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 Dealing with an ICD shock 
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Joined: June 3rd, 2011, 10:41 pm
Posts: 98
Post Dealing with an ICD shock
This is an excellent article on how to deal with an ICD shock


http://circ.ahajournals.org/content/111/23/e380.full


April 2nd, 2013, 1:46 pm
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Joined: April 21st, 2009, 1:59 pm
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Location: Melbourne, Australia
Post Re: Dealing with an ICD shock
The page doesn't seem to want to open for me. dontknw


April 2nd, 2013, 3:33 pm
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Joined: October 3rd, 2011, 4:44 pm
Posts: 542
Location: Ireland
Post Re: Dealing with an ICD shock
Thanks Jean Good Article

Chris

:snoball:

_________________
Idiopathic Ventricular Tachycardia
1st Medtronic ICD Dec 07; 2nd August 09; 3rd on right side Sept, 2011
14 Shock Storm July 09; 5 days induced coma
Sprint Fidelis Lead and ICD Explanted July 09
3 Ventricle Ablations July 2009
Lead Erosion; Leads and ICD Explanted August 2011
Medtronic ICD Re-implanted Right side Sept, 2011
Drugs: Mexiletine .50mg 2 daily; Metoprolol .25mg 2 daily. Omacor


April 2nd, 2013, 3:34 pm
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Joined: April 18th, 2009, 8:19 pm
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Post Re: Dealing with an ICD shock
JR1966 wrote:
The page doesn't seem to want to open for me. dontknw
It seems like some links are for those living in that country. Here is the article;
Please note one of the athurs is Dr Sears.


How to Respond to an Implantable Cardioverter-Defibrillator Shock
1. Samuel F. Sears Jr, PhD;
2. Julie B. Shea, MS, RNCS;
3. Jamie B. Conti, MD
+ Author Affiliations
1. From the University of Florida Health Science Center, Brigham & Women’s Hospital, and Harvard Medical School.
1. Correspondence to Samuel F. Sears, Jr, PhD, University of Florida, Department of Clinical and Health Psychology, Box 100165, UF Health Science Center, Gainesville, FL 32610. E-mail ssears@phhp.ufl.edu

The implantable cardioverter-defibrillator (ICD) has consistently demonstrated a life-saving benefit in patients at risk for sudden cardiac arrest. Quality-of-life outcomes with the ICD may be directly related to coping successfully with ICD shocks. Although most people are able to tolerate a shock to some extent, the experience of shock is discomforting and can prompt feelings of anxiety, depression, or fear. The purpose of this article is to review patient and family preparations and responses to ICD shock to limit its impact on quality of life.


Understanding Shock
The ICD provides continuous monitoring and treatment for cardiac arrhythmias (abnormal heartbeats). The ICD automatically detects an abnormal heartbeat and will deliver small rapid pacing impulses or an electric shock to the heart to restore a normal heart rhythm. During the first year after implantation, the chances of receiving at least one ICD shock can range from one third to one half of all ICD recipients.1,2 The shock sensation has been likened to a swift kick in the chest and rated a “6” on a 0 to 10 pain scale.1,3 Nonetheless, quality-of-life research indicates that the ICD is at least equal to or better than antiarrhythmic medications on most indicators of quality of life.2,4–8 Most research has pointed to ICD shock as the primary culprit if reductions in quality of life occur.2
Psychological Responses to Shock

ICD-specific fears and symptoms of anxiety (for example, excessive worry, increased muscle tension, sweating, and increased heart rate and respiratory rate) are the most common psychological symptoms experienced by ICD recipients, with approximately 13% to 38% of recipients experiencing significant levels of anxiety. Common ICD-specific fears include the shock experience, device malfunction, and/or concerns of death. Depressive symptoms are reported at rates similar to those of other heart patients (24% to 33%).9 Younger age (50 years and younger) and greater frequency of ICD shocks were the two most commonly reported ICD-specific risk factors for psychological distress.
How to Respond to ICD Shock

It is possible that you will experience a shock at some point during your time with the ICD. As an ICD patient, you cannot control shocks, but you can control your reaction. Although shocks are often startling and discomforting, they are also an indication that the ICD is doing its job, keeping you protected from life-threatening arrhythmias or a rapid heart rate. Having a plan for shock helps reduce uncertainty and anxiety, so that you and your loved ones know how to handle the shock and in what circumstances you should contact your doctor or go to the emergency room.
Preparing for Shock

• Educate yourself. Learn as much as you can about the ICD and how it works. Understanding the purpose of the ICD, how it operates, and how to respond if a shock occurs will help to reduce your anxiety and help you to cope more effectively. Join a local support group of heart patients or ICD patients to learn more about cardiac disease and how your ICD works to keep you safe. Review the additional resources listed below to stay informed.
• Information control. Three sources of information are important to have available at all times: your ICD identification card, a list of your medications, and your doctor’s name and telephone number. This information will allow healthcare providers to take the best possible care of you in an emergency. Use an index card to write down all of your medications and your doctor’s name, and keep it in your wallet.
• Action plan. Preparing for an ICD shock might involve rehearsing what you should do if you were to receive a shock. Your doctor may have a specific plan for you. The Table contains a typical plan for an ICD patient that you may want to use for a discussion with your doctor.

Action Plan

Experiencing shock is generally recognized as discomforting, but an organized response can minimize the short- and long-term negative effects. Managing your reaction involves strategies involving both your mind and your actions. The goal of all of these strategies is to maximize your quality of life.

Strategies for Coping With ICD Shock
Relax and Focus

The automatic response to a shock is arousal (a heightened awareness to your body and health). Hyperarousal can occur if you do not take charge of your reaction and focus on relaxing. Allowing yourself to engage in deep-breathing techniques and tension reduction exercises will reduce the effects of arousal. To practice relaxed breathing, do the following:
• Put yourself in a comfortable, reclined position, and place one hand on your upper chest and the other on your belly, just below your navel (belly button).
• Close your eyes and focus on your breathing. Notice how the hand on your belly moves more than the hand on your chest, indicating that you are using calm, restful breathing.
• Keep your attention on your breathing. It is inevitable that your mind will wander to other topics, but just return your attention to your breathing.
• Practice this exercise for at least 5 minutes twice a day. This will allow you to gain skill and comfort with focusing on your breathing and relaxing your body.

Positive Thinking
Recent research has highlighted how the attitudes of ICD patients are among the best predictors of quality of life.10,11 Shock can reduce your faith in your safety and your future or could serve as a reminder of your commitment to living. Therefore, actively reminding yourself about the positive aspects of your life, your relationships, your activities, and your future can provide you with hopeful ideas and rewarding plans for the future. You may want to make a list of the people and activities that give you quality of life so that you can remind yourself of how important your positive outlook is to recovery.

• Debriefing. The desire to avoid a shock is universal. Only regular medical follow-up and medications are related to preventing shock at this time. Therefore, the best plan is to discuss the reasons for a shock with your doctor. Your doctor will take every action possible to avoid a future shock by possibly adjusting your medications or the settings of your ICD.
• Return to life. Quality of life usually involves engaging in activities that are rewarding, pleasant, peaceful, or exciting. Many ICD patients try to avoid a future shock by avoiding any action that has ever preceded a shock, but this can reduce your quality of life. Preventing a shock is not possible by our actions alone. Because shock can occur during any part of daily life, fearfulness about shock can trick you into trying to prevent it by reducing activities. A step-by-step plan can allow you to eventually return to all of the activities that you did before shock. Start a “Coping To-Do List” that highlights both everyday activities that reduce stress (for example, take a warm bath, watch a sunset) and long-term goals (take a vacation or trip, attend an important event) that can provide you with future activities that are motivating to remain healthy.

Conclusions
Experiencing an ICD shock can be an unwelcome reminder about your heart condition. However, the ICD remains the best treatment option to keep you safe from cardiac arrhythmias. Desirable quality of life can also be achieved despite the experience of shock. Collectively, you, your family and significant others, and your healthcare team can plan for shock, engage in preshock and postshock coping strategies, and resume a desirable quality of life.


Additional Resources

• Medtronic home page. Available at: http://www.Medtronic.com. Accessed January 14, 2005.
• Guidant Corporation home page. Available at: http://www.Guidant.com. Accessed January 14, 2005.
• St. Jude Medical home page. Available at: http://www.sjm.com. Accessed January 14, 2005.
• Heart Rhythm Society home page. Available at: http://www.hrspatients.org. Accessed January 14, 2005.

Footnotes
• The information contained in this Circulation Cardiology Patient Page is not a substitute for medical advice or treatment, and the American Heart Association recommends consultation with a physician or healthcare provider.

_________________
Bob

Medtronic-Virtuoso™ VR implanted 2-4-09
6947 Sprint Quattro Secure lead
Major heart attack, carcinogenic shock and quad bypass 10-13-08
Syndrome, post myocardial infarction, old inferior MI complicated by shock and CHF
Heart failure, combined, Atherosclerosis, abdominal aortic Aneurysm 2.9 cm infrarenal,
Seroma 7 cm, left leg from bypass surgery
Stent in the left main vein 10-7-2014

My "Wardens" are my bride of 50+ years and my eldest daughter.


April 2nd, 2013, 4:09 pm
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Joined: September 27th, 2008, 10:28 am
Posts: 4584
Location: Australian
Post Re: Dealing with an ICD shock
Wonderful article.

From my own personal experience I was extremely lucky, my neighbour is an Intensive Care Nurse, and she was brilliant. I ran out the front of the house in a panic, and luckily she was also out the front. She just sat me down, calmly took my pulse and rang the Ambulance for me. (I was shocked 3 times) The whole experience with her being so professional and calm, made me feel calm and at one stage I wanted to cancel the Ambulance because I felt it may have been a waste of time.

I now really believe that you need to have a plan in place, I was lucky, but I can't say I would have been that way if my neighbour hadn't been there. I also don't know how I would have coped if I had more than the 3 shocks and had a storm. I had a second shock about 6 weeks later, and I was driving, and was able to pull over to the kerb. I rang my brother and went to the clinic and had the device checked.

I honestly believe that it is staying calm that makes all the difference, and the fact that my shocks were appropriate. I think though that having a plan would be a great idea. You should also educate those who are with you the most about the device, what the shock has done, and what they should do. I bought a new phone with two handsets, so that I could have one permanently in the bedroom. I couldn't find my cordless phone and that caused panic, as I was running around the house looking for it. (I live alone)

_________________
"People will forget what you said; People will forget what you did.
But people will never forget how you made them feel."

Diagnosed with cardiomyopathy in 10/99
LBBB & VT diagnosed Feb 06
Guidant Biventricular Pacer ICD inserted Feb 06: Boston Scientific Incepta CRT-D inserted May, 2012
Latitude Monitoring System with scales and bp monitor
Bare Metal Stent May, 2012
Have had appropriate shocks and still here.
Meds: Coralan, Eurtorxsiq, Frusehexl, Spiractin, Coversyl, Sigmaxin, Aspirin,
Supplements: Cabot - Liver Tone Plus: Vitamin D & Calcium: Mag Min:


April 3rd, 2013, 5:07 am
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Joined: September 14th, 2009, 3:36 pm
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Post Re: Dealing with an ICD shock
I've found the best source for information on how to cope with/after a shock is those who've gone before. I know that every newly indoctrinated Zapper who has contacted me expressed skepticism about people disseminating information if they've never experienced the pleasure first hand. Perhaps we don't have the medical degree, or don't speak as eloquently as some of the writers who've published articles on the subject, but we speak from the heart.

_________________
Broken Heart
Nobody has ever survived life, but I'm trying...
My story and sticking to it
http://www.icdsupportgroup.org/board/viewtopic.php?f=36&t=9897&p=91375


April 5th, 2013, 11:26 am
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Joined: January 17th, 2009, 4:13 pm
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Location: Netherlands
Post Re: Dealing with an ICD shock
Robo, could have been my comment ... :2thumbs: Fully agree.

_________________
My name is Gijs but in English you can call me Gilbert as this might be easier te remember :-)

SCA Nov 13, 2004, shocked Sep 2 (2x) & 5 2005, Dec 31 2005, May 20 2006, Dec 29 2008, Oct 31 2009 and April 6 2010 (3x). 'Repaired' by epicardial ablation April 16th, 2010.
First ICD Guidant Vitallity, second (May 16, 2012) Boston Scientific Energen ICD


April 5th, 2013, 5:10 pm
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Joined: October 3rd, 2011, 4:44 pm
Posts: 542
Location: Ireland
Post Re: Dealing with an ICD shock
Hi Gijjs
Great seeing you on the site again and hope all’s good with you.

Chris


:snoball:

_________________
Idiopathic Ventricular Tachycardia
1st Medtronic ICD Dec 07; 2nd August 09; 3rd on right side Sept, 2011
14 Shock Storm July 09; 5 days induced coma
Sprint Fidelis Lead and ICD Explanted July 09
3 Ventricle Ablations July 2009
Lead Erosion; Leads and ICD Explanted August 2011
Medtronic ICD Re-implanted Right side Sept, 2011
Drugs: Mexiletine .50mg 2 daily; Metoprolol .25mg 2 daily. Omacor


April 5th, 2013, 5:20 pm
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Joined: January 17th, 2009, 4:13 pm
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Location: Netherlands
Post Re: Dealing with an ICD shock
Still a regular visitor, not reacting too much. Feeling my problem gets far behind. Only when I recently was writing personal experience with ablations for an article for our Dutch patientsgroup I felt it is history as an event, I know now that emotionally it still is not that far behind.

Activities? Too much, giving éducation on nature was added this winter too the long list of activiteit like painting, local history, cooking, photography, work for our patientsgroup STIN for which I maintain website date, topping willows for our nature group, etc.
Only gardening activities were very low with this spring that still has to start - we are some 3 weeks late already.

_________________
My name is Gijs but in English you can call me Gilbert as this might be easier te remember :-)

SCA Nov 13, 2004, shocked Sep 2 (2x) & 5 2005, Dec 31 2005, May 20 2006, Dec 29 2008, Oct 31 2009 and April 6 2010 (3x). 'Repaired' by epicardial ablation April 16th, 2010.
First ICD Guidant Vitallity, second (May 16, 2012) Boston Scientific Energen ICD


April 6th, 2013, 5:07 pm
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Joined: October 1st, 2009, 9:42 pm
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Location: Toronto, Ontario, Canada
Post Re: Dealing with an ICD shock
I guess it takes much longer than we realize for some of the memories/experiences to really fade away.
I'm happy to hear you're doing so well Gijiss!! :D
Spring is late here too. I'm looking forward to doing some gardening!
Keep well.

_________________
~ Suzanne ~

St Jude ICD and Lead Implanted Feb.20/09
8 Shock Storm March 21/09
Lead Dislodged, so Replaced with Medtronic Lead June 16/09
ICD and Lead Explanted Nov.23/09
Medtronic Reveal XT (Cardiac Monitor) Implanted Jan.25/10...explanted and new one reinserted on July 21/11

Cardiac Monitor explanted Sept.9/14


April 7th, 2013, 10:32 am
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Joined: October 3rd, 2011, 4:44 pm
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Location: Ireland
Post Re: Dealing with an ICD shock
Great Gijjs
......nice to see both Suzanne and yourself are real success stories to ablations.

And time is a great “healer” in relieving and getting over anxiety.

Please continue to keep in touch your experience and input is truly valued.

Chris

:snoball:

_________________
Idiopathic Ventricular Tachycardia
1st Medtronic ICD Dec 07; 2nd August 09; 3rd on right side Sept, 2011
14 Shock Storm July 09; 5 days induced coma
Sprint Fidelis Lead and ICD Explanted July 09
3 Ventricle Ablations July 2009
Lead Erosion; Leads and ICD Explanted August 2011
Medtronic ICD Re-implanted Right side Sept, 2011
Drugs: Mexiletine .50mg 2 daily; Metoprolol .25mg 2 daily. Omacor


April 7th, 2013, 11:02 am
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Joined: January 17th, 2009, 4:13 pm
Posts: 405
Location: Netherlands
Post Re: Dealing with an ICD shock
Will stay in touch.
And the good news is that today I did a walk with a group, 19.5 Km, 12 Celcius, sunny all day ... And I saw my first dandylion of the year. Keeping records on first dandylion (among others) for some 8 years, always 2nd half of March, only once on April 2. Spring is late but coming :D :D :D :D :D

_________________
My name is Gijs but in English you can call me Gilbert as this might be easier te remember :-)

SCA Nov 13, 2004, shocked Sep 2 (2x) & 5 2005, Dec 31 2005, May 20 2006, Dec 29 2008, Oct 31 2009 and April 6 2010 (3x). 'Repaired' by epicardial ablation April 16th, 2010.
First ICD Guidant Vitallity, second (May 16, 2012) Boston Scientific Energen ICD


April 7th, 2013, 5:13 pm
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