January 2, 2011

Is Your Defibrillator Beeping?

Posted in Heart disease tips, Uncategorized tagged , , , , , , , , , at 8:44 pm by keepyourhearthealthy

photo by Jeroen van Oostrom

At first you may not realize that the beep is coming from inside your body but eventually you find that the metal box inside your chest is making a strange sound.

Patients who undergo implantation of a device such as a defibrillator may hear a beeping from their device at some point.  It may seem harmless in the beginning but soon enough panic can set in.  You start to wonder if the lifesaving box is broken and immediately look for your cardiologist’s office number.  You might even consider going to the Emergency Room if it’s late at night.

Laurie Racenet, an electrophysiology nurse practitioner and device expert, explains all you need to know in a situation like this:

“As a Nurse Practitioner in a Device Clinic, I hear all kinds of questions from patients about their devices.  One of the more common questions is: ‘Why is my device beeping?’

Devices beep for a number of reasons.   Currently Implantable Cardiac Defibrillators (ICDs) are the only device that will beep.  There are no pacemakers currently on the market that will beep for any reason. [Pacemaker and defibrillator combinations will also beep as long as it has a defibrillator component in the device.]

The most frequent cause of beeping is that the device is nearing the end of the battery. Depending on the device manufacturer, the device may have anywhere from 2 – 6 months of battery left when the beeping first sounds.  Most devices are designed to only beep for a short time each day; however, the sound can be annoying for patients who are sensitive to noise.  Sometimes the beep can be so soft that the patient doesn’t hear it at all.  This is particularly true for folks with hearing impairment.   It is not uncommon for a family member or friend to be the first to hear the beeping.  One manufacturer has tried to address this issue by making the device vibrate in the chest when the battery is getting low.

Another cause for the beeping is that there is a problem with one of the leads, or an internal problem with the device.   Modern devices are designed to do internal testing at various intervals.  If this internal testing shows some type of problem with a lead or some other problem, the device will beep to alert the patient that there may be a problem.  It is important to understand that the internal testing is not perfect and the device may beep when there is no problem.  It is designed to err on the side of safety and notify the patient if it thinks something is wrong.

Some devices may be programmed to beep when the patient has received therapy from the device. Since more and more devices are being set up to deliver painless therapy for abnormal heart rhythms, many people do not even know when they have received therapy from the device.  The device can be set up to beep if multiple therapies are delivered.

So what does all of this mean to the person who hears the device beeping?

  • Whenever beeping is heard, call your device clinic.   If you are being monitored by one of the many remote follow-up devices, you will be able to download the information from home for the device clinic to evaluate.  One of the best parts of the newest remote monitoring systems is that the device will send an alert to the clinic for any circumstance that would cause it to beep, thus adding an extra measure of safety to device monitoring.  Otherwise, the device clinic will have you come in and they will download the information in the clinic.
  • If you know your device is getting low on battery, you can usually wait and call during regular business hours, but it is never wrong to call and talk to whoever is on-call for the device clinic if you have any concerns about the device beeping.  Most of us would rather have a patient call so that we can assess the situation, rather than find out later that there was a problem.
  • If you have a newer device and have no reason to suspect that your battery is getting low, you should call the on call person for the device clinic whenever you hear a beeping.  During regular clinic hours, you can call the clinic directly.
  • If you have a lead that is known to be high risk for problems, call immediately whenever you hear a beep.  You may be asked to call 911 and go to the Emergency Room.  Your device clinic can let you know if you have one of these high risk leads.

To determine if you can hear the beep, ask your device clinic to demonstrate these tones to you at your next clinic visit.  Ask how your device is set up and what your device can or will beep for.  Some devices have different tones for different issues. Ask to have all the tones that are on your device demonstrated.  In addition, ask your clinic who you should contact when your device beeps.  Make sure you know what number to call after regular business hours to reach someone if you have concerns.

Having a device can be stressful for most people.  I hope this has helped to answer some questions.”

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.