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Arrythmia Due To Kidney Infection. Want To Get Rid Of Defibrillator Life Vest. What Are My Options?
Question: i have an ejection fraction of 47 and an arriythmia. This is very recent and was a result of a kidney infection. They fitted me with a defibulator life vest in October because my ejection fraction was 30 . Now that I'm up to 47 but still have arrythmia ( i'm on medication too ) . I really want to get rid of the vest....can i albeit with a procedure to corect the arrmythia. What are my options.
Dear XXXXXXX
Thank you for your query.
In order to answer your query better, I would like to know some more details.
1) Did you suffer a heart attack (myocardial infarction)?
2) What was the specific type of arrhythmia experienced? Was the arrhythmia a Ventricular Tachycardia or was it Ventricular Fibrillation?
3) Do you have an ECG of the arrhythmia? If so, can you upload that ECG here using the upload option? I would also appreciate a recent ECG at rest too.
4) You don't appear to be on specific anti-arrhythmic drugs like amiodarone. Coreg, digoxin, lisinopril, statin and frusemide have been given to improve the pumping ability of the heart (though they do have anti-arrhythmic properties). Warfarin is to prevent blood clot formation.
5) What arrhythmic episodes have you experienced in the recent past?
6) Has the vest delivered any shock since you started wearing it?
7) Did you have a kidney infection or a lung infection, or both? Are you cured of that with no residual disease as of now?
8) Has a “24-hour-Holter test” been done recently to see how your heart rate varies through the day and to check for any arrhythmias?
9) Can you upload the complete report of the echo?
10) Are there any other risk factors for heart disease like smoking, diabetes, hypertension, abnormal cholesterol, family history of heart disease, etc?
Kindly give me the answers to these questions so that I can give you a more useful and specific reply.
Awaiting your reply
With regards,
Dr RS Varma
Thank you for your query.
In order to answer your query better, I would like to know some more details.
1) Did you suffer a heart attack (myocardial infarction)?
2) What was the specific type of arrhythmia experienced? Was the arrhythmia a Ventricular Tachycardia or was it Ventricular Fibrillation?
3) Do you have an ECG of the arrhythmia? If so, can you upload that ECG here using the upload option? I would also appreciate a recent ECG at rest too.
4) You don't appear to be on specific anti-arrhythmic drugs like amiodarone. Coreg, digoxin, lisinopril, statin and frusemide have been given to improve the pumping ability of the heart (though they do have anti-arrhythmic properties). Warfarin is to prevent blood clot formation.
5) What arrhythmic episodes have you experienced in the recent past?
6) Has the vest delivered any shock since you started wearing it?
7) Did you have a kidney infection or a lung infection, or both? Are you cured of that with no residual disease as of now?
8) Has a “24-hour-Holter test” been done recently to see how your heart rate varies through the day and to check for any arrhythmias?
9) Can you upload the complete report of the echo?
10) Are there any other risk factors for heart disease like smoking, diabetes, hypertension, abnormal cholesterol, family history of heart disease, etc?
Kindly give me the answers to these questions so that I can give you a more useful and specific reply.
Awaiting your reply
With regards,
Dr RS Varma
Above answer was peer-reviewed by :
Dr. Prasad
There is scarring to indicate a heart attack a while back but they are not sure.
ventrilal fibrillation
i dont have an ECG available
No i'm not on Amiodrone , they are assessing and coming to a conclusion of what to do. I have an electrophysicist today. My Injection Fraction is 47.
No arrythmic episodes experienced , i feel no symptoms.
the vest has not delivered any shocks in three months.
Sorry I had a kidney infection but I'm now completely clear.
The life vest also acts as a Holter too.
I have stent , but I dont smoke ( never have ) dont have diabetes , cholesterol is good and I dont drink alcohol and have not been diagnosed with hypertension.
sorry i have charts to send but this is an accurate picture.
ventrilal fibrillation
i dont have an ECG available
No i'm not on Amiodrone , they are assessing and coming to a conclusion of what to do. I have an electrophysicist today. My Injection Fraction is 47.
No arrythmic episodes experienced , i feel no symptoms.
the vest has not delivered any shocks in three months.
Sorry I had a kidney infection but I'm now completely clear.
The life vest also acts as a Holter too.
I have stent , but I dont smoke ( never have ) dont have diabetes , cholesterol is good and I dont drink alcohol and have not been diagnosed with hypertension.
sorry i have charts to send but this is an accurate picture.
Hello XXXXXXX
Thank you for sending all the details.
If the ventricular fibrillation was clearly documented to be due to electrolyte imbalances as a result of your kidney problem, and if the problem has been permanently rectified with low chances of a recurrence, then I would presume that you may not need a defibrillator.
However, if there is any doubt that the arrhythmia was a result of underlying heart disease and if there is a possibility of scar-related arrhythmia, it would be better to go for an implantable defibrillator (ICD) as a lasting solution. The vest will need to be worn till the time the ICD is implanted.
The results of the electrophysiological study also will help to guide therapy. Certain types of arrhythmia are amenable to Radio-Frequency Ablation therapy which is curative. Despite this, since you have ischemic heart disease with LV dysfunction, and since you have had one episode of VF (which is a life-threatening arrhythmia), ICD implantation may be a good solution. If the Holter shows persistence of arrhythmias, this would be an additional factor in favour of implanting an ICD.
Another detail that I would like to point out is that you should also be on low dose Aspirin daily, in addition to the drugs listed (since you have stents implanted).
I hope this answer helps to resolve your query. Feel free to contact me again for any further clarifications.
With regards,
Dr RS Varma
Thank you for sending all the details.
If the ventricular fibrillation was clearly documented to be due to electrolyte imbalances as a result of your kidney problem, and if the problem has been permanently rectified with low chances of a recurrence, then I would presume that you may not need a defibrillator.
However, if there is any doubt that the arrhythmia was a result of underlying heart disease and if there is a possibility of scar-related arrhythmia, it would be better to go for an implantable defibrillator (ICD) as a lasting solution. The vest will need to be worn till the time the ICD is implanted.
The results of the electrophysiological study also will help to guide therapy. Certain types of arrhythmia are amenable to Radio-Frequency Ablation therapy which is curative. Despite this, since you have ischemic heart disease with LV dysfunction, and since you have had one episode of VF (which is a life-threatening arrhythmia), ICD implantation may be a good solution. If the Holter shows persistence of arrhythmias, this would be an additional factor in favour of implanting an ICD.
Another detail that I would like to point out is that you should also be on low dose Aspirin daily, in addition to the drugs listed (since you have stents implanted).
I hope this answer helps to resolve your query. Feel free to contact me again for any further clarifications.
With regards,
Dr RS Varma
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
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