Pre PM advice

Dear Forum,

I am 43 years old male. I had a near death experience three years ago when I was taken to hospital while I was facing a massive heart attack. I was lucky and survived that terrible attack. I was treated with a stent into the main artery. Naturaly, some part of my heart got damaged due to this incident.

Later on (2 months post incident), my echo test results were coming around 35% which means my heart was not fully functional. (For a normal healthy person, the echo results start from 55% onwards).

Couple of months back, my doctor advised me another echo test and latest results showed 25% percent of heart functioning. With these results, my doctor advised to me to go for a PM and this way I can avoid number of risks associated to heart diseases.

So here I am, nervous and scared of going through a heart surgery and specially on the feeling that wires will land straight into my heart and hence I am not able to make up mind for this PM.

I need advise and help around following questions from the forum for which I will be really really grateful.

- What if I do not go for PM? what do I lose? I mean I don't have any breathing issues or any sleeping abnormalities so what's the point of going planting a foreign device in your body?

- Can we remove it afterwards, say after the surgery I don't feel like keeping this PM inside me so will it be okay to do the reversals?

- Which PM device is most recommended? I mean with today's latest technology, what's the best of the best option out there?

Farhan.

6 Comments

I think it helps, WaspCVS-18

by WaspCVS-18 - 2014-05-13 01:05:41


Farhan; Had my 3 lead Biventricular PM and De-fib installed a week ago, I'm 75 and still or trying to work (my own Co,) AC & R. I have a 20+ EF or ejection fraction and Tim (my cardiologist and Friend) told me that this was what I needed. I think from just the last few days that I'm tickled pink. I have more energy, My wife is looking more delicious every day and am looking forward to Ship reunion and visiting our daughters on two continents. If you trust your Cardiologist and read thru all the comments here (most all are positive) that having the installation is the way to go. I've had some phrenic Nerve (lead to close to nerve but which means it is in the right position) issues but hope Tom (my surgeon) will adjust or fine tune unit today in about 3 hours. Will let all know later for info purposes. I'm very pleased with mine so far. Bob














Love you all guys, Seriously...

by farhan - 2014-05-13 02:05:25

To be honest, I was not hoping for this much detailed and quality response from this forum. The guidance that I received from you means a lot to me.

Trust me, I don't have words to pass on my sincere thanks to you all and I really wish if I could express my feelings in words... You guys are awesome.

You have no idea how much stressful and how weak I was feeling earlier but now with your wisdom, I feel much stronger or I would say, I am not scared anymore and feel very optimistic about CRT.

My conclusion and listening to TraceyE's advise is that I will wait till the time life is heavy on me. I don't have any lifestyle issues or abnormalities that have prompted me to go for CRT so I think I will wait for now. So my Doctor is also not pushing me for this and he just mentioned this as an advise that this will improve my lifestyle and this view of Doctor made me nervous. Now joining the dots, I think best option for now is to relax a little and wait till the time (if it comes) the routine life gets tough. So far, I have no issues with my current routine, I can do my stuff quite easily, my office life is perfect, my personal life is just great, I do my routine walk so summing up everything, no issues so far.

The strength that I have got from you all is that, it's not a big deal at all so it's fine... end of the day, it is all adding up to a better and a longer life and it's worth taking that initial pain (if you call it so).

I am really grateful for your advice and helping a needy person with what I was looking far.

Thank you so much.

Will update more if anything changes or I get more updates from my Doc.

Get a second opinion

by Duke999 - 2014-05-13 08:05:04

Get a second opinion. PLEASE.

Do not rush into making this decision. That's all I can tell you.

Duke

choices

by Tracey_E - 2014-05-13 10:05:31

Sounds like they're talking about a CRT, which is a 3-lead rather than a standard 2-lead pm. If your EF has dropped off, a CRT is your best chance of bringing it up again. A regular pm has a lead in the atria and one in the ventricles and will increase heart rate. It wont' affect heart function, simply make the heart go faster. A CRT has a lead in both the left and right ventricle. By pacing both ventricles, it forces them to stay in sync which can increase efficiency (EF).

As your EF drops, you will lose quality of life. Your stamina will drop, you will get tired and dizzy more often. If you feel good now, then the best choice might be to wait. 25% is low but now horribly low. If you can still do what you want to do, then I would wait if I was in the same situation.

Once you get it, it can come out reasonably easily for the first year. After that, the scar tissue grows around the leads and it gets much more complicated to take them out.

Can I give some unsolicited advice? You are over-thinking this. It is not open heart surgery and compared to what you've been through, this is easy and not at all scary. It is minimally invasive surgery - one fairly small incision on the chest- then they run the wires through the veins into the heart.

People get screws and plates when they break bones, joint replacements, tooth implants, all sorts of "foreign objects" and no one thinks anything of it. Add the heart to the mix and suddenly it's a big deal. Please believe me when I tell you it is not, and that little piece of titanium can work miracles. It can make you live longer. It can give you back your quality of life. Try to look at it as a blessing. If you go into it expecting to hate it, expecting it to not make a difference, obsessing over having wires in your heart, then you can be pretty darned sure you won't get good results. It sucks to be young with heart problems. Been there, done that, got the scars. There are many studies that patients with a positive attitude do better. Some of our problems are genetics, some are luck, some are payment for lifestyle choices but all of us have the choice to fight. There is a cool computer out there that can give you back some of your lost efficiency. Whine, complain, take some time to feel sorry for yourself, then ask questions and learn as much as you can and try to embrace it.

St Judes has wonderful animations on their site that show how the pm works and how it's put in.
http://health.sjm.com/arrhythmia-answers/videos-and-animations

2nd and 3rd Openion

by farhan - 2014-12-01 04:12:01

One more thing before I forget again per Duke's advise, I was able to get 2nd and third opinion from renowned practitioners and all of them suggested to go for the implant. So now I am on for single chamber ICD. My echo results these days are looking good with 32ef.

See you all again in few days.

I am planned to go for it on 16th Dec.

by farhan - 2014-12-01 04:12:15

Hi Again,

Just to keep my friends posted on the progress (after a long time), I am planned to go for the procedure on 16th December.

I thank you all for your opinions and suggestions as these all played a vital role for me to come to a decision.

I will keep this forum and you all informed on how it went. Until then, wish me luck.

Best Regards,

Farhan.

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