Defibrillators

Will my defibrillator ever need to be replaced?

Eventually, yes. Your defibrillator runs on a battery. Like all batteries, the battery in your defibrillator will eventually wear out. At each follow-up visit, your doctor or nurse will check your battery. When the battery power reaches a certain point, your defibrillator needs to be replaced. We make it a high priority to replace defibrillators while they are still working correctly. Your doctor can program your defibrillator to beep when it is almost time to replace it. If you hear your defibrillator beeping, call your doctor immediately.

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How often should my defibrillator be checked?

Most ICD patients have their devices checked every 3 months. Your doctor will determine a follow-up schedule that is best for you.

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When can I resume sexual intimacy after a defibrillator implant?

The natural heart rate increase that occurs during sex is the same as the heart rate increase that occurs when you exercise. You should be able to resume sexual activity after a ICD implant without problems under most circumstances. Exercise testing may sometimes help your doctor program your defibrillator better to avoid inappropriate shocks. If you do get a shock, your partner may feel a tingling sensation. The sensation is not harmful to your partner.

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Is ICD Therapy the Only Treatment for SCD?

A number of treatments have been investigated to help people at risk for SCD. These include:     * Medications. ACE inhibitors, beta blockers, channel blockers and other medications are prescribed to control abnormal heart rhythms or treat other conditions that may contribute to heart disease or SCD. There have been many clinical trials and other studies of medications currently available to prevent cardiac arrest. Medications often are helpful in treating other symptoms of cardiovascular disease. Sometimes, more than one medication is prescribed at the same time. These medications also often are prescribed for patients who have an ICD. The results of drug therapy alone have been disappointing. In some cases, certain medications have actually increased patients” risk of SCD. ICD implantation remains the most effective way to prevent SCD in high-risk patients.     * Radiofrequency Catheter ablation (RFA). In this technique, Radiofrequency energy is used to destroy small areas of heart muscle that give rise to the abnormal electrical signals that cause rapid or irregular heart rhythms. RFA often is used in conjunction with ICD therapy to decrease the frequency of abnormal heart rhythms in the ventricles. It is not a substitute for an ICD.

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How Can People Find Out If They are At Risk for SCD?

There are a number of tests that will help determine if heart attack survivors and people with other conditions that may put them at risk for SCD will benefit from ICD therapy. These include:     * echocardiogram. The first test performed is usually an echocardiogram, which will determine whether the heart”s pumping function is impaired. In this painless, noninvasive test, a device called a transducer is placed on the chest and sound waves are bounced off the heart. This provides a moving picture of the heart.     * A Holter monitor is an external device worn by an individual who may be at risk for heart rhythm disorders. The monitor automatically records a continuous electrocardiogram (ECG) of the heart”s electrical activity; it usually is worn for 24 to 48 hours.     * An event recorder is a small, pager-sized device that also records the electrical activity of the heart. Unlike a Holter monitor, it does not operate continuously, but instead is activated by the individual whenever he or she feels the heart begin to beat too fast or chaotically. After the device is activated to record the heart rhythm, the patient can report the event and transmit the recording by phone to a doctor or other health care provider.     * An electrophysiology study (EPS) is a test that can predict if an individual is at high risk for SCD. In this study, electrical signals are administered to the heart muscle through a thin tube called a pacing catheter to see if they will stimulate ventricular tachycardia, the too-rapid heart rate that often leads to VF and SCD. The test is performed in a safe and controlled electrophysiology laboratory at a hospital or clinic and the patient is in no danger.       In an EP study, local anesthetics are used to numb areas in the groin or near the neck, and small tubes called catheters are passed into the heart to record its electrical signals. During the test, the physician studies the speed and flow of electrical signals through the heart, identifies rhythm problems and pinpoints areas in the heart”s muscle that give rise to abnormal electrical signals. An electrophysiology study can:           o     Identify which patients who have had a prior heart attack, or MI, are at risk for serious heart rhythm disturbances and, perhaps, SCD.           o     Help determine which patients may require aggressive treatment to prevent SCD.           o     Identify individuals whose hearts cannot be induced into dangerous arrhythmias. They appear at lower risk for developing rhythm disorders that can lead to SCD.

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Who is a Candidate for an ICD?

The American College of Cardiology and the American Heart Association, along with representatives of the Heart Rhythm Society, have developed guidelines to help physicians and patients decide whether an ICD is the best treatment for an individual at risk for SCD. For example, it is agreed that ICD therapy is of benefit for: Secondary Prevention. This includes individuals who have suffered a prior cardiac arrest or who experience spontaneous, sustained episodes of ventricular tachycardia (VT) that is not self-correcting), especially if they also have episodes of unexplained fainting. VT is a too-rapid heartbeat that can lead to VF. Primary Prevention. This is treatment for patients who have never experienced the deadly heart rhythm disorders that lead to SCD, but have significant risk factors for the conditions. This includes certain patients with an ejection fraction of less than 35-40 percent and documented episodes of VT that are self-correcting and cause no adverse symptoms, but in whom sustained VT can be induced during the electrophysiology study. Ejection fraction is a measure of the amount of blood pumped out of the heart with each beat. An ejection fraction below 55 is considered abnormal. Vice President Cheney”s ICD is for primary prevention.

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How Effective Are ICDs?

Studies of ICDs show they are 99 percent effective in detecting and stopping deadly heart rhythm disorders. In clinical trials, ICDs have been shown to be the most successful therapy to prevent sudden cardiac death in certain groups of high-risk patients.

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How and when is the battery replaced?

The battery check at each visit will determine when the ICD should be replaced. The electronic circuitry as well as the battery are sealed inside the ICD. When replacement time arrives the lead(s) will be tested and then a new ICD is attached to the lead(s). Usually the original lead(s) are reused.

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Can I use a cellular phone with my ICD?

Yes, with these general guidelines:     * Hold the phone to the ear on the side of the body opposite of the implanted device.     * Do not carry the phone in the ON position in a breast pocket over or within 6 inches of the [KevcuTNHSCDNfjNMtRWOJ].     * Maintain a minimum of 6 inches between the [KevcuTNHSCDNfjNMtRWOJ] and the phone.

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How Can an ICD Help a Patient Who Has Suffered a Heart Attack?

The damage done by a heart attack, or MI, can affect the heart”s electrical system and its ability to pump blood effectively. The damaged heart muscle that results from a heart attack may give rise to abnormal electrical signals that sometimes cause deadly heart rhythms, which the ICD detects and corrects. The most common underlying problem seen in victims of SCD is coronary artery disease. This is a condition in which the arteries that supply blood to the heart are narrowed or blocked, usually due to arteriosclerosis (sometimes called “hardening of the arteries”). In this disease, a fatty substance called “plaque” builds up in the blood vessels, and can affect the normal flow of blood to the heart and other parts of the body.

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How Does an ICD Differ from a Pacemaker?

Both an ICD and a pacemaker are devices that are implanted under the skin and connected to wires, or leads, that are placed in the heart. Both continuously monitor the heart to detect changes in its natural rhythm. A pacemaker, however, is used to detect a too-slow heart rate (bradycardia). When it senses that the rhythm is too slow, it sends an electrical signal to stimulate (pace) the heart so it continues its normal electrical beat. The electrical signal that is sent from the pacemaker is strong enough to stimulate the heart to beat, but not strong enough for the patient to feel. An ICD, on the other hand, detects a too-rapid or chaotic heartbeat and delivers a stronger electrical shock to restore the heart to its natural beat. Some ICDs also act as pacemakers.

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What is an ICD

ICDs are pacemaker-like devices that continuously monitor the heart rhythm, and deliver life-saving shocks if a dangerous heart rhythm is detected. They can significantly improve survival in certain groups of patients with heart failure who are at high risk of ventricular fibrillation (VF). Modern ICD devices have an electronic memory that records the electrical patterns of the heart whenever an abnormal heart beat, or arrhythmia occurs. This record is available for review during regular checkups by the physician, who can monitor the frequency and severity of problems in the heart”s electrical conduction system that may lead to cardiac arrest or other serious heart disorders.

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Will I ever outgrow the need for a Defibrillator?

For most people, the defibrillator will be needed for the rest of their life. There are specific individuals who may get a device for prophylactic purposes, or for some reason the condition resolves. That does not happen very often. If it can be determined for a fact that the problem has resolved, then occasionally it is possible to remove devices. Sometimes, patients would prefer not to live with the device, after a period of time, and the device is either pulled out or turned off, depending on the wishes of the patient.

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Why should by driving be restricted after ICD implant.

Patients with arrhythmias may suddenly lose consciousness—arrhythmias cause about 15% of syncopal episodes. Therefore, whether a patient with an ICD should drive is a matter of both personal and public safety. After ICD implantation, driving privileges that were taken for granted are often curtailed as a matter of patient preference, physician recommendation, or law. It is not the ICD that makes driving dangerous, but rather the tachyarrhythmia, which may cause unexpected and sudden dizziness or loss of consciousness. The available data do not support the contention that sudden cardiac death while driving is a significant public safety issue.

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Can I drive after ICD implant.

No commercial driving Recommendations are most clear for commercial driving: it is permanently prohibited, whatever the clinical circumstances leading to ICD therapy. Noncommercial driving ICD patients who have not had symptomatic ventricular dysrhythmias can resume driving after 1 to 2 weeks, much like patients who receive pacemakers. The guidelines regarding driving are (and should be) less restrictive for patients who have received an ICD but have never had an episode of arrhythmia affecting consciousness. ICD patients who have had nonsustained symptomatic arrhythmias should not drive for 3 months after implantation. Patients who received an ICD after an episode of sustained symptomatic ventricular dysrhythmias should not drive for at least 6 months. Episodes restart the clock. Anytime after the initial driving restriction that the patient experiences another episode of ventricular tachycardia or ventricular fibrillation that triggers the ICD, the “clock starts over,” and the patient should abstain from driving for 6 months—long enough to adjust the medical therapy and to judge whether the new regimen is adequate. Thus, because driving status can change on the basis of the frequency of arrhythmias and their symptomatic consequences, it is recommended you talk to your doctor regarding specific instructions for driving.

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What if I am going into a hospital or clinic for a medical procedure?

Tell the hospital personnel that you have an ICD before you undergo any medical or dental procedure or test. Talk to your doctor if you have to undergo the following medical procedures:     * Diathermy     * Electrosurgery     * Electrocautery     * External defibrillation     * Lithotripsy     * Radiation therapy     * MRI When in doubt, tell your doctor you have an ICD.

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What should I do if I am near a source of EMI?

In most cases you can just walk away from the EMI source or turn it off. If you feel symptoms such as lightheadedness or palpitations after being near an EMI source, contact your doctor.

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What electrical equipment is safe to use?

Most home appliances in good working order are safe to use. This includes microwave ovens, blenders, toasters, electric knives, ultrasonic dental cleaners, televisions, VCRs, electric blankets, electric stoves and garage door openers. Office equipment and most medical equipment is safe to use. The ICD will work properly during chest and dental x-rays, diagnostic ultrasound, CT scan, mammography and fluoroscopy.

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What causes EMI?

EMI or electromagnetic interference can be caused by:     * Electrical appliances in poor condition or not grounded correctly     * Electrical equipment that produces a great deal of energy, like industrial generators     * Certain devices, notably arc-welders     * Medical equipment including MRI devices, therapeutic radiation, and TENS (pain-control devices)

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What is EMI?

EMI means electromagnetic interference. Certain types of electrical or magnetic energy can interfere with your pulse generator”s operation. You should do your best to avoid major sources of EMI.

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What is an ICD identification card?

This card lets everyone know that you have a pulse generator. You will get a temporary card at your implant. Your permanent card will be sent to you by the ICD manufacturer. It contains information on the type of ICD you have and other important information. If you are ever in a medical emergency, this card will give emergency personnel critical data that could save your life. Keep it with you at all times.

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Can ICDs set off airport security and interfere with aviation navigation equipment?

ICD recipients can travel without restrictions. However, metal detectors and anti-theft systems used in airports, stores, and other locations create electromagnetic fields that can interfere with the ICD. Be sure to pass through the archway at a normal pace and avoid lingering in the immediate area. Passing through the metal detector at airports will not damage an ICD, but the metal in it may sound the alarm. If this happens, patients simply show security personnel their ICD identification card. If a search with a handheld wand is performed, ICD patients should stress to the security personnel that the search should be performed quickly and that they should avoid holding the wand directly over the ICD for a prolonged period of time.

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Will a cellular phone interfere with my ICD?

You can use a cellular phone without any problems with most newer implantable defibrillators. Ask your doctor about using a cellular phone.

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What if I’m touching someone when I receive therapy?

The person you are touching may feel a tingling sensation. It is not harmful to him or her.

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Do ICDs place any limitations on my sex life?

Other than a brief stay in the hospital, followed by a short recovery period, an ICD typically doesn”t have any adverse effects on a person”s sex life.

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Can ICD recipients live an active lifestyle of jogging, tennis, skiing, and such? What if I do something that is too strenuous for the ICD to handle?

Typically, ICD recipients can continue to lead active lives. If you did a certain activity before, more likely than not, you”ll be able to continue that activity after ICD implantation. In fact, you should be able to participate in most activities. Because people may have more energy after the ICD is implanted, they may be able to do more than they have been able to do for some time. If there are special activities that you would like to participate in, this needs to be discussed with your physician prior to the procedure, as it may affect the device that is selected and how it is implanted.

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What does my family need to know about my ICD?

It is smart to work out an emergency plan for your family, friends, and even co-workers. Keep your doctors’ phone numbers and a list of your medications available at home and work.

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What should I do if I receive therapy?

You should call your physician”s office during working hours if a therapy is delivered. The physician will setup an appointment to see you for a device check within 1-2 days. If therapy is delivered more than once call EMS and go to the closest emergency room. ER doctor will contact your Electrophysiologist who will then make arrangements for checking your defibrillator and your medical care.You should keep an activity log, containing such information as when therapy occurred, what you were doing prior to therapy, and any symptoms you experienced.

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Will it hurt if I receive therapy?

People perceive therapy differently. For some it’s painful, for others it’s mild, and a few don’t even notice it. Therapy will also be delivered in different strengths, so not all therapies will feel the same. Any discomfort associated with shock therapy lasts for only a short time.

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an the patient feel the device working?

Most patients will not even notice the device if it is working as a pacemaker. However, if the device delivers shock therapy, many patients describe the sensation as a “hit” or “kick” in the chest.

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How long does it take to implant a defibrillator?

The implant normally takes one hour. Most patients can leave the hospital after one day and resume normal activity, although there may be some soreness at the incision site.

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Can a defibrillator prevent a heart attack?

No, a defibrillator cannot prevent a heart attack. It treats arrhythmias that lead to SCD. A heart attack occurs when blocked or diseased arteries (in your body”s “plumbing system”) cut off blood flow to the heart muscle. This results in areas of damaged or dead heart tissue. Damaged tissue can cause abnormal heart rhythms. A defibrillator continuously looks for rapid heart rhythms (in your body”s “electrical system”) that can cause SCD. SCD is often confused with other cardiac conditions and complications such as heart attack, coronary artery disease, heart failure and stroke.

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What is the difference between a pacemaker and an implantable derfibrillator?

A pacemaker speeds up a heart rate that is too slow. An implantable derfibrillator delivers an electrical shock to terminate fast and chaotic heart rhythms. The two devices are implanted in much the same way; however, there are some differences regarding lead design and lead placement. A lead is an insulated wire that carries the heart signal from inside the heart to the defibrillator. Today, most defibrillators actually include both pacemaker and defibrillator functions in one device for patients requiring the functionality of both.

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How long will an implantable defibrillator last?

Like all battery-powered devices, an implantable derfibrillator will eventually need to be replaced. The average lifespan of an implantable derfibrillator is approximately five to six years, but this depends on how often the device has delivered therapy and how it is programmed. Implantable defibrillator patients are seen regularly for follow-up visits so that their doctors can monitor how much battery capacity is left in the device.

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How does an implantable cardioverter defibrillator prevent SCD?

An implantable cardioverter defibrillator (ICD) is a pacemaker-like device and is about the size of three silver dollars. It is placed under the skin just below the collarbone. Signals from wires or leads that are threaded into the heart”s chambers monitor every single heartbeat. If a lethal rhythm appears, the ICD shocks the heart back to a normal rhythm.

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What causes sudden cardiac death?

Sudden cardiac death (SCD) can be caused by a sudden chaotic heart rhythm called ventricular fibrillation. The ventricle, or the heart”s main pumping chamber, fibrillates or quivers so that it stops pumping blood to the body. Although there are other causes of SCD, the vast majority are due to ventricular fibrillation

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How do I send a manual transmission on my St Jude and Medtronic Remote Device?

St Jude: 1.) All of St. Jude remote monitors should be wireless. Tell them to send a manula transmission after you explain these directions, but they can not do it while you are on the phone with them. The signal will not go through. OPTION: ask them to get on their cell phone. 2.) You must hold the remote monitor 1 ft from their chest and ”push” the white button once, and the ”push” the white button a second time and hold it for 3 sec. The light  will go through the icons in  succession. It will go from —-Person, to—- Tower, to—Stars. If it stops on any icon, or starts to blink in unicen they must call St. Jude. 3.) St. Jude: 1-877-696-3754.   Integron Wireless service: 1-877-300-3606 Medtronic: 1.) You must ask if they have a wireless or manual remote monitor. 2.) Ask the patient to hold the wond up to their chest and push the button and allow it to go through all the icons. If the it stops on any icon and blinks in a unicen fashon, the transmission will not go through. But, if it makes it through all icons the transmission has gone through.  3.) If the patient continues to have an issue they may need an analog converter from Medtronic  to send a transmission.  4. Medtronic: 1-800-929-9066.  MLINK: 1-877-609-6698 Biotronik: 1.) Ask if they have the land line model or wireless (i.e., wireless model has a cell phone in a case, land line does not). 2.) There home monitor must be turned on by the programmer and given a transmission schedule  in the office. 2.) If they are having issues, have them call 1-800-889-9066 Boston Scientific: 1.) Only ICD”s and CRT-D”s can be enrolled in Lattitude. 2.) Any issues, have them call 1-866-484-3268

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