hospital down here nearer me in Rhode Island.

    Best to you ,

    Happy Valentines Day, I usually have mine done around the 4th of July...electrifying

    Pam
    Dx @ 47 with HOCM & HF:11/00
    Guidant ICD:Mar.01, Recalled/replaced:6/05 w/ Medtronic device
    Lead failure,replaced 12/06.
    SF lead recall:07,extracted leads and new device 2012
    [email protected] Tufts, Boston:10/5/03; age 50. ( [email protected] 240 mmHg ++)
    Paroxysmal A-Fib: 06-07,2010 controlled w/sotalol dosing
    Genetic mutation 4/09, mother(d), brother, son, gene+
    Mother of 3, grandma of 3:Tim,27,Sarah,33w/6 y/o old Sophia, 5 y/o Jack, Laura 34, w/ 5 y/o old Benjamin

    Comment


    • #3
      Hi Leon
      I have my ICD tested yearly since 2001. I've never questioned if there was an alternative. I am due to have the procedure February 25th.

      You have me curious now, I will have to ask.

      Take care
      Esther

      Comment


      • #4
        I know several people here go that route to test their ICD's but my husband's doctors have never suggested this to him. They interrogate the device regularly and they test the threshholds by pacing him, but haven't ever forced it to decide to shock him since the day it was implanted. I'm not sure why one method is preferred over the other.

        Reenie
        Reenie

        ****************
        Husband has HCM.
        3 kids - ages 23, 21, & 19. All presently clear of HCM.

        Comment


        • #5
          I have had my device since 1997. I have it checked every 3-4 months I hae never had a NIPS done.

          Lisa
          Knowledge is power ... Stay informed!
          YOU can make a difference - all you have to do is try!

          Dx age 12 current age 46 and counting!
          lost: 5 family members to HCM (SCD, Stroke, CHF)
          Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
          Therapy - ICD (implanted 97, 01, 04 and 11, medication
          Currently not obstructed
          Complications - unnecessary pacemaker and stroke (unrelated to each other)

          Comment


          • #6
            Me either

            I don't think i would have it if i had to go through all that and come March i will have mine for 2 years

            Shirley
            Diagnosed 2003
            Myectomy 2-23-2004
            Husband: Ken
            Son: John diagnosed 2004
            Daughter: Janet (free of HCM)

            Grandchildren: Drew 15,Aaron 13,Karen 9,Connor 9

            Comment


            • #7
              My hubby's had his for about 4 1/2 years now.

              Reenie
              Reenie

              ****************
              Husband has HCM.
              3 kids - ages 23, 21, & 19. All presently clear of HCM.

              Comment


              • #8
                I am not sure why some EP's prefer it over others either. It does sound kind of "guineapiggish" to me. I did try to get out of it and asked my HCM specialist at NEMC about it . He said to continue having it tested this way as well as having three interrogations per year. I guess there is no uniform method here.

                Pam
                Dx @ 47 with HOCM & HF:11/00
                Guidant ICD:Mar.01, Recalled/replaced:6/05 w/ Medtronic device
                Lead failure,replaced 12/06.
                SF lead recall:07,extracted leads and new device 2012
                [email protected] Tufts, Boston:10/5/03; age 50. ( [email protected] 240 mmHg ++)
                Paroxysmal A-Fib: 06-07,2010 controlled w/sotalol dosing
                Genetic mutation 4/09, mother(d), brother, son, gene+
                Mother of 3, grandma of 3:Tim,27,Sarah,33w/6 y/o old Sophia, 5 y/o Jack, Laura 34, w/ 5 y/o old Benjamin

                Comment


                • #9
                  Andrew has had his ICD for 5 years and has never had a NIPS. He has interrogations every 6 months. (currently every month via CareLink though due to low battery)
                  Dolly~
                  mom to Andrew(HCM) 21 years old
                  Diagnosed \'95 age 5
                  Myectomy \'96 age 6
                  ICD implant \'99 age 9
                  First ICD shock (X2) \'04
                  ICD replacement surgery \'05 age 15

                  *And aunt to 7 year old Kenny who had HCM and suffered sudden death in gym class. (2/20/87 - 4/6/94)

                  Comment


                  • #10
                    NIPS or whatever it is

                    I have had my ICD for 2+ years and have never had this done. However, it has fired once and has paced me out of VT several times. They also check it every three months by pacing me with it. I guess the combination of those things is enough to let them know it is okay. I'm certainly comfortable that it is working.

                    Sue

                    Comment


                    • #11
                      Thanks for all your thoughts and comments.

                      Whenever I go in for a download they test the thresholds etc. so I would be quite comfortable with that as well. My wife and I will discuss it and see what we decide to do. Thanks again.

                      Peace,

                      Leon
                      God Squad co-moderator
                      Nothing is as gentle as strength and nothing is as strong as gentleness

                      Comment


                      • #12
                        When this NIPS test is performed, is the energy level typically reduced from the level that would be used in the case V-tach is detected by the AICD?

                        I've got to believe the level is reduced (I hope, I hope, I hope) because I don't see any strenuous "I can't believe they did this to me!" comments so far in this thread. (I have seen other threads reporting "I almost passed out when my ICD went off..")

                        It seems I'm scheduled to receive a device in about a week and a half and the EP said "of course I'll have to test it." (It will be a bi-ventricular type ICD.)

                        Is there a difference in brands/manufacturer's recommendations for NIPS?

                        Regards,
                        Rob Thomas
                        --Living life on the edge .. of a continent!
                        Charter member: Tinman Club

                        Comment


                        • #13
                          All AICD's are tested when they're implanted to make sure they work. The tests these people are talking about are after they have had the devices for a period of time. I'm not sure why some doctors perform this test versus the threshhold test through interrogation. I understand that the patient is under some anesthesia when they do the NIPS, though. They don't just shock you while you're fully awake and aware.

                          Reenie
                          Reenie

                          ****************
                          Husband has HCM.
                          3 kids - ages 23, 21, & 19. All presently clear of HCM.

                          Comment


                          • #14
                            Reenie,

                            Thanks for the info. I was unaware of the "anesthesia" portion of the NIPS procedure. I'm sure that makes it a little less "startling" to the implantee.

                            Being an engineer with some practical experience, I can definitely see why some Doc's might prefer to see the device in action rather than rely on a device's self-reported status. Could it be there is a correlation between age and/or "curmudgenlyness" of the Doc and running NIPS? Maybe "naive" docs don't run the test?

                            regards,
                            Rob Thomas

                            P.S. I'm new here, but I'll catch-up with a bio/background info, soon.
                            --Living life on the edge .. of a continent!
                            Charter member: Tinman Club

                            Comment


                            • #15
                              I have my ICD since Jan. 2001 and replaced once, I have never had the NIPS test done, although I know mine is working, I got my first shock a couple weeks ago. I have the thresh holds checked every 3 months as well.
                              Jen

                              Comment

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