Checkup and Replacement Info

I just finished my checkup and all is great. The current prevarication is that this pacer should easily last another year.

While I was there and the cardiologist was in a talkative mood, I ask about the replacement procedure. This was at 9:00AM and he said if I had needed a replacement today he would have ask me to skip lunch and meet him at the outpatient clinic this afternoon. He figured it would take less than an hour. I ask him about how he handles the issue of my being 100% dependent in my ventricles. His approach is to open the pocket, take out the old pacer and lay it on my chest. Then he gets the new one ready with a lead attachment wrench already inserted in it. The trick is to quickly disconnect the ventricular lead from the old one, insert it in the new one, and turn it on. He said I would probably flat line for a few beats, but not enough to be a problem. Then it is just a matter of moving the atrial lead over to the new one, putting it back in the pocket and sewing it up. With my not using any anesthesia I should be out the door in a short time.

thought some of you might like the info,

frank

4 Comments

tmi, lol

by Tracey_E - 2009-04-09 01:04:36

Figures you had to ask! I like knowing how things work but get squeamish knowing too many details about the surgery.

Because mine is so buried, they've done them all with general, and I'm still home in time for lunch if I get an early appointment. You probably won't even be there long enough to warm the sheets!

They can do an external pm short term if they can't make the change fast enough and/or our underlying rate is too low. I know they always turn my pm completely off for a few seconds when I have my last test before a change to see what my latest underlying rate is. It's usually low 20's. I've survived all my battery changes, never asked how they handle the dependency. :o)

Is it technically flatlining if the atria is still beating?

Hi Frank

by sputnick - 2009-04-09 06:04:24

That's good to know how it works. I am new to all this, I have only had my pm for 10 weeks so have a way to go b4 changeover. Have just learned that I have a slightly larger extended life St Jude pm so won't b 4 a while yet, but I had wondered what happens as I* am 99% vent paced. Not sure I will feel o.k. at the time but I managed without the pm b4 so I'm sure I can manage for a short while without it at tha time, At least you don't have to think about it for a while yet!
Tracey, you are so lucky to b cloncked out. It isn't too bad being awake but I think I would prefer to be out of it at the time!
Keep well Jan

Flat lining

by ElectricFrank - 2009-04-09 08:04:40

I don't know how they define it. I think it is one of those medical TV show terms.

I know I can handle 5 seconds with no ventricular beat. I had it happen when I lost capture a year or so ago. I never reached the point of feeling fuzzy. Maybe I'm so fuzzy all the time I wouldn't notice.

As for anesthetic I would rather avoid it as much as possible. There are too many things that can go wrong. I also learn a lot being awake. If I could look down enough to see the site I could likely change it myself. Maybe I can get him to prop up a mirror so I can watch his handy work.

Back in the mid 80's when I had back surgery I turned over during the night and pulled the IV line out. After waiting for 15 minutes for a nurse to answer my call I put it back in myself. Heck the drug types do it all the time, why can't I? The funny thing is that as a teenager I couldn't stand to look at anyones injury. Maybe raising 2 kids changed things.

frank

flat-lining

by esperry - 2009-04-21 01:04:23

Flat-lining is a pop-culture term, indeed; however, it is a real, in-use medical term as well. To flat-line, the EKG must not show any contraction of either the atria or ventricles. Thus, if one hypothetically removes the ventricular lead first, the atria, if they fail to pace, will pace from the generator. Therefore, flat-lining isn't really possible.

In non-paced individuals, failed ventricular contraction usually stems from either heart block or failure to pace the atria. However, heart block can induce atrial shock (electrical "regurgitation" of sorts), which causes the atria to stop beating. Therefore, one can flat-line, even if their atria are capable of contracting properly!

You know you're wired when...

Your signature looks like an EKG.

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