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What are the after effects of excessive shocks after getting an internal defibrillator?

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Posted on Sat, 12 Dec 2015
Question: Cardiologist wants me to have internal defibrillator. I am concerned with receiving unneeded shocks...and unable to have an MRI afterward..so am considering not doing this. Your opinion.
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Answered by Dr. Ilir Sharka (43 minutes later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello XXXXXXX

I understand your concern and would like to explain that has concluded about a clear indication for implanting an ICD (internal defibrillator), means that you are at risk of potential life-threatening cardiac arrhythmias.

This is the most important issue to consider. I advice you to agree with your doctor's decision.

Regarding inappropriate ICD shocks, I would explain that this is a debatable issue.

There are consistent evidence that excessive shocks may increase the patient non-compliance and also morbidity.

Minimizing the rate of inappropriate shocks needs a comprehensive approach regarding the optimal patients selection, but the most important challenge is the general medical care which could lead to decreased arrhythmic events rate (controlling potential electrolyte imbalances, properly treating heart failure, catheter ablation of any evident arrhythmic focus prior to ICD implantation, the right choice of hardware and device programming, etc).

So, I would conclude that it is quite possible to minimize inappropriate ICD shocks,

Regarding MRI limitations in ICD patients, I could explain that this is not a problem.

ICD patients may undergo safely MRI exam, by reprogramming the device to not detect any fast rhythms during the scan (to avoid inappropriate sensing of the magnetic field-related generated noise and potential shock).
In the case of the ICDs (which sense tachycardia, a racing irregular heartbeat), this function may temporarily be disabled.

At the same time a trained nurse monitors cardiac rhythm.

So, as you see, no drawbacks seem t obe raised by the above concers.

I recommend you to relax and don't worry too much!

You should discuss with your attending cardiaologist about the above mentioned issues.

Hope to have been helpful to you!

If you have further uncertainties, do not hesitate to ask me!

Kind regards,

Dr. Iliri



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 8609 Questions

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What are the after effects of excessive shocks after getting an internal defibrillator?

Brief Answer: I would explain as follows: Detailed Answer: Hello XXXXXXX I understand your concern and would like to explain that has concluded about a clear indication for implanting an ICD (internal defibrillator), means that you are at risk of potential life-threatening cardiac arrhythmias. This is the most important issue to consider. I advice you to agree with your doctor's decision. Regarding inappropriate ICD shocks, I would explain that this is a debatable issue. There are consistent evidence that excessive shocks may increase the patient non-compliance and also morbidity. Minimizing the rate of inappropriate shocks needs a comprehensive approach regarding the optimal patients selection, but the most important challenge is the general medical care which could lead to decreased arrhythmic events rate (controlling potential electrolyte imbalances, properly treating heart failure, catheter ablation of any evident arrhythmic focus prior to ICD implantation, the right choice of hardware and device programming, etc). So, I would conclude that it is quite possible to minimize inappropriate ICD shocks, Regarding MRI limitations in ICD patients, I could explain that this is not a problem. ICD patients may undergo safely MRI exam, by reprogramming the device to not detect any fast rhythms during the scan (to avoid inappropriate sensing of the magnetic field-related generated noise and potential shock). In the case of the ICDs (which sense tachycardia, a racing irregular heartbeat), this function may temporarily be disabled. At the same time a trained nurse monitors cardiac rhythm. So, as you see, no drawbacks seem t obe raised by the above concers. I recommend you to relax and don't worry too much! You should discuss with your attending cardiaologist about the above mentioned issues. Hope to have been helpful to you! If you have further uncertainties, do not hesitate to ask me! Kind regards, Dr. Iliri