July 10, 2010

Think Carefully Before Getting a Pacemaker or Defibrillator

Posted in Heart Disease in the News, Heart disease tips tagged , , , , , , , at 12:42 am by keepyourhearthealthy

by Arvind Balaraman

After reading an article called “What Broke My Father’s Heart” in the New York Times I was reminded of how life-changing cardiology can be.  Working in the field, I often take for granted the significant decisions that must be made by the patients and caregivers.  In my mind, getting a pacemaker or defibrillator seems as easy as pie!  I hardly consider it to be surgery at all anymore!  There’s only a few stitches required and the patients may go home the next day.  It’s certainly nothing like having your chest cracked open.

As the article points out though, the problem with these devices exists when there is longevity of a poor quality of life.  In my opinion, the pacemaker should not have been pushed on this particular writer’s father.  He had already suffered a stroke and required constant assistance from his elderly wife.  The only reason the pacemaker was placed was to get the patient through hernia surgery.  There are temporary pacemakers for that!  Eventually the family had made the decision to turn off the pacemaker but were denied due to ethical reasons on behalf of the doctor.  The whole ordeal was a complete mess for the patient and family!

I am not one to criticize or deny any patient a pacemaker/defibrillator when needed.  However, I sincerely encourage caregivers to consider every option before agreeing to a cardiac device.  I have personally helped a patient and his caregivers turn off an implanted defibrillator.  It was a much less dramatic experience than the one that the New York Times author had but it was still a big decision for everyone!  If quality of life is good at the time a pacemaker or defibrillator is needed then I say go for it.  If you really do not want to prolong suffering, then you always have the option of refusing a device.

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