To ICD or not to ICD

[ssimak]

Hi Everyone,

I had a heart attack in Nov. 2008.  I am about 5 months post op.  My ejection from has gone from 30% post heart attack to 41% last week.  My docs feel I am borderline and are "encouraging" me to have an ICD because I am at risk (albeit low) of Sudden Cardiac Death.  I went for a second opinion and they suggested I wait two months and revaluate because my EF has gone up everytime tested.  

Since I have two opposing opinions, I am going for a third.  I am in Los Angeles if anyone can recommend anyone great.  Any advice to those of you out there who were borderline cases?  Thanks

Steve

[Jerry_NJ]

Thanks for the informed answer, my confusion was I was thinking pacemaker not defibrillator.  

[banglamom]

An ICD would be an insurance for in the event of Sudden Cardiac death.  Having a low EF and a prior cardiac history makes you at risk.  There are ICD/ pacer combinations, but just an ICD would sit there.. and IF you went into a shockable rhythm be able to save your life with a much lower electric supply shock immediately to your heart.  The best treatment, and in many cases the ONLY, is electric treatment.  Waiting on someone to bring an AED and do the shocking if needed can mean disaster.  If your EF is going up, some of it is healing and some of it relying on the medical interventions.  Left to its own, it may well go down again.  The only shockable rhythms are ventricular fibrillation and ventricular tachycardia.  Tired boggy hearts are much more inclined to get into those rhythms.  If you get one, there may some inconveniences, but if you need it even once, it saves your life.  For me, I have a pacer that now supports me 100% of the time.  It was put in "just in case" so the md could treat the bad rhythms with drugs.  It takes a LOT to control them and then my own rhythms are gone.  It couldn't be treated without killing me if I didn't have the pacer.  I love it!  It brings me a great deal of day to day reassurance.  Hope that word of encouragement helps.

[Jerry_NJ]

I'm not suffering from the same problems, but figured I'd give your post a "bump" as it is drifting to the lower end of the list.

An EF of 41% is still rather low, so I understand your first opinion concern, but I don't know how an ICD addresses that condition... do you understand the low EF to be due to a low HR?   Do you suffer from a low HR?  My understanding of ICD is to prevent the HR from going too low, from stopping.  Is that a specific risk that you have?

Are you currently on any heart medications?