Cardioverter Defibrillator implant

As a clinical engineer, I know what kinda gizmo they have inside you.

Keep calm, take your meds, listen to your doctors.

And damned glad you're still with us!

Just wanted to say that I am very happy that you are still with us and good luck!

Iwinder
Hello all, I had the misfortune of dieing two weeks ago and now I am the recipient of a Cardioverter Defibrillator implant and I am looking for any helpful information as what to expect or not to expect regarding this implant.

I tried the search to no avail, so here I am.

Two weeks ago I sat at the kitchen table at 6 am and called out to my wife to phone for an ambulance.
She looked at me and asked why?.....next thing I see is her looking down at me on the floor trying to breath but without much luck.

The Fire/Rescue was on site first closely followed by the EMT's and I got the air I was screaming for ASAP then it kind of gets blank.

Next thing I know I am in the Ambulance and they are putting in the pipeline IV's in both elbow joints and screaming at me to keep my eyes open.

At this point I am very weak and cannot even lift up my arm which fell off of the gurney and the EMS guy yelling at me was really pissing me off.

All I wanted to do was shut my eyes but he kept screaming at me to look at him and I wanted to punch him in the face if I was able :-)

It turns out that my Heart rate was 240BPM and not slowing down ......now wonder the EMT was excited and yelling.
I held that heart rate for over half an hour and when we got to the hospital they were waiting right at the door for me.
20 seconds later the trauma doc says to me.." I am going to shock you now and this is going to hurt"

Between gasps for air I said get to it please, I went over a foot in the air and landed to the smell of smoke.
There was one hell of a bang too but apparently only I could hear it?

Instantly I could breath and all was good withing seconds, next thing I know is I am hanging onto the docs arm and looking at him as he is asking how I feel.


My very first coherent words spoken since my attack were these and they were loud......HOLEEEEEEE F***K followed by silence then all these people start clapping.

Once I lifted my head up to look what all the racket was about, there had to be at least 15 people standing around me 3 of which were the ambulance guys and gals.

There I lay in all my glory as I lost my bodily functions when they zapped me and nobody cared the least.
Before they shipped me off to the ICU I thanked them all as best as I could and let me tell you it was very emotional.

So two weeks in different hospitals and two surgeries here I am now black and blue and wondering if anyone else has had this happen?
Now being a new to these implants I am hoping that someone here has some personal experience with them and might enlighten me to what I am in for now.
The monster they implanted in me is a Medtronic Defibrillator plus a pace maker which is not enabled at this time.

Any words of wisdom would be much appreciated indeed.

Many thanks.
Regards, Iwinder

edit on 28-3-2014 by Iwinder because: (no reason given)

I've been the trainer & education specialist for ICD's for two of the major device companies.
There probably isn't much I don't know about them so what would you like to know?

Pardon?
I've been the trainer & education specialist for ICD's for two of the major device companies.
There probably isn't much I don't know about them so what would you like to know?

What do they do with the used ones?

How do I get a specification with the programming and interrogation protocols in so I can write a home-brew programmer?

Bedlam

Pardon?
I've been the trainer & education specialist for ICD's for two of the major device companies.
There probably isn't much I don't know about them so what would you like to know?

What do they do with the used ones?

How do I get a specification with the programming and interrogation protocols in so I can write a home-brew programmer?

A jailbroken cardioverter defibrillator implant? I want one!

Bedlam

Pardon?
I've been the trainer & education specialist for ICD's for two of the major device companies.
There probably isn't much I don't know about them so what would you like to know?

What do they do with the used ones?

How do I get a specification with the programming and interrogation protocols in so I can write a home-brew programmer?

The used ones are sent back to the manufacturers for to be dismantled and disposed of.
Although often they're given back to the patient as a keepsake (after being cleaned).

As for programming, each manufacturer have their own bespoke systems, mainly for patent reasons but also to differentiate between them.
Hacking them used to be very easy, theoretically speaking anyway as they weren't thought to be under threat however this has now been tightened up.

I remember in the 90's a Japanese firm created a "one-for-all" programmer but ran into difficulties trying to bring it to market due to all the copyright and patent infringements it caused.


The one the poster has in will probably have a remote monitoring device which will upload data to his local hospital reducing the need to visit there personally. Any issues or events will be passed on immediately.
They work in two ways to control tachyarrhthmias (fast heart rates); if the rate is within a certain range and regular(ish) they can try to pace (deliver small electrical pulses) slightly faster to interrupt and halt the rhythm or if the rhythm is fast and chaotic they can deliver a shock directly to the heart's surface, usually of the order of around 30-35 joules.
This doesn't seem a lot to an external defib which delivers 10 times that but it's more than enough to stop the chaotic rhythm (and give the recipient a fair old jolt!).
They are, quite literally, a life saver.

GetHyped

Bedlam

Pardon?
I've been the trainer & education specialist for ICD's for two of the major device companies.
There probably isn't much I don't know about them so what would you like to know?

What do they do with the used ones?

How do I get a specification with the programming and interrogation protocols in so I can write a home-brew programmer?

A jailbroken cardioverter defibrillator implant? I want one!

You really don't.
Trust me on that!

Pardon?

The used ones are sent back to the manufacturers for to be dismantled and disposed of.

Pity they can't be recycled for veterinary use. My local vet got a demo/sales unit that had some sort of cosmetic issue sterilized and kept a dog going for years with it, with the under-the-table help of the local rep.

Bedlam

Pardon?

The used ones are sent back to the manufacturers for to be dismantled and disposed of.

Pity they can't be recycled for veterinary use. My local vet got a demo/sales unit that had some sort of cosmetic issue sterilized and kept a dog going for years with it, with the under-the-table help of the local rep.

They can!
A friend of mine is a vet and I gave him an explanted one with more than a year left on the battery and went in to the procedure to program it for him.
Kept the dog going for quite a while, a labrador I think it was.

I used to do that a lot with old pacemakers too.

Pardon?

GetHyped

Bedlam

Pardon?
I've been the trainer & education specialist for ICD's for two of the major device companies.
There probably isn't much I don't know about them so what would you like to know?

What do they do with the used ones?

How do I get a specification with the programming and interrogation protocols in so I can write a home-brew programmer?

A jailbroken cardioverter defibrillator implant? I want one!

You really don't.
Trust me on that!

Might look like the bathtub scene on "It Crawled Out Of The Woodwork". Tried to find that on YouTube, can't believe no one put that up. It gave me the horrors as a six year old. These physicists were all some sort of zombies - being read onto the project involved being sacrificed to an energy monster (might be a metaphor for the project security officer...?) and afterwards you were a sort of zombie kept alive by an external pacemaker that looked like a TENS unit on steroids. If you talked about the project, the monster would come out of the crypt and suck your batteries dry.

In the bathtub scene, the new project director gets pushed into a full bathtub by his little brother and went off like a bad line transformer - the thing wasn't waterproof, obviously, which sort of made me wonder if they all had really bad body odor and really good umbrellas.

I think my all time record with a reentrant SVT was 290-300, they couldn't keep track of the count to be sure. Everything was far and wee for a few seconds. You don't move a lot of blood at 300 bpm.

reply to post by Bedlam

That was the feeling I had too, very similar to when you are just going under when they knock you out for surgery ......not a good feeling and that was how I ended up on the kitchen floor with no idea how I got there.

Regards, Iwinder

beezzer
As a clinical engineer, I know what kinda gizmo they have inside you.

Keep calm, take your meds, listen to your doctors.

And damned glad you're still with us!

You betcha I am following orders and taking my meds.
Thanks for the kind words.

The size of the unit surprised me as it was much larger than I expected, and the wire is very long too.
No matter if it saves my life then all is good.

Regards, Iwinder

Night Star
Just wanted to say that I am very happy that you are still with us and good luck!

Thank You your comment is much appreciated.
I hope I am here for many more years to come.

Regards, Iwinder

I've been the trainer & education specialist for ICD's for two of the major device companies. There probably isn't much I don't know about them so what would you like to know?

reply to post by Pardon?


Thanks for the offer and I will take you up on that, My unit is supposed to last 12 years but they don't tell you how much battery life is lost when it fires off a charge.

So lets say it fires off once a year from today till it dies can I expect a shorter battery life(probaly) any idea how much a drain there is per shock?

Regards, Iwinder

ETA......they told me that there is no known reason why these rapid heart rate things happen and it might just be a "One OFF" occurrence but they insisted that this was a good choice because if it ever shocks me odds are it would be a life saver.

Iwinder

I've been the trainer & education specialist for ICD's for two of the major device companies. There probably isn't much I don't know about them so what would you like to know?

reply to post by Pardon?

 

Thanks for the offer and I will take you up on that, My unit is supposed to last 12 years but they don't tell you how much battery life is lost when it fires off a charge.

So lets say it fires off once a year from today till it dies can I expect a shorter battery life(probaly) any idea how much a drain there is per shock?

Regards, Iwinder

ETA......they told me that there is no known reason why these rapid heart rate things happen and it might just be a "One OFF" occurrence but they insisted that this was a good choice because if it ever shocks me odds are it would be a life saver.

edit on 29-3-2014 by Iwinder because: (no reason given)

Any projection on the battery life includes a set number of shocks (or rather charges) per year.
The batteries charge capacitors within the box and it's those which deliver the shock. Most ICD's routinely charge these capacitors to keep them "fresh" and then let the charge drain. Again, this happens a number of times a year.

If you were to have more shocks than is projected for then this will drain the battery faster but on average the least time they last for is 5-7 years with moderately heavy use. 12 years is pretty good.
When they first came out in the early 1980's you were lucky to get a couple of years out of them. Thankfully battery and circuit technology has improved dramatically.

When the batteries finally drain (there'll be plenty of warning as they drain slowly and predictably over a period of several months) they will need to change the whole box. Usually the leads are left and a new box attached to them. Generally takes about 30-40 minutes to do.

I can't really comment on the reason they've implanted it specifically as I don't know what rhythm you were in or anything about your family history etc.
I think that would be best discussed personally with your doc rather than on here anyway.

Anything general though feel free to ask and I'll do my best to answer you.

You should have a look round your area for any ICD patient groups as it's good to get together with them and swap experiences, allay any fears etc as I know it's probably been a very worrying time for you and you may feel like your life has been turned upside down and inside out!

reply to post by Pardon?


Thank you for your response to my question, my unit says it lasts 12 years but I think that is an estimate.
When they removed my bandages on Thursday and ran the first scan/test on it the printout said the expected battery life was 11.1 years so we will ask them next month at my next appointment what that is all about.

We live in a cooler climate ( Southern Ontario) would being outdoors a lot in the winter have any drain on the battery?

This thread is very helpful for us, questions come to mind when you are not with the technician or at the hospital.
Driving home from the hospital other day we talked and came up with loads of questions that we should have asked.

I could probably come up with a few hundred in a few days if I let my mind wander.

Your input is much appreciated.
Thank You Pardon

Regards, Iwinder

Iwinder
reply to post by Pardon?

 

Thank you for your response to my question, my unit says it lasts 12 years but I think that is an estimate.
When they removed my bandages on Thursday and ran the first scan/test on it the printout said the expected battery life was 11.1 years so we will ask them next month at my next appointment what that is all about.

We live in a cooler climate ( Southern Ontario) would being outdoors a lot in the winter have any drain on the battery?

This thread is very helpful for us, questions come to mind when you are not with the technician or at the hospital.
Driving home from the hospital other day we talked and came up with loads of questions that we should have asked.

I could probably come up with a few hundred in a few days if I let my mind wander.

Your input is much appreciated.
Thank You Pardon

Regards, Iwinder

The remaining time left is usually quite accurate after a few months post implant. It may fluctuate a little before then so wait until then to get a more exact idea.
As the battery gets used its "resistance" (impedance) increases and this, along with what the device is set at, is what the battery life is projected from.

The cold weather won't have any appreciable effect on the device as it's going to be kept warm by your body with no real fluctuation.
Saying that, they can function well from about 5 degrees celcius (41F) up to about 45C (104F) and beyond.


If there are any questions you want to ask but don't want to post them on the thread feel free to send me a message.

ANNED
As a EMT I have hit a few people with a AED(Automated external defibrillator) and some complained that was no fun ether.

seses

I tell you that it was one hell of a shock, I really did launch into the air and I got to watch the whole thing.
The thing I cannot understand is that I heard a very loud bang similar to firing a 22 cal right up by your ear.
I asked the EMT's that transported me later on to another hospital for surgery and they said it makes no noise at all.

They did agree with what you said above and that is if you are awake and aware for the shock it is a bad ride.
I was in such bad shape that if they said they were going to cut off a leg I would have suggested both just so I could breath.

Regards, Iwinder

reply to post by Pardon?

If there are any questions you want to ask but don't want to post them on the thread feel free to send me a message.

Thanks and I will if I feel they should not be posted here on the thread, I am hoping for more information and stories to be posted here.
Perhaps down the road somebody here will need information on this subject and will find some helpful posts.

We find it a little unnerving at the moment but I suppose we will relax as we learn more and more about this situation.

Makes me think years back when we bought our first microwave, plugged it in but did not use it for two days because we wanted to read the manual that was about 3 inches thick :-)
You can tell by my posts and questions I am spooked having this thing in my chest, that should wear off with time hopefully.

Regards, Iwinder

Dear gawd Iwinder...

So glad you're still with us !

Reading your story scared the bejesus out of me and hit a nerve. I've had arrythmias (palpitations) for years and take beta blockers to try to keep it under control, doctors have no idea what the problem is other than the fact that I was born with a slightly deformed atrial valve that doesn't quite work properly causing a slight aortic insufficiency, but they don't think that's what's causing the problem. Had my first attack when I was 15 years old.

But my palpitations have never been more than a minute or two in length (knock on wood), but even at that short interval I experience the oxygen instantly cutting off to my brain causing me to almost black out, shortness of breath, etc, followed by a massive headache afterward.

I can't even imagine such an intense attack lasting for 30 minutes like what you went through !

You are one helluva lucky man, my friend !

I can only hope that I'll be surrounded by such great EMTs, doctors, and nurses like you were when my time comes...



I'm going to crack a nice cold bubbly in your honour.

Cheers... and here's to second chances at life !