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Extra Palpitations after ICD Implant?

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  • Extra Palpitations after ICD Implant?

    I got my ICD Implanted this last Friday. I am wondering if anyone else experienced more than usual amounts of palpitations after this procedure?


    Theo
    26 years old, diagnosed April 2005. ICD July 2005.

  • #2
    As I recently had a new devise put in the 21st of June , I too noted more ? palpitations. I soon realized it was my pacer going on and off. When you go for your follow up be sure to mention this sensation of palpitations. They will be able to tell you what % your pacer is pacing you. If it is the pacer they can turn the threshold down a bit if they feel you can tolerate it. I wanted to go back to my original 50bpm , but the NP said for now she would go to 55. They put it at 60 after my surgery. When I go Friday for my 3 week check, I will ask again to go to 50. I however am having less pacing since the turn down to 55bpm. I want to preserve all the battery life that I can.

    I am quessing that the pacing is what you might be feeling. It takes a while to get used to the different things our AICD's will do.

    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
      Theo,

      I received an ICD in March and have managed to have two additional minor surgeries since then. While I don't usually notice these things, I've noticed palpitations after each surgery. I attribute it to being tired or suffering from after-effects from the anesthesia. It got better after a few days of recovery. Hopefully it's less of a problem now?

      Pam--I was told that the effect on battery life from pacing was pretty insignificant, particularly if your lead(s) establish a good connection to the heart wall and the EP can turn-down the operating voltage of the device. I was wondering if you notice a difference in how you feel being paced at 50 vs. 60 bpm? Do you have any more energy at 60 than you have at lower numbers?

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

      Comment


      • #4
        Thanks for the info.

        I am not sure if it is pacing me. The specialist who did the surgery said that he would set the pacer at 40 BP and I have felt these palpitations at around 55-60. hmmm.

        I will go see my GP today, and also try to get my referral to an HCM specialist and call my surgeon.

        Theo
        26 years old, diagnosed April 2005. ICD July 2005.

        Comment


        • #5
          Hi Rob,

          No nothing is different in the energy department , actually felt a little better since my weight has come down 18 lbs and that started before the replacement and higher setting. When my heart rate goes up and breaks 70 , which actually happens as I mill about, even w/ 250mgs of Atenolol and 180mgs of cardizem and 40mgs of Lasix, I feel worse. The stress of having a higher heart rate makes me very exhausted and physically spent . I am glad that the meds keep me low when I am sedentary.

          As far as the leads , one of mine is using higher voltage and they are watching it. It has not increased over the last several months. With the continuous pacing I had before myectomy , my EP had predicted replacement by year 5. Instead due to the recall it was year 4. Oh well now it is better at demand only.

          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


          • #6
            Pam,

            Now I've got something to talk to my doctors about. Since my implant (March) they've left my ICD set to pace at 60 and below, which seems to be a fair percentage of the time (maybe 60-70%). The presentation to me was that I'd have more energy if they left it higher.

            I know I totally crap-out if my rate goes to 90 bpm so I've got to wonder if I'm also in your situation where I'd actually feel better with a lower rate. My rate had been in the 50s at rest before the AICD--but I'd probably be comatose below 50!

            Thanks.

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

            Comment


            • #7
              Well Rob, went for my check-up on my new medtronic and the NP says, "everything looks great but I don't know how long this devise is going to last." I twisted my head around and said what? Well she said, that the lead down in my ventricle is now eating up battery on this new AICD due to high voltage readings , we have known about this problem for awhile and now I am wondering why my EP did not put another lead in 4 weeks ago when she had the oportunity. As I thought about it , I really don't want to start adding new wires sooner then I have to. She basically told me that I am pacing 100% so it is using up faster with this lead problem( I do wonder if it is the Guidant wire), I will have to follow up on this GRRRRRR!!!!! So I sugested once again she turn me down to 50. She did and then advised me she had resigned and if I had any symptoms I would have to call the EP , oh well dynamics in the cardiology office don't work for everyone.

              I am hoping that lowering it will decrease the use of the pacer( save the battery) and I will not fall on my face. I shouldn't as I told you in an earlier post that I have been at 50 since 2003 . They were a little concerned as my Bp was 120/30 then 90/40. She felt that was a bit low. I wonder if I might have to lower my BB. I keep having these sudden surges of heat and then profuse sweating , it might be my heart rate , I'll have to pay much closer attention. I seem to have the same energy level though, so we will see, its only been today.

              On the way out , saw my EP she said ," just watch it," and also added, "actually for your very stiff heart it is better if you can tolerate it; gives you a longer time for the ventricle to fill with blood volume." Her and I speak the same language and I am glad she has followed me from the beginning of HCM diagnosis and to my geographical area. Providence is an easier trek then Boston for my HCM cardio's

              Will let you know how it works out.

              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


              • #8
                Originally posted by Pam Alexson
                .. she said, that the lead down in my ventricle is now eating up battery on this new AICD due to high voltage readings, we have known about this problem for awhile and now I am wondering why my EP did not put another lead in 4 weeks ago when she had the oportunity. As I thought about it , I really don't want to start adding new wires sooner then I have to.
                Though device or battery changes aren't fun (right?) I've gotta believe it's preferable to adding new leads if you don't have to. Much better for you to be "on demand" instead of high percentage of pacing if your voltage has to be set higher. As I understand it, the voltage level is the most significant of the factors contributing to battery drain.

                (fyi, I'm hoping that my buddy will get disconnected long before the battery wears out--they literally just snip the lead off during a transplant and leave the generator in for about a year before removing it to reduce the risk from infection.)

                Did they really use a Guidant lead with a Medtronic device? I'm a little surprised, actually, that there is that level of standardization between the devices. (Does your Medtronic temporary ID card show more than one model and serial number on it? Nothing on it that looks like a lead? I know new implants start off with a higher operating voltage for about 6 weeks until the leads "bed-in" to the heart wall and the lead-heart impedance goes down.)

                Originally posted by Pam Alexson
                .. oh well dynamics in the cardiology office don't work for everyone.
                Hah! My EP's office is alway's a little frantic and somewhat disorganized--kind of like my EP, although I do believe him to be a very, very smart guy and only a little-bit crazy.

                I am definitely going to have discussions with my cardio and my EP about turning down the rate from 60 to maybe 55 as I want to see what they say. I think you have some very good points supporting a lower rate (if I don't fall on my face, as you say!)

                Originally posted by Pam Alexson
                Providence is an easier trek then Boston for my HCM cardio's
                The Thomas family ancestors (this particular Thomas family, at least) are from Rhode Island, having moved there from England/Wales way back when. For the most part my branck of the family stayed in the Northeast, but I'm the Black Sheep having escaped to California almost 30 years ago.

                Cheers! Be well!

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

                Comment


                • #9
                  So I went and saw my doc. It was me pacing and not extra palpitations. The pacing was more intense because my heart was a little inflamed. Today I took some ibuprofen and I am feeling much better.

                  Apparently I have the latest Guidant Pacer Model. Apparently It corrects afib too, for those of you who get a fib you might want to inquire about this latest model. I guess I am the testing ground to so? Well see. Hopefully I wont need its De-fib or Afib services.

                  Theo
                  26 years old, diagnosed April 2005. ICD July 2005.

                  Comment


                  • #10
                    Rob,

                    Yes , since 2001 I have had one medtronic lead and one guidant lead. The interesting thing is back in 2001 they were supposed to and told me beforehand that I was getting a Medtronic devise. I asked while on the operating table and they chuckled and the EP simply said , "Oh we are not using Medtronic devises right now. " I tried to press them further but it fell on deaf ears and the retort was , " well, we will give you one medtronic wire so you won't be left out. " Of course there had to be a reason for that as well.

                    Later on down the road , several months passing and I found an article written by my former EP. It stated that they had implanted an 80 odd year old with a medtronic devise and on testing in the OR , the BATTERY EXPLODED.... EEEEK. I have never forgotten that. I would theorize since my implant occured 3months after that dated article , that this was the reason I got a guidant devise. I have been told that sometimes an EP has better results with some leads for different areas of the heart, but who knows the real deal.

                    As far as the leads , there has to be interchangeability since I have one of each. When my EP was connecting them in the OR at this recent change out it sounded like she was winding a big old clock. She laughed at my comments and said , " no, just connecting your leads with a torque wrench." Wow , I felt like a car in amechanics shop!!

                    See this big ole internet makes the world so much smaller and closer , you a former Rhodey out in big ole California. I have really come to love and respect Rhode Island and all its many things to offer. It has everything; the ocean , a beautiful capitol city, great hospitals, very much historic value, hills and farmlands , lakes, and on and on, oh and nice people who often migrate to other places in the world

                    Have a great day.

                    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


                    • #11
                      Theo ,

                      I am glad you were able to get some answers, help, relief and are feeling better, takes time.

                      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


                      • #12
                        Pam,

                        I must say you certainly have some interesting stories to tell--you're the only person I know or heard about with a hybrid Medtronic-Guidant ICD.

                        Exploding battery stories? I'm not surprised--in my not so humble opinion there is no satisfactory battery technology. It is (was) a running joke at work that any project that involved battery-powered devices should be given to me because I despised them so much! Anyone for a nuclear powered ICD?

                        You take care!
                        Rob
                        --Living life on the edge .. of a continent!
                        Charter member: Tinman Club

                        Comment


                        • #13
                          Rob,

                          Now that is interesting, you mean it is truly not that common? I had never thought about it and thought that it occured all the time. Now maybe we should have a poll of individuals... Any takers out there? Does anyone else have one of each wire from different companies like me?

                          This should be an event , Now ready set .... Everyone check your cards and reply. I want to know.

                          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


                          • #14
                            I am all Medtronic over here. 2 Medtronic leads, and on my second Medtronic ICD (replaced after recall earlier this year).

                            BTW, I also have a Medtronic Ventriperitoneal Shunt in my head from my little run in with a brain tumor a few years ago. I joke with the Medtronic reps that I want to have an endorsement deal with Medtronic.
                            Daughter of Father with HCM
                            Diagnosed with HCM 1999.
                            Full term pregnancy - Son born 11/01
                            ICD implanted 2/03; generator replaced 2/2005 and 2/2012
                            Myectomy 8/11/06 - Joe Dearani - Mayo Clinic.

                            Comment


                            • #15
                              My husband is all Medtronic too. And Cyn, if you get the deal, can I say, "I knew her when...." ???

                              Reenie
                              Reenie

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

                              Comment

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