Thank you Dr Cooper. My partner is having a pacemaker, so I naturally look for as much information as possible. A balanced, informative and easy to follow post. Thank you.
Thank you for this presentation. It has cleared up several questions that I had. I am on my 3rd month of having a CRT-D, biventricular pacemaker with a defibrillator. Fainting spells are gone, and I pretty much live a normal life.♥
Thank you for all the information! I've had a dual chamber for 5 weeks now. It has taken care of the bradycardia but now i have the fast rates. Have had Afib at 229 and my brady was in the 30s-50s. Feeling better but still not quite right. This video has answered so many of my questions. Thank you for helping people like me with this type of situation. Stay safe and take care!
Thank you for this clear, concise explanation. I'm a week into living with my pacemaker and naturally wonder about all of these issue despite reading everything my doctors gave. Your video should be show to every patient before having the procedure because it would help to set their mind at ease.
@@dav14pawest thank you so much! That is exactly the goal, to provide reassurance and support for people who may need or who already have an implanted pacemaker.
From the Netherlands: as a retired EP and device technician l have always appreciated your excellent teaching ability, since I have watched all your previous videos here.
Thank you so much for your kind comments! Out of curiosity, how did you come across the video? It had been sitting online for a little while without that many views at first, and for some reason it seems to have picked up interest, which of course I'm happy to see!
@@dr.joshuacooper-arrhythmia9917 I had a dual chamber pacemaker inserted almost two years ago, so now and then I search for pacemaker related videos. I must say you did answer some of the questions that I had asked at my pacemaker check last week i.e end of life with a pacemaker. As a former nurse I like to keep up as well.
Oh my! I've learned so much more from you than from the device tech and cardiologist , but its hard to learn much from a 5 minute doctor appointment. I've only seen the cardiologist for 5 minutes in the 15 months I've had the pacemaker that was 5 months ago when he told me one of the leads was not working and that it broke a few months after getting it. He doesn't want to run any tests besides remote interrogations to see if the separated or why it's not working.
What an excellent presentation, thank you for taking the trouble to publish this video. I am still struggling to find defined dos and don’ts in relation to welding - there appears to be a level of (hooby)welding which is possible but generally no specifics are to be found.
Thank you so much for your comments and question. I haven't found one resource that speaks to all of the issues. The main principal is trying to avoid the pacemaker (or implanted defibrillator) and the pacemaker wires in the body being exposed to a high enough electromagnetic field that the device could detect the electrical signals/field and falsely think that these signals are coming from the heart. This situation could include being very close to a strong electromagnetic field, a rapidly pulsating electric field, or having current run through the body because of poor grounding or moisture on one's hands while welding. Here's one example of "rules" i found: Keep amperage range under 130A Avoid using any welding machines with Pulse function (typically found on some higher-end / professional TIG and MIG machines, however can be found in some Stick/MMA machines as well), or High-Frequency function (typically found on professional TIG machines, and some plasma cutters). Keep your clothing (includes gloves and shoes) and work area dry at all times There should be at least a 600mm / 2 ft. distant between your pacemaker and the welding arc Keep welding cables and the welding machine as far from you as possible. The recommended distance for the welding unit is around 1.5m / 5 feet from where you work. Where possible, twist the welding cables together, and ensure that the pacemaker user is not stood in a current loop, with the torch on one side and the return cable on the other.
Very interesting. My question is whether there are any differences between treatment/tips for males and females? Women have a different torso to men, which may mean that different muscle groups in the chest need different maintenance.
Why would a pacemaker not send a signal when the patient is having an arrhythmia? Why would it not show up on remote interrogation? The atrial lead is not working ,could that be why? I know the remote interrogation is always done during the middle of the night and I've never felt an arrhythmia when I lay down. I feel so confused. They don't tell me much of anything.
@@gemmasantos1572 epicardial pacing wires essentially work the same as an implantable pacemaker. They cannot prevent atrial fibrillation. They can only prevent the heart rate from falling below a programmed cutoff.
Good morning Doctor, is there the possibility of removing the pacemaker in the event that a second degree atrioventricular block type Mobitz I regresses? Thank you very much and congratulations
You didn’t discuss pacemaker performance in exercise when the device is responsible for pacing under exertion. Prior to receiving a pacemaker implant I was a keen cyclist and swimmer. That all changed after the pacemaker took control. This device has a simple accelerometer which is used to sense physical exertion but it does a very poor job of that with low impact exercise. I could be drowning in the pool I am so exhausted but my pulse rate is less than 85. If I jog on the spot and am not tired at all my heart rate rockets to more than 130 bpm. When cycling, going up hills my heart rate slows but going down the other side it rises because it senses it bumps in the road. In short, worse than useless. So unless your a runner avoid having a pacemaker control your heart rate response on exertion, because they really suck at it.
You raise a very important and interesting aspect of how pacemakers function. In patients who are not able to raise their own heart rate with exertion, the "rate responsive pacing" feature of pacemakers is intended to restore the ability to accelerate heart rate in proportion to the body's need. You are quite right that the accelerometer (motion sensor) type of sensor doesn't work equally well for everyone, and certainly there are types of activity for which it works better than others. All brands of pacemaker have an accelerometer. However, there are other types of sensors, including a minute ventilation sensor (breathing rate sensor) in Boston Scientific pacemakers, and the "closed loop sensor" (aka CLS) in Biotronik pacemakers. The former uses the breathing rate to detect level of activity, and the latter detects how strongly the heart muscle is squeezing around the end of the lead/wire in the heart, as a way to try to detect adrenaline levels/effect. And so if your quality of life is significantly impaired due to the type of sensor in your pacemaker not working well for you, it might be worth talking to your EP doc about switching to another brand of pacemaker (particularly Boston Scientific with its minute ventilation sensor) that might do a much better job adjusting heart rates for activity. Of course there is a small risk of an infection each time a pacemaker is changed out, which needs to be considered if a pacemaker were changed well before the usual time at battery depletion. But it might be worth it in your case, to improve heart rate adjustments during physical activity/exercise.
What type of exercising if any would cause the leads to break? Push-ups? Pull-ups? High Overhead stretch as in Bikram Yoga? Slalom Water skiing - getting up - arms pulled forward to skiing a course (one handed turns)? Thank You for your responses!
Pacemaker lead fracture is difficult to predict and there are no specific activities that are predictably associated with lead fracture. The anatomic relationship between the pacemaker leads, the clavicle (collar bone), the ligament between the clavicle and the 1st rib likely plays a role in lead fracture risk, but that has more to do with the lead implantation and patient anatomy than specific activities. And so, both for quality of life reasons, as well as no data to support activity restrictions, there are no prohibitions on any particular type of exercise with a pacemaker in place (including no restrictions on push-ups, pull-ups, overhead reach/stretch, slalom water skiing) - but I envy the person who is this physically active and I must vow to do better myself!! :)
@@DCFunBud Because induction heating uses an alternating current, the strength of which fades dramatically with distance, a person with a pacemaker is indeed able to use an induction stove, but they should not lean forward and have their chest be close to the induction surface while it is on. Recommended distance is ~24 inches to be safe, according to pacemaker vendors.
Yes, every in-person pacemaker check and every remote monitoring pacemaker check generates a full report that you can ask to see/have (although there's a lot of information there and it will be mostly hard to interpret without detailed explanations!)
I am congenital bradycardia patient. I had complete heart block. Got pacemaker few months ago but since i got it. Life is not normal. I'm 40. Get tired and feel shortness of breath. Sometimes feel slight pain and pressure on left side and left arm. Is it normal after pacemaker?
There are several reasons that someone might not feel well after getting a pacemaker for heart block. Much of it has to do with the way the pacemaker is programmed, and lead placement in the heart can also impact how the pacemaker functions. You should see your EP doc and let them know you are not feeling well so that they can help figure out solutions.
Yes, electrical cardioversion can be done safely in patients with pacemakers (recommend not putting a defib adhesive pad right on top of the pacemaker, although that's not the proper location for the front pad anyway!)
Thanks for that reply, It’s very comforting. There are questions regarding electrophysiology of the heart which are not easy to find answers to despite all the literature out there .
i am only 25 years old and dr recommend me pace maker it may be safe for me ? people scared me that it cause many issues after installation u are suffering from many issues and some time pain as well as feeling of discomfort all the time . life with pace maker is more tough than the normal one
@@deborahbleidl6789 Appropriate in some situations, but unnecessary in most. Either way, understanding what the decision means (possibly resulting in symptoms, etc) is so important so each individual can make the right decision for them!
i had a pacemaker implanted because of bradycardia i had pulse rate below 30 for 3 seconds . my question is how dangerous was this and how will it be corected .i also have occasional a fib they are treating with meds if that doesn't work what can be done for this .
@@chuckweatherford1601 There are a number of different reasons why the heart rate could fall below 30 beats per minute for 3 seconds, some of which do not require treatment at all, some of which warrant treatment to alleviate symptoms, and some of which can predict future dangerous heart rhythms and require urgent pacemaker implantation. A pacemaker can treat any of the above conditions very effectively to prevent the heartbeat from going too slowly for almost any reason. In addition, some people have both atrial fibrillation at times, that can make the heart go fast, and slow heart rates at other times when they are not in atrial fibrillation. Those situations can be tricky, because the medications to treat atrial fibrillation can make the periods of slow heart rate go even slower. And therefore sometimes we implant a pacemaker in part to allow more aggressive medical treatment for atrial fibrillation.
Thank you Dr Cooper.
My partner is having a pacemaker, so I naturally look for as much information as possible.
A balanced, informative and easy to follow post.
Thank you.
@@6thdayblue59 thank you so much for the note! I'm so happy to hear that this video was helpful for you and your partner. Best of luck!
Thank you so much for the information you provided. It is very helpful and appreciated. Just got my dual chamber pacemaker 5 days ago.
I am waiting in a hospital to be discharged after they implanted a pacemaker yesterday. Now, I have a better idea of how it works. Thank you!
Thank you for this presentation. It has cleared up several questions that I had. I am on my 3rd month of having a CRT-D, biventricular pacemaker with a defibrillator. Fainting spells are gone, and I pretty much live a normal life.♥
Thank you for all the information! I've had a dual chamber for 5 weeks now. It has taken care of the bradycardia but now i have the fast rates. Have had Afib at 229 and my brady was in the 30s-50s. Feeling better but still not quite right. This video has answered so many of my questions. Thank you for helping people like me with this type of situation. Stay safe and take care!
As a retired cardiac nurse I think your presentation is terrific.
@@bethcornelius4156 thanks so much for taking the time to give feedback! 🙏
Thank you doctor! Very well explain, God bless you
Thank you for this clear, concise explanation. I'm a week into living with my pacemaker and naturally wonder about all of these issue despite reading everything my doctors gave. Your video should be show to every patient before having the procedure because it would help to set their mind at ease.
@@dav14pawest thank you so much! That is exactly the goal, to provide reassurance and support for people who may need or who already have an implanted pacemaker.
Am about to get my
Can we be friends
Thanks Doctor. I get my pacemaker tomorrow morning.
I am a doctor...yr presentation is awesome... explaining every thing... u are a good teacher
From the Netherlands: as a retired EP and device technician l have always appreciated your excellent teaching ability, since I have watched all your previous videos here.
Thanks so much! 🙏 I hope this one makes sense! (I don't always phrase things exactly how i wanted to 🤷♂️)
What a wonderful presentation. So informative and explained in a simple understandable way. Thank you
Very useful presentation for me, because a pacemaker is recently inserted. Thank you very much
Very helpful Necessary information. Thank you Doc!
The method of explaining is amazing.
Humans are very intelligent creatures🔥 thanks to the people who invented these kinds of medical machines and medicines❤️
That was an outstanding presentation! Simple, concise and patient friendly, thank you so much!❤️
Thank you so much for your kind comments! Out of curiosity, how did you come across the video? It had been sitting online for a little while without that many views at first, and for some reason it seems to have picked up interest, which of course I'm happy to see!
@@dr.joshuacooper-arrhythmia9917 I had a dual chamber pacemaker inserted almost two years ago, so now and then I search for pacemaker related videos. I must say you did answer some of the questions that I had asked at my pacemaker check last week i.e end of life with a pacemaker. As a former nurse I like to keep up as well.
Thank you so much sir for sharing this valuable knowledge about the pacemaker.
Bless you and thank you! When you do not know the question, hard to ask it!!!!!!
Oh my! I've learned so much more from you than from the device tech and cardiologist , but its hard to learn much from a 5 minute doctor appointment. I've only seen the cardiologist for 5 minutes in the 15 months I've had the pacemaker that was 5 months ago when he told me one of the leads was not working and that it broke a few months after getting it. He doesn't want to run any tests besides remote interrogations to see if the separated or why it's not working.
Loved it! You're a wonderful teacher.
It definitely helps. My mother might have to get one. Thanks for the great info
Thanks for your kind feedback!
What an excellent presentation, thank you for taking the trouble to publish this video. I am still struggling to find defined dos and don’ts in relation to welding - there appears to be a level of (hooby)welding which is possible but generally no specifics are to be found.
Thank you so much for your comments and question. I haven't found one resource that speaks to all of the issues. The main principal is trying to avoid the pacemaker (or implanted defibrillator) and the pacemaker wires in the body being exposed to a high enough electromagnetic field that the device could detect the electrical signals/field and falsely think that these signals are coming from the heart. This situation could include being very close to a strong electromagnetic field, a rapidly pulsating electric field, or having current run through the body because of poor grounding or moisture on one's hands while welding.
Here's one example of "rules" i found:
Keep amperage range under 130A
Avoid using any welding machines with Pulse function (typically found on some higher-end / professional TIG and MIG machines, however can be found in some Stick/MMA machines as well), or High-Frequency function (typically found on professional TIG machines, and some plasma cutters).
Keep your clothing (includes gloves and shoes) and work area dry at all times
There should be at least a 600mm / 2 ft. distant between your pacemaker and the welding arc
Keep welding cables and the welding machine as far from you as possible. The recommended distance for the welding unit is around 1.5m / 5 feet from where you work.
Where possible, twist the welding cables together, and ensure that the pacemaker user is not stood in a current loop, with the torch on one side and the return cable on the other.
@@dr.joshuacooper-arrhythmia9917 Many thanks once again.
Please add a section on Battery Electric Vehicles and their charging.
Excellent analysis
Very interesting. My question is whether there are any differences between treatment/tips for males and females? Women have a different torso to men, which may mean that different muscle groups in the chest need different maintenance.
Pacemakers are small, compared to local muscles of either men or women. No specific gender differences in recovery or maintenance. 👍
Great education !Thank you very much.
Thank you so much for this information, as it was very informative.
That was super clear . Perfect . Thankyou .
Why would a pacemaker not send a signal when the patient is having an arrhythmia? Why would it not show up on remote interrogation? The atrial lead is not working ,could that be why? I know the remote interrogation is always done during the middle of the night and I've never felt an arrhythmia when I lay down. I feel so confused. They don't tell me much of anything.
Thanks for sharing
Thanks! I hope it makes sense! 🤞
In epicardial pacemaker in a post CABG patient, can we pace afib or same as the implantable ones that it has no effect? On a fibrillating heart?
@@gemmasantos1572 epicardial pacing wires essentially work the same as an implantable pacemaker. They cannot prevent atrial fibrillation. They can only prevent the heart rate from falling below a programmed cutoff.
@@dr.joshuacooper-arrhythmia9917thank you dr for the reply.
Good morning Doctor, is there the possibility of removing the pacemaker in the event that a second degree atrioventricular block type Mobitz I regresses? Thank you very much and congratulations
No answer cause they don't take it out after placing? There's something wrong and fine underwrite going on they don't tell why thou
Can you be more clear please? Thanks
Thank you for this!
Do smart watches and fitness trackers worn on the wrist interfere with the functioning of a pacemaker.
I have seen some commentary to that effect.
You didn’t discuss pacemaker performance in exercise when the device is responsible for pacing under exertion. Prior to receiving a pacemaker implant I was a keen cyclist and swimmer. That all changed after the pacemaker took control. This device has a simple accelerometer which is used to sense physical exertion but it does a very poor job of that with low impact exercise. I could be drowning in the pool I am so exhausted but my pulse rate is less than 85. If I jog on the spot and am not tired at all my heart rate rockets to more than 130 bpm. When cycling, going up hills my heart rate slows but going down the other side it rises because it senses it bumps in the road. In short, worse than useless. So unless your a runner avoid having a pacemaker control your heart rate response on exertion, because they really suck at it.
You raise a very important and interesting aspect of how pacemakers function. In patients who are not able to raise their own heart rate with exertion, the "rate responsive pacing" feature of pacemakers is intended to restore the ability to accelerate heart rate in proportion to the body's need. You are quite right that the accelerometer (motion sensor) type of sensor doesn't work equally well for everyone, and certainly there are types of activity for which it works better than others. All brands of pacemaker have an accelerometer. However, there are other types of sensors, including a minute ventilation sensor (breathing rate sensor) in Boston Scientific pacemakers, and the "closed loop sensor" (aka CLS) in Biotronik pacemakers. The former uses the breathing rate to detect level of activity, and the latter detects how strongly the heart muscle is squeezing around the end of the lead/wire in the heart, as a way to try to detect adrenaline levels/effect. And so if your quality of life is significantly impaired due to the type of sensor in your pacemaker not working well for you, it might be worth talking to your EP doc about switching to another brand of pacemaker (particularly Boston Scientific with its minute ventilation sensor) that might do a much better job adjusting heart rates for activity. Of course there is a small risk of an infection each time a pacemaker is changed out, which needs to be considered if a pacemaker were changed well before the usual time at battery depletion. But it might be worth it in your case, to improve heart rate adjustments during physical activity/exercise.
What type of exercising if any would cause the leads to break? Push-ups? Pull-ups? High Overhead stretch as in Bikram Yoga? Slalom Water skiing - getting up - arms pulled forward to skiing a course (one handed turns)? Thank You for your responses!
Pacemaker lead fracture is difficult to predict and there are no specific activities that are predictably associated with lead fracture. The anatomic relationship between the pacemaker leads, the clavicle (collar bone), the ligament between the clavicle and the 1st rib likely plays a role in lead fracture risk, but that has more to do with the lead implantation and patient anatomy than specific activities. And so, both for quality of life reasons, as well as no data to support activity restrictions, there are no prohibitions on any particular type of exercise with a pacemaker in place (including no restrictions on push-ups, pull-ups, overhead reach/stretch, slalom water skiing) - but I envy the person who is this physically active and I must vow to do better myself!! :)
Can you use induction cooking stovetops or hobs?
@@DCFunBud Because induction heating uses an alternating current, the strength of which fades dramatically with distance, a person with a pacemaker is indeed able to use an induction stove, but they should not lean forward and have their chest be close to the induction surface while it is on. Recommended distance is ~24 inches to be safe, according to pacemaker vendors.
Great information!!!!!!!
Can I request my own pacemaker report? From my cardiologist?
Yes, every in-person pacemaker check and every remote monitoring pacemaker check generates a full report that you can ask to see/have (although there's a lot of information there and it will be mostly hard to interpret without detailed explanations!)
I am congenital bradycardia patient. I had complete heart block. Got pacemaker few months ago but since i got it. Life is not normal. I'm 40. Get tired and feel shortness of breath. Sometimes feel slight pain and pressure on left side and left arm. Is it normal after pacemaker?
There are several reasons that someone might not feel well after getting a pacemaker for heart block. Much of it has to do with the way the pacemaker is programmed, and lead placement in the heart can also impact how the pacemaker functions. You should see your EP doc and let them know you are not feeling well so that they can help figure out solutions.
Can a patient with a dual chamber pacemaker , undergo an electro cardioversion for atrial flutter ?
Yes, electrical cardioversion can be done safely in patients with pacemakers (recommend not putting a defib adhesive pad right on top of the pacemaker, although that's not the proper location for the front pad anyway!)
Thanks for that reply, It’s very comforting. There are questions regarding electrophysiology of the heart which are not easy to find answers to despite all the literature out there .
I have a pacemaker 2 weeks ago, after 4 or 6 weeks,can I have my bracelet and necklace put on?
i am only 25 years old and dr recommend me pace maker it may be safe for me ? people scared me that it cause many issues after installation u are suffering from many issues and some time pain as well as feeling of discomfort all the time . life with pace maker is more tough than the normal one
GOD BLESS YOU
What about fast hearbeats
When I am on my deathbed I will be turning it off.
@@deborahbleidl6789 Appropriate in some situations, but unnecessary in most. Either way, understanding what the decision means (possibly resulting in symptoms, etc) is so important so each individual can make the right decision for them!
i had a pacemaker implanted because of bradycardia i had pulse rate below 30 for 3 seconds . my question is how dangerous was this and how will it be corected .i also have occasional a fib they are treating with meds if that doesn't work what can be done for this .
@@chuckweatherford1601 There are a number of different reasons why the heart rate could fall below 30 beats per minute for 3 seconds, some of which do not require treatment at all, some of which warrant treatment to alleviate symptoms, and some of which can predict future dangerous heart rhythms and require urgent pacemaker implantation. A pacemaker can treat any of the above conditions very effectively to prevent the heartbeat from going too slowly for almost any reason.
In addition, some people have both atrial fibrillation at times, that can make the heart go fast, and slow heart rates at other times when they are not in atrial fibrillation. Those situations can be tricky, because the medications to treat atrial fibrillation can make the periods of slow heart rate go even slower. And therefore sometimes we implant a pacemaker in part to allow more aggressive medical treatment for atrial fibrillation.
@@dr.joshuacooper-arrhythmia9917 thanks for info I'm sure my cardiologists knows why .