Boston Scientific I/v cardioverter) defibrillator question

[Chinkoflight]

Hi looking for first experiences of having the above device fitted. I'm one week on from the implant and the soreness from the operation is settling down. I am still sleeping on my right side which is fine. But when I am lying flat the box starts firing off, I guess in cardioverter mode. It's set to atrial pace at 60 which I don't notice at all. I feel pulses of 5-10 beats which are mildly disconcerting because of the frequency. I can also feel these when sat up. However, when lounging I get the occasional thump which is enough to produce a noticeable bounce in my body. I don't think this is a full on shock but it's quite hefty. I can guarantee this happens if I lay flat!

I've tried to get in touch with my EP but no joy as yet having given it a few days to settle. Is this normal? I can't imagine the battery lasting long at this level of intervention.

[BobD Volunteer]

This does not sound right to me. I suggest you call your GP or if that fails NHS hot line. I know its not the same , but I never feel any pacing from my PM. I have heard of such devices malfunctioning. There was a case a while back of a French yachtsman who had to be rescued from his boat due to constaant firing if his ICD.

[Chinkoflight in reply to BobD]

Thanks Bob, I will be trying to get through to the EP team again today and if no joy I may just walk in later today.

[Chinkoflight in reply to Chinkoflight]

Hi Bob, finally spoke to an EP technician late yesterday. They said the ectopics were setting off ATP corrections. The device was working correctly and hopefully I will get accustomed to it. Part of my new life....I'll have to get more into stoic mode and look for some new #chinkoflight. 😁

[Chinkoflight in reply to BobD]

See also response to sustainedvtach270 below. Thanks again for your quick as ever helpful response.

[Sustainedvtach270]

Hello, firing from an ICD (defibrilator) feels like being hit by a steel bar on the chest quite a painful and traumatizing experience... When that happens, I call the pacemaker clinic and they can interview my box that records my daily cardiac events (or non event hopefully...) I hope you get this sorted out quickly. Thierry

[Sustainedvtach270]

And it only fires if your heart rate is too fast, for me the treshold was HR 180, now it is 220. When my HR is less 50, my pacemaker kicks in but that's barely noticeable and mostly at night.

[Chinkoflight in reply to Sustainedvtach270]

Hi that's helpful to know. My guess is it's a lower cardioverter shock rather than a full blown defibrillator shock. I've been in touch now with the pacing team after two days of repeat calling. Hopefully I'll get a call back today to call me in for a check. My Afib pacer is set at 60 which I feel is too high, my top end is set at 185. 🤞all round!

[Chinkoflight in reply to Sustainedvtach270]

Hi, again. I've just written an update to Bob above. I won't repeat it. Before the device was fitted originally I was going to have an s-ICD fitted. One of the key claims of the sICD is that it responds to arrhythmia runs and will allow self correction, whereas the I/v ICD responds to beat by beat. I wasn't happy with the change of device but was reluctantly persuaded because of my Bradycardia which is normally at rest 40 but on the bisoprolol (1.25mg) dropped this in sleep to low 30 and on one occasion below 30. The explanation was the bisoprolol is the primary response to knocking off the fast VT's and was absolutely important, the device was secondary. I needed bottom end pacing to counter the consequential bradycardia. That doesn't cause me problems, I don't notice it. With the hospital monitoring I could see how many ectopics I was having, on average 3 a minute but occasionally I was getting pairs, triplets and I also noticed 2 longer bursts which the monitor picked up and labelled as AIVR events. I was consciously stressed at the time. So this will explain the ATP events firing off which I feel.

[Sustainedvtach270]

Glad to hear that.