This is all new to me and want to find out as much as I can. My heart is racing and tires me out and have been asked to consider having ICD Impantation defribullator. I wouuld like to know if anyone has had this done. Did this work. Any side effects? This will be done on the NHS. How long did you wait to have the implant done? Do you stay over night at hospital? How soon can you go back to work. This is a new chapter to my life and I’m 60 years old.
ICD Implantation: This is all new to me... - British Heart Fou...
ICD Implantation
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Maxy9
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Hi Maxy
Will it be an ICD or a CRT-d?
An ICD doesn't do anything to improve the heart at all, it's there to pace you out of any dangerous abnormal heart rhythms &, if unable to do that, it will deliver a shock to re-start your heart.
A CRT-d synchronises your ventricles so that they beat in time which, hopefully, improves your heart function which improves your symptoms, tiredness, etc
I would think waiting times for implantation would depend on the severity of your condition/symptoms. My husband had his 1st ICD in 2012, if I remember rightly he waited a couple of months. When he had a battery change in 2021 he waited about 3 months. He's recently had his ICD upgraded to a CRT-d and I think he waited about 2 months. It's usually a day job, because of my husband's health he stayed in overnight for the ICD & the battery change but not for the CRT-d.
Recovery is the same for both devices. It takes about 6 weeks for the leads to bed in so no lifting your arm above your head, no heavy lifting etc for 6 weeks. It can be very painful for the first few days so make sure you have painkillers on hand, some people get away with just paracetamol others need something stronger. Depending on the reason your having the device fitted will determine the length of time you can't drive. If you're having it fitted because of a cardiac event it's 6 months no driving, if it's fitted as a precaution then it's a month no driving. If the device shocks you then it 6 months no driving. If your device shocks you again within that 6 months, the 6 months period starts again. My husband wasn't able to drive for 10 months last year. How soon you can go back to work would depend on what your job is & your medical team will advise you on this, but I would think if you work in an office the risk of dislodging the leads would probably be minimal. I think I'd avoid public transport for a while, in case someone bumps into you, that will hurt!!
My husband's ICD saved his life last year, think of it as your own personal paramedic sitting there looking after you 24/7.
I hope this helps, good luck 🤞
Hello Lezzers,
Thank you for your comments. I am glad your husband is ok now and what a worry at the time for you both. You’ve been helpful. My heart is racing and beating too fast for just over a week. Not had any heart attacks or other problems apart from my heart murmur. It has slowed me down and have been put on Biospirol and been told to take 2 now to slow the heart beats down. I’m hoping this will and can avoid having the ICD Implant. Having an ECG Monday so that will tell the doctors more then I will have to make a decision. So I am doing some homework first and to guide me and knowing what to expect. Hopefully if decided I will have this I hope my lifestyle will improve and I can be a bit more fitter so I can manage the inclines to walk. I was doing so well til last week.
Bisoprolol is usually the first line of meds they use to try & control your heart rate. Has there been any mention of a cardioversion? I would have thought they'd try that before fitting an ICD, but of course I don't know you're medical issues 🤷♀️ also I would ask if the device they're thinking of is an ICD or CRT-d, an ICD doesn't do anything to help your heart function better & therefore isn't going to help your fitness levels, walking up inclines etc. what it will do is correct your heart if it goes into an dangerous abnormal rhythm.
Courage, Maxi, mon brave. An ICD is also a pacemaker. Mine paces my heart for well over half the time. I had it fitted age 61, 13 years ago, and while it hasn't always been plain sailing (quite the opposite, in fact, see below), it made me much more confident about my future, after some initial fear. I had a VT in that June (should have died) and fairly soon had a scan. Then some secretary lost the urgent result, but when it was found, they couldn't get me "in" quickly enough (4 days, including a weekend). Op. was a doddle, but, unusually, I was in overnight, due to a slip by the practisioner (and my lack of muscle). In 2017, one of the wires broke, and I spent 7 unhappy weeks in St. Thomas waiting for "the team" to be all available together. in June 2023, I had another VT but the ICD was set too high to catch it! Since, it has false-alarmed twice (very annoying: it goes off every 4 hours until reset) and needs replacing. I am sure 99% of ICDs are much more reliable, I have just been unlucky, but I am still glad I had it put in. Oh, and I have no idea what a CRT-d is: an "ordinary" pacemaker?
I think you've replied to me by mistake, it's the op who was asking. Sorry to hear you have problems with your ICD. An ICD doesn't pace like a pacemaker as such. An ICD can be set to pace you if your heart rate falls below a certain number, i.e, my husband's was set to pace him at 50, so should his HR fall below 50 his ICD would bring it back. If your ICD is pacing you more than 40% of the time then it could potentially damage your heart. My husband's ICD was pacing him at 42% which is why they upgraded his ICD to a CRT-d as that can pace at 100%, and not cause problems. A CRT-d is cardiac resynchronisation therapy, basically its a pacemaker which helps the ventricles of the heart to beat in sync. There are 2 types of CRT's, a CRT-d which I've already refer to and is also a defibrillator and a CRT'p which does the same job but doesn't have the defibrillator function.
Ah, sorry, as a newbie, there didn't seem to be a way to reply to the original. When I went back from your reply, it didn't go to the original question. I thought replies must be in a continuous stream. I've also (maybe) posted a question, but it has not appeared.
It's not always easy to navigate this site!! I'll see if your post was successful
I've found your post & commented on it. Hopefully others will also see it now and also comment.
Ah, now I see my question. Also, I think I may have clicked on the wrong "reply". Sorry, again, and thanks. However, you definitely know more on the subject than I do, so I'm glad I didn't show my ignorance to anyone (except you). My ICD clinic has never told me what you just did about pacing when they give me the figures. I'm hoping that any damage caused by ICD pacing is minimal (after 13 years of it!). Maybe that explains why I now have angina, as well (yes, unlikely, i know).
Not knowing about something is never ignorance, it's just something you don't know yet. I've been dealing with my husband's health issues for years & being responsible for someone else can be difficult, I have to ensure that any decisions made are right for him & I can't do that unless I know the whys & wherefores of everything, so I research, ask questions and research again.I only found out about the pacing issues in January 2023 when it was vaguely mentioned. Then, like you, things went haywire last year and the issue was put to one side. However, I bought it up again about 4 months ago and was told, that too much pacing doesn't necessarily damage the heart but it has the potential to do so. As his heart is already severely damaged & because he'd also developed LBBB which slows down the HR even more, it was decided to fit the CRT-d. That is apparently pacing him at 100%,
100%? Wow. Thanks for the info. Sorry to hear about your husband's problems, there IS someone worse off than me! I hope your health (especially mental health) is good. My partner (of 42 years) has MS, stage 4 kidney disease and diabetes, so we are mutually dependent. Last year she made a good recovery from breast cancer. Today she said "My body copes with everything they throw at it." Hopefully.
Wow, you've both had a lot to deal with too!! I'm glad your partner has made a good recovery form her cancer though she's still dealing with a lot but great that you support each other. Earlier this year my husband was told his cancer is in remission & we'll be celebrating our 40th wedding anniversary on Sunday, a date we wasn't sure we'd actually reach after last year!!
Yes apparently his CRT-d is pacing him at 100%, according to his nurse. Apart from what I've already mentioned I don't know too much about CRT-d's yet, I hope to know more when he's had his implantation follow up appt. But his nurse explained it like this; the CRT-d has fully taken over the beating of his heart and his heart is just sitting there the background. If I take his pulse now it's nicely strong & steady, but thats not his heart I'm listening to it's the CRT-d that's doing the beating for him, the only way to know what/how his heart is doing is by having an ECG. So much more complicated than an ICD! A
CRT-D is also known as a biventricular pacemaker, it has 3 wires, 1 going into the atrial, the other 2 into each ventricle to synchronise his heart beats.
I had to laugh - his pulse is steady (possibly at 0), but the CRT is fine. I wonder if it would work for me when my cardiac blood vessels give up entirely? (Um,no, otherwise everyone would want one). Ruby wedding? Well done, both of you. As a newbie, I'm taking up too much of your time, you probably have lots of correspondants and not just on this site, so I'll sign off. Stay as well as possible
You too & your partner
Hi Lezzers
Haven’t used the blog for a while so not quite sure if my reply is to you personally or all on Maxi post. So, all the best Maxi as you move forward. Thanks to all who replied to Maxi.
To you Lezzers, many thanks for your clarification! I can’t believe I’ve had my CRT-d since Feb 2018 and haven’t really understood the technical workings of the device. I’ve always wanted to be in and out of each clinic checkup as quick as possible!
Many thanks to all for keeping this site so informative and to those who manage it!
Hi lez,I have been upgraded to a CRT 9 weeks ago from a two lead PM, I have total heart block following AV ablation and since my first pacemaker insertion 28 month ago I have developed persistent AF and heart failure hence the crt upgrade, it's been mentioned that Its down to pacing induced cardiomyopathy, unsynchronized ventricles causing a delayed QRS due to 2 lead pacing
Have a cardioversion planned for next week so hoping that will resolve the AF.
I'm still learning things as I go along but kind of worried what the future holds as I'm only 53.
I still struggle with energy levels, sob, walking on inclines and dizzy spells which is kind of frustrating since the crt upgrade as I thought I'd feel more benefit from the CRT.
Enjoyed reading your posts on this thread, informative, often wonder why things aren't better explained by the health professionals.
Tbh 28 month ago I didn't have a clue on anything heart related, I was just told I was 5x more at risk of having a potential stroke/blood clot if I didn't have surgery.
Thanks to this site and ppl like yourself I'm still learning, there's has been a lot to understand and take in.
Thanks
Hi Nomis
That's really interesting to hear your story, very similar to my husbands. It's a long story so I'll keep it brief, but basically his ICD was 1 lead and they were just going to fit another lead but they went for the CRT-d instead. My husband has HF, bradycardia & recently diagnosed LBBB. Apparently because of the additional LBBB fitting another lead would just increase the ICD pacing potentially causing further damage, a CRT-d makes the heart beat in sync. He was told he won't necessarily feel any better but it'll be working away in the background. He has said that he doesn't feel any better but hopefully it just early days. The best thing though is, because of his slow HR & low blood pressure he's been limited on what meds he can take , having the CRT-d they've been able to increase his beta blocker from 1.25 daily to 10mg daily! Additionally his nurse said that as the CRT-d is making his heart function better that'll improve his blood pressure & they can increase his Entresto, something they've not been to do before now. So he's now been taking the middle dose, it did initially reduce his BP quite a lot, his nurse said so long as he's not dizzy etc, they'll go with the low BP as it could improve once he's become accustomed and 6 weeks later his BP is improving.
I totally get your concerns, it might help to know my husband had a heart attack & cardiac arrest when he was 42, he'll be 70 next year!! Today's medication & devices have kept him going all these years!
If you do Facebook I highly recommend joining the pumping marvellous heart failure support group, both groups are incredibly friendly, supportive & have a wealth of knowledge
facebook.com/groups/pmhelpf...
And the icd support group
What does CRT-d stand for. In my case it was just the opposite. I had a slow pulse despite having a pacemaker fitted some years ago. It was not properly monitored by the pace maker clinic, I dare to say. In order to get a Cardiac resynchronisation therapy device or Biventricular pace maker I had to go private as I had no chance getting it on NHS.
CRT stands for Cardiac Resynchronisation Therapy, the 'd' refers to it also being a defibrillator. There is also a CRT'p which is the same thing but doesn't have the defibrillation function. I'm no expert but my understanding is the 'resynchronisation therapy' is the device is synchronising the beating of the heart so it functions better rather than a regular pacemaker which regulates the heart beat. So in my husband's case his HR was slow because his ventricles weren't beating in sync (LBBB) so that slowed his HR, that's not normally a problem but because he also has bradycardia his HR was going too slow which was causing his ICD to pace him up to 50bpm more than 40% of the time (his nurse explained that it meant 42% of the time his heart wasn't beating properly) which, in his case, could cause further damage to his heart.
I am absolutely astonished that you had to pay for your own device, they're incredibly expensive!! Do you have to pay for the monitoring, or does the NHS pick that cost up?
Hi Maxy9
I hear you and really understand you will have so many questions the more you look into getting an ICD. I am nearing one year since I had my ICD. Around this time of year last year, the NHS sent me a letter which confirmed that the surgery would take place on January 26th. So mine was quite quick. It depends on what area you live in and how long the waiting list is. I was suggested for the waiting list in summer last year.
Depending on how your surgery goes, your age, how well you feel after it they will decide if they keep you overnight. I got to go home the same day. And I think generally they aim at releasing you home the same day.
Discuss with your cardiologist what the risks can be, but I can guarantee that it will be a safety net, in the case your heart ever goes to the point where only a defibrillator can recover it. If it’s an ICD, it is my understanding it has a double function, it paces your heart as well so that, coupled with medical therapy, might regulate your heart rhythm.
I would say, don’t let it scare you. Try and keep a level head and think of the questions someone else might have if you gave them the news that they might need an ICD implant. Ask your doctor anything.
Wish you all the best!
I had mine fitted back in 21 had AF ON MAY20 then in July 20 I had heart attack I was taken to the cath lab where they put a stent in my left ventricular which pumps the blood back around your body to be told that now I have HF and at that time was told my blood is only pumping at 25% that’s scary .
I then was asked by my cardio nurse that the consultant said that I should have an ICD fitted as I was at high risk of cardiac arrest so I had it done under local anesthetic you don’t feel it and you are awake , then sometime later went in for cardio version for the AF again sedated then they stop your heart and shock you so that your heart is in sync , if you have been told you should have it done as you never know when it might possibly save your life , Ihave a monitor by the bed and that downloads the information to physiology . I am still here over 4 years later and hope I have got a few k milk ore years yet , good luck
I think you have had plenty of reassuring replies, mine fitted 2016, out of hospital same day , no problems , remote heart monitor by my bed . Hospital does a remote check every 3/6 months.
Thank you and to the all the people who have written on this thread and for the original poster (Max?)
Sorry to divert from it for my own issues. 🙃
I’m jumping in here because I had my ICD/pacemaker consultation yesterday and came home feeling pretty despondent.
I hadn’t realised that I would only feel better after the AV node ablation and would still take the same pills and still have AFib!
Also, it felt so big and heavy in my little hand.
I know I probably shouldn’t worry about these things, but I do.
I was wondering if they do a metal allergy test beforehand?
I can’t wear cheap earrings because they make my ears sore. Think it’s the nickel?
HI Maxy 9, You've had lots of useful info already so I'll just tell you about my late husband, Harry, who had a big heart attack at the age of 52 back in 1992, so big that part of his heart died so he couldn't have stents or a bypass. By the time he was 60 he was having rapid heartbeats, like you, all the time. He was given an ICD which gave him another 20 years of good life. The ICD shocked him several times which meant no driving for 6 months but worth it to have all those happy years together. I wish you well, Pam N
First of all wlcome and you will find lots of helpful advice here. If they have suggested an implant they obviously think it will help. Good luck
I had an ICD fitted in the NHS 5 years ago when I was 50. The actual procedure took about an hour and I was discharged the same day.
Mine was fitted to help control arrhythmia, I have tachycardia (a fast heart rate). It works well and has kicked in twice to get my heart rate back to normal in the time I've had it.
It's nothing to worry about.
You're not allowed to raise your arms above shoulder height for the 1st seven days, in case you dislodge the electrical leads (or lead the number of leads varies depending on your personal condition) in your arteries/artery.
And you should be fine after that, but the cardiologist would have the final say depending on your particular set of conditions.
Mine was fitted within a week of my condition being identified, but my condition was very serious so it would depend on your condition and also the wait time at your local hospital.
But the most important thing is don't worry about it, it's quick and routine and it will help you when you need it most.
Dear Maxy thanks so much for your post.
I really understand your concerns because I have them too!
I’ve read everything here and replied to someone else but it would be rude to not reply to you too!
I have HCM and AFib and a fast heart rate and need a dual implant it seems.🙂↕️
Sending you many kind thoughts from Somerset this afternoon.
Hello Maxy. I had this device fitted in December last year, four days after surviving a cardiac arrest during an unsuccessful attempt to fit a stent in a blocked artery. I also suffer from AF. I felt no pain or discomfort during the fitting of the ICD and although my chest was very bruised, there was no subsequent pain. Weeks later during a telephone call with my consultant, he told me I was only getting 6% of benefit from the ICD and he was looking for 96% which is why he recommended I have an ablation. That took place in early September and following a six week pacing check, I was told it is indeed working at 96%. I now walk up steep slopes, inclines etc far more easily than before when I was often very breathless. I'm so glad I had it inserted and its given me a lot more confidence. I hope this is of some help to you and I would certainly recommend. Good luck!
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