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Question:
Why would man have continued arrhythmias after ICD and pacemaker implants? submitted by Debbie from El Paso, TX, 9/4/08
My father in the past 6 months has had an ICD and a Pacemaker put in him but he is still getting arrhythmias. From what we were told and read and understood these devices are suppose to stop that. Yet it keeps happening. Why would this be occuring? And is it common to have both devices? His current doctor doesn't seem all that concerned and keeps saying we just need to shock it back, but when they are about to he magically goes back to normal rhythm. My father is only 68. His quality of life is deteriorating. This man was very active and into hiking and his job is physically demanding. He said after he walked in for a check up and was told he had total AB blockage he hasn't felt good since.
Answers:by Texas Heart Institute cardiologist, Mehdi Razavi, MD
Pacemakers and defibrillators do different things. A pacemaker prevents the heartbeat from being too slow. A defibrillator treats (but does not prevent) the heartbeat from being too fast. All defibrillators can act as a pacemaker but pacemakers alone cannot defibrillate ("shock" the heart back into rhythm).
Furthermore, most defibrillators are programmed to treat fast heartbeats originating in the bottom chambers of the heart, not the ones in the top chamber. This may be what your father is feeling. The irregular rhythm can spontaneously normalize, and this is probably what is happening in your father's case.
Frequently medication or a procedure called an ablation is used to treat heart rhythm disorders. These then prevent the rhythm disorders to occur in the first place. You should consider asking his cardiologist about these alternatives.
by Texas Heart Institute cardiologist, Abdi Rasekh, MD
An ICD would not stop arrhythmias of short duration and that happen on and off. The purpose of an ICD implant is to correct sustained, life-threatening arrhythmias. In the case of recurrent arrhythmias, the first question that must be answered is where is the origin of the arrhythmia. Did it start in the upper or lower chamber? The option for treatment depends upon the arrhythmia’s origin, the underlying heart function, and the absence or presence of coronary disease.
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Updated September 2008
