IN THIS ISSUE

Patients Talk

ICD Patient Stories

Richard N. Fogoros, M.D. (Dr Rich) is a former professor of medicine, and a longtime practitioner, researcher and author in the fields of cardiology and cardiac electrophysiology. Dr. Fogoros is also on the LifeBeat editorial board.

LifeBeat attempts to bring real-life patient experiences into living with a heart rhythm device. In this issue, we present common stories/questions from ICD patients. Some patients received ICD therapy. Some patients learned about their heart disease. Other patients learned how the LATITUDE® system works. You may find your experience in one or more of these stories.

We asked Dr. Richard Fogoros to share what he would tell a patient in these situations.

I like to exercise but...
George was running on his treadmill when he felt a shock from his device. He stopped the treadmill and sat down. He felt fine. So why did the ICD give him a shock?

Dr. Fogoros: When you exercise your heart rate goes faster. If your heart goes fast enough when you exercise, your ICD device may deliver therapy based on its settings. Your ICD device is programmed by your health care provider based on your heart condition.

George has an ICD because he is at risk of dying from sudden death. We need to remember that the device is there to treat a dangerous rhythm if it occurs. The ICD device uses heart rate and other features to control when the device delivers therapy. We can look how fast George’s heart rate was during exercise. Then the rate that the ICD device uses can be changed to not treat the exercise heart rate, but still treat the dangerous rhythm when it occurs.

After my shock, I found out I had atrial fibrillation.
Lois sat in her favorite chair whenever she felt her heart beat in an odd way. It would feel like it was skipping beats. Today she also felt a hard punch in her chest. Why did that happen?

Dr. Fogoros: The ICD system saves a picture of the heart rhythm it treats. This picture showed that Lois’s heart rhythm was atrial fibrillation. Atrial fibrillation is often discovered when a patient has an implanted device. Patients may receive ICD therapy for fast rates caused by atrial fibrillation. The ICD device can be programmed to identify atrial fibrillation and not treat this heart rhythm.

The picture of the rhythm can help the health care provider determine the best treatment for Lois. Treatments for patients with atrial fibrillation include medicine to prevent blood clots and medicine to slow down the heart rate. Cardioversion may be used to deliver electrical therapy to the patient’s chest to restore a normal heart rhythm. Ablation procedures try to stop the fast atrial rate from making the ventricles beat fast in the future.

The clinic called me about the battery in my ICD.
Karen goes to the clinic to have her ICD device checked twice a year. Other times, the LATITUDE system checks her ICD device remotely from home. She was surprised when the clinic called to schedule her ICD device to be replaced. How did they know that?

Dr. Fogoros: Remote monitoring systems, like the Latitude patient management system, can help the health care team get information more frequently than in the past. These systems can check the device at home and tell the clinic if the patient’s device needs any attention. The battery in Karen’s device is measured every day. When the LATITUDE system checked the battery information, it showed that the ICD device had reached replacement time. The Latitude system then sent that information to the clinic.

I still work on my cars, but not when the engine is running.
Every time Harry worked on the running engine of his car, he felt dizzy. He found out that the engine caused the pacemaker in his ICD device to think he had a fast heart rate, when in fact he doesn’t!

Dr. Fogoros: Your implanted ICD device is designed to work properly around most appliances and equipment. Most things you handle or work near every day will not cause a problem. However, some machines can create electromagnetic interference (EMI). Harry’s running car engine created a large EMI field. That is why health care providers and device manufacturers do not recommend working too closely around an engine that is running.

EMI occurs when the signals from an electromagnetic field temporarily interfere with how the implanted device works. That was what Harry felt. The pacemaker in the ICD device may see the EMI as a heart rate and not pace the heart. The ICD device may see the EMI as a fast heart rate and deliver shock therapy. For all device patients, the closer your implanted device is to the EMI source, the stronger the effect. The farther away, the less likely you will experience an EMI effect. EMI effects do not usually harm your device.

Note: Individual symptoms, situations, circumstances, and results may vary. This information is not intended to be used for medical diagnosis or treatment or as a substitute for professional medical advice. Please consult your doctor or qualified health care provider regarding your condition and appropriate medical treatment.

Talk to your doctor about important safety information.