Pre-implant consult

Posts from Jan 1 2008 thru Dec 31 2008

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4Csaba
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Joined: November 11th, 2008, 10:19 pm
Location: Ontario - Canada

Pre-implant consult

Post by 4Csaba » November 14th, 2008, 1:27 am

Hi everyone and thanks for the welcome. I will be having a consult with the surgeon doing my implant a few days before the procedure and was wondering what questions I should be asking him regarding the operation, post-op etc. Any suggestions would be helpful.

Thank you very much ,
Erzsi

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hugooc
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Joined: November 24th, 2007, 12:01 pm

Post by hugooc » November 14th, 2008, 9:07 am

Hi Erzsi,

I received my implant almost exactly one year ago today (11/17/07) and these are the questions I had for my EP:

• How many implants have you done? How long have you been doing this?
• What ICD maker/model of ICD you'll be using? Why specifically this one?
• How many types of leads are available and how do you chose them?
• Can I see the device/leads?
• How long does the procedure take from the time of incision to the time of closing up the wound?
• Can you run through the procedure step-by-step for me?
• What is the most critical part of the procedure?
• I read that ICDs can be implanted either subcutaneously or under the pectoral muscle. What's your plan?
• What complications (if any) have you had to deal with other patients?

I had a lot of other basic questions about battery replacement (don't laugh at me, but I used to think they'd have to take out the device, replace the batteries and put the thing back in place. Not so.)

Here's another thought on leads. Boston Scientific has recently come out with a new defibrillating lead called ENDOTAK RELIANCE G. What's special about this lead is that the electrode coils are covered with a material called GORE to prevent tissue ingrowth around and between the shocking coils. If you're a young person, chances are you'll be looking at lead replacement(s) in the future and it is very important to have a lead that is easy to be extracted. The problem with defibrillating leads is that they usually have two uninsulated metallic coils (needed to deliver the shock), one of which sits inside the superior vena cava. This particular coil tends to get encapsulated by scar tissue and becomes very difficult to be removed. Boston Scientific claims that GORE prevents that adhesion while it doesn't interfere with electrical conductivity.

I'd ask your doctor's thoughts on this lead. Good luck!

Couple of links:
http://tinyurl.com/6q6dn9
http://icdusergroup.com/2008/08/lead-encapsulation.html

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~guin
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Post by ~guin » November 14th, 2008, 10:16 am

Hugo has alot of great questions here, but maybe you don't want to know the answer to ALL of them. My mama told me not to ask the question, if I didn't want to know the answer!

I was 41 when mine was implanted and my biggest concern was how big the scar, where and how the unit was gonna look under my skin. I talked with the surgeon and my scar was cut diagonally under my bra strap area. My unit was placed under the muscle, so you could not see the outline of the unit through my skin. Also since I travel the world I wanted a unit that was recognized world wide -- For this reason the Doc put a Medtronic ICD in me. I have had three over the last 9 plus years.

What Docs are finally telling women now - is to wear a sports bra 24/7 while healing (at least 6 weeks). This prevents the scar from stretching and also the "pocket" Which is created for the ICD to sit in.

Good luck to you and keep us posted.
~guin
:gobble:

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Aamos
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Joined: August 6th, 2008, 10:04 am
Location: South Dakota

Post by Aamos » November 14th, 2008, 11:59 am

If you use the search function, you can pull up photos of other folks' implants. Some are not so pretty, others are barely noticable. I know some people ran them off and took them to their consult to help show the doc what they wanted (and didn't want).

grins,
A
Amy/Aamos--wife of DanL, who had SCA 6/1/08; 4x bypass 6/5/08 and Guidant Vitality dual chamber ICD 11/7/08

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markokc4863
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Post by markokc4863 » November 14th, 2008, 1:16 pm

Since I actually had a SCD, I never got the opportunity to ask questions, so I have never really given much thought to it.
Mark

Medtronic Virtuoso DR
Sudden Cardiac Death - 5/7/2008 (my wedding anniversary)
ICD Implant - 5/9/2008
First Shock - 6/9/2008

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Aamos
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Post by Aamos » November 14th, 2008, 2:40 pm

hugooc wrote: Boston Scientific has recently come out with a new defibrillating lead called ENDOTAK RELIANCE G. What's special about this lead is that the electrode coils are covered with a material called GORE to prevent tissue ingrowth around and between the shocking coils. If you're a young person, chances are you'll be looking at lead replacement(s) in the future and it is very important to have a lead that is easy to be extracted. The problem with defibrillating leads is that they usually have two uninsulated metallic coils (needed to deliver the shock), one of which sits inside the superior vena cava. This particular coil tends to get encapsulated by scar tissue and becomes very difficult to be removed. Boston Scientific claims that GORE prevents that adhesion while it doesn't interfere with electrical conductivity.
I think this is what D. has--I'll know more in a few days when the company sends me the info we've requested.
I just have to comment, however, do you think the marketers of the material could have come up with a better name than GORE? :roll:
Amy/Aamos--wife of DanL, who had SCA 6/1/08; 4x bypass 6/5/08 and Guidant Vitality dual chamber ICD 11/7/08

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hugooc
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Joined: November 24th, 2007, 12:01 pm

Post by hugooc » November 14th, 2008, 2:54 pm

Aamos wrote:do you think the marketers of the material could have come up with a better name than GORE?
I agree. But the name comes Wilbert Gore, who invented the waterproof fabric he called GORE-TEX. It now has many medical applications and is extensively used in implants.

http://www.goremedical.com/

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Aamos
Posts: 537
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Location: South Dakota

Post by Aamos » November 14th, 2008, 4:47 pm

And there's that Al guy out there ..... :wink:

................still, I'd have proposed GORELON or something less graphic. But then, I'm a word-girl.
Amy/Aamos--wife of DanL, who had SCA 6/1/08; 4x bypass 6/5/08 and Guidant Vitality dual chamber ICD 11/7/08

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AndreaA
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Post by AndreaA » November 14th, 2008, 10:21 pm

Like Mark, I didn't have a lot of time to think about what questions I may have, but, I did manage to blurt out as they were rolling me into the OR, "just make sure you don't interfere with any future enhancements I may want to add later!" It gave everyone a chuckle, but seriously - this was need to know info for me!
Long QT Syndrome -
Sudden Cardiac Arrest 5/13/08;
Medtronic Virtuoso DR 05/16/08
West Palm Beach, Florida

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