Re: AICD Interrogation

[Guest guest]

Pat, how frightening that must have been for you. Now I'm going to be nervous at my next interrogation...lol. I haven't had anything that severe happen but usually during the interrogation when the nurse is doing this, there is a time when I feel really "funny". My throat tightens and I feel like I need to cough. I've mentioned it and was told that most people don't feel it but a few others, such as myself, are very sensitive to these feelings and can tell it whenever they're doing that particular part of the interrogation. In fact, that was mentioned by the nurse at my post-op visit with my EP earlier this week. I had been feeling really weird, with my heart pounding and being terribly, terribly tired with the least bit of exertion. The EP said he had changed one thing--something about either shortening or lengthening "something". My lack of medical knowledge is showing--sorry! I think it had something to do with the length between beats or something like that. Anyway, whichever he had done, either lengthening or shortening the interval, he changed back to the way it was. He said at that time he couldn't imagine that I would possibly be able to tell the difference. His nurse reminded him, though, of my sensitivity to that type of thing. Bottom line, it did make all the difference in the world. I am finally feeling like I may recover from this ICD replacement and will be able to resume my former daily activities. I'm not ready to run a marathon yet, but I'm making progress.

It will be interesting to see if anyone else here has had a similar experience--hopefully not quite as severe as your husband's, though. Hope everything will go much better for him now. Keep us updated. Barb

[Guest guest]

Hello Pat,

I have a Guidant Prizm. I was told during my first few interrogations that the purpose for pacing the heart during the interrogation is to evaluate the voltage at which the pacing function "captures" the heart tissue and takes control. They use that value to set the voltage output of the paing portion of the defibrillator. That value changes after the wires are first inserted, as they heal in place, and then throughout the life of the defibrillator and wires. The lower the voltage needed the better the connection, also the longer the battery life -- if pacing is needed.

I find it rather uncomfortable and I always tell the nurse doing it to warn me before they attempt pacing, since it elicits a feeling of panic in me.

I hope that helps somewhat. Take care -- Ken McCormick

>From: Pat Pulasky

>Reply- > >Subject: AICD Interrogation >Date: Sat, 9 Aug 2003 15:58:22 -0700 (PDT) > >My husband has a new biventricular Guidant to replace >his five-year old Guidant. As was done with his old >device his new Guidant was interrogated by his doctor; >also, as usual, other testing was done...speeding up >heartrate, slowing it down, etc. I understand the >interrogation, but could someone please explain the >other testing procedures to me please? Thanks much. PatP MSN 8 helps ELIMINATE E-MAIL VIRUSES. Get 2 months FREE*.

[Guest guest]

Ken: Thank you for your reply. I appreciate your info. I really need to know the mechanics of this kind of testing. You see, my problem with the procedure was that for the first time in the five years that my husband has had an AICD the doctor took it past the safe threshold and stopped my husband's heart. My husband was sitting on the edge of the examining table and I noticed by the look on his face that it seemed as though he was going to pass out. I ran to the table and caught him just as he went into a full-blown seizure....which meant that his heart had stopped and no blood was getting to his brain. About scared me to death. I don't weigh much and I had a tough time hanging on to him to keep him from hitting the floor! (I came out of it with bruises and a wrenched shoulder). Seems to me that the doctor went too far that time. Opinions, anyone? Has anyone else had this experience? (When

my husband regained consciousness, he kept saying that he'd had the weirdest dream. From the other side, I wonder????) PatPKen McCormick <kmccmedia@...> wrote:

Hello Pat,

I have a Guidant Prizm. I was told during my first few interrogations that the purpose for pacing the heart during the interrogation is to evaluate the voltage at which the pacing function "captures" the heart tissue and takes control. They use that value to set the voltage output of the paing portion of the defibrillator. That value changes after the wires are first inserted, as they heal in place, and then throughout the life of the defibrillator and wires. The lower the voltage needed the better the connection, also the longer the battery life -- if pacing is needed.

I find it rather uncomfortable and I always tell the nurse doing it to warn me before they attempt pacing, since it elicits a feeling of panic in me.

I hope that helps somewhat. Take care -- Ken McCormick

>From: Pat Pulasky

>Reply- > >Subject: AICD Interrogation >Date: Sat, 9 Aug 2003 15:58:22 -0700 (PDT) > >My husband has a new biventricular Guidant to replace >his five-year old Guidant. As was done with his old >device his new Guidant was interrogated by his doctor; >also, as usual, other testing was done...speeding up >heartrate, slowing it down, etc. I understand the >interrogation, but could someone please explain the >other testing procedures to me please? Thanks much. PatP

MSN 8 helps ELIMINATE E-MAIL VIRUSES. Get 2 months FREE*. Please visit the Zapper homepage athttp://www.ZapLife.org

[Guest guest]

Dear Pat,

Yikes! I never had an experience like that before. I was a bit ticked off at my first interrogation when they began to run my heart without telling me they were about to start. I routinely tell them I want a warning before they begin, so I can brace myself for the discomfort and emerging panic I may feel.

At Tufts New England (where I go) I sit in a very substantial, somewhat reclining chair -- apparently designed for the purpose of supporting patients during this procedure. Asking a patient to sit on an examination table seems unprofessional. Could your husband be the first person to have an unfavorable physical reaction to an interrogation? I don't think so.

Was the doctor doing it your husband's main provider for his condition? If not talk to the person most responsible and ask what you can expect from these visits in the future. I wouldn't take this lying down (no pun). My wife has been as concerned and probably has suffered at least as much as I have during the whole process of determining my condition and my need for an ICD. Her involvement is integral to my treatment. They need to communicate well with you about what happenned and not to gloss it over. That's one of the things they're paid for. Sometimes you get a doc who is really great with people. Most will do a decent job when pushed. A few are lousy and think they can just do cardiology and you should just take what they dish out. Get rid of them and move on.

Good Luck -- Ken McCormick

>From: Pat Pulasky

>Reply- > >Subject: Re: AICD Interrogation >Date: Sat, 9 Aug 2003 21:40:48 -0700 (PDT) > >Ken: Thank you for your reply. I appreciate your info. I really need to know the mechanics of this kind of testing. You see, my problem with the procedure was that for the first time in the five years that my husband has had an AICD the doctor took it past the safe threshold and stopped my husband's heart. My husband was sitting on the edge of the examining table and I noticed by the look on his face that it seemed as though he was going to pass out. I ran to the table and caught him just as he went into a full-blown seizure....which meant that his heart had stopped and no blood was getting to his brain. About scared me to death. I don't weigh much and I had a tough time hanging on to him to keep him from hitting the floor! (I came out of it with bruises and a wrenched shoulder). Seems to me that the doctor went too far that time. Opinions, anyone? Has anyone else had this experience? (When my husband regained consciousness, he kept saying that he'd had the weirdest > dream. From the other side, I wonder????) PatP >Ken McCormick wrote: >Hello Pat, > >I have a Guidant Prizm. I was told during my first few interrogations that the purpose for pacing the heart during the interrogation is to evaluate the voltage at which the pacing function "captures" the heart tissue and takes control. They use that value to set the voltage output of the paing portion of the defibrillator. That value changes after the wires are first inserted, as they heal in place, and then throughout the life of the defibrillator and wires. The lower the voltage needed the better the connection, also the longer the battery life -- if pacing is needed. > >I find it rather uncomfortable and I always tell the nurse doing it to warn me before they attempt pacing, since it elicits a feeling of panic in me. > >I hope that helps somewhat. Take care -- Ken McCormick > > > > > >From: Pat Pulasky > > >Reply- > > > >Subject: AICD Interrogation > >Date: Sat, 9 Aug 2003 15:58:22 -0700 (PDT) > > > >My husband has a new biventricular Guidant to replace > >his five-year old Guidant. As was done with his old > >device his new Guidant was interrogated by his doctor; > >also, as usual, other testing was done...speeding up > >heartrate, slowing it down, etc. I understand the > >interrogation, but could someone please explain the > >other testing procedures to me please? Thanks much. PatP > > > >--------------------------------- >MSN 8 helps ELIMINATE E-MAIL VIRUSES. Get 2 months FREE*. >

[Guest guest]

It was my understanding that during an interrogation they tested the threashold of the leads by bringing the pacemaker part of a dual chamber (unsure of non dual chamber devices) up - past your resting rate to see if it paces your heart faster. Yes it feels uncomfrtable, but I didn't think that they could 'stop' ones heart doing that? Perhaps it was paced and sent him into an arrythmia - which I have never heard of happening during an interrogation, but I suppose its possible.

AICD Interrogation > >Date: Sat, 9 Aug 2003 15:58:22 -0700 (PDT) > > > >My husband has a new biventricular Guidant to replace > >his five-year old Guidant. As was done with his old > >device his new Guidant was interrogated by his doctor; > >also, as usual, other testing was done...speeding up > >heartrate, slowing it down, etc. I understand the > >interrogation, but could someone please explain the > >other testing procedures to me please? Thanks much. PatP > > > >--------------------------------- >MSN 8 helps ELIMINATE E-MAIL VIRUSES. Get 2 months FREE*. >

[Guest guest]

Sharon:

Several other posts have given you excellent technical info on interrogation, so I will discuss the human angle. I want to emphasize here that my husband's unpleasant experience was VERY unusual. He's going into his sixth year of a Guidant AICD and has had interrogations sometimes as often as every week (when he was having too many episodes). And all those interrogations were uneventful. (Looking back, I'd 'guesstimate' that he's had close to a hundred interrogations in the lifetime of his first AICD).

I promise that, normally, this is a breeze......when we lived in Southern California this procedure was usually in the hands of a representative from the Guidant company.(These folks are known as 'Guidant reps') And what a great bunch of people they are, too. Very pleasant, very knowledgeable, very caring. Some doctors prefer to handle this procedure themselves rather than to leave it to company reps. In the hands of a competent and caring doctor or rep it will go smoothly. I'd suggest that if it's not mentioned that the patient lie down during the procedure that the patient request it, rather than sitting on the edge of an examining table (as was normally done in this office!) Better do that than to feel nervous about it. PatP

[Guest guest]

I'd suggest that if it's not mentioned that the patient lie down

during the procedure that the patient request it, rather than sitting

on the edge of an examining table (as was normally done in this

office!) Better do that than to feel nervous about it. PatP

Just out of curiousity, how can an interigation happen while the

patient is sitting up? Doesn't the wand slide off?

Bridget

[Guest guest]

Bridget: A Guidant wand is on a cord (similar to an extension cord). A couple of reps have just given the wand to my husband to hold against the AICD area, but most of them place the cord around the back of the neck with the wand extending down in front to the AICD area. PatPBridget <rumpleteasermom@...> wrote:

I'd suggest that if it's not mentioned that the patient lie down during the procedure that the patient request it, rather than sitting on the edge of an examining table (as was normally done in this office!) Better do that than to feel nervous about it. PatPJust out of curiousity, how can an interigation happen while the patient is sitting up? Doesn't the wand slide off?Bridget

[Guest guest]

I've always been interrogated while sitting up. Sometimes on the table,

sometimes in a chair. The tech drapes the cord around my neck to hold

the wand in place. The wand looks like a magnifying glass without the

lens. A big donut on a stick.

Mike

>

>

> Just out of curiousity, how can an interigation happen while the

> patient is sitting up? Doesn't the wand slide off?

>

> Bridget

>

>

>

>

[Guest guest]

Wow, I guess I'm in the minority. The device nurses I see do use an

examination table but they have me lie back, not flat but most of the

way back.

Bridget

> I've always been interrogated while sitting up. Sometimes on the

table,

> sometimes in a chair. The tech drapes the cord around my neck to

hold

> the wand in place. The wand looks like a magnifying glass without

the

> lens. A big donut on a stick.

>

> Mike

> >

> >

> > Just out of curiousity, how can an interigation happen while the

> > patient is sitting up? Doesn't the wand slide off?

> >

> > Bridget

> >

> >

> >

> >