Reader Question: Questions about a Pacemaker
Dear readers,
It's time. After 12 years, the bullet has to go through the church or temple. My heart is running out. I have a genetic heart defect. Technical:
1. Genetic variant MYH7. Genotype: c.4996G>A (p.Asp1666Asn) variant in MYH7.
2. MRI shows hypertrophic CMP with serum thickness up to 16 mm and marked intramural fibrosis.
3. NSVTb (28 beats) during DSE
4. Coronagraphy 2016. slightly reduced LVES (51%) no significant stenoses
5. Pump strength 30 to 40% 60% normal
Diagnosis;
1. Minimal Pacemaker
2. With an angel on the shoulder ICD
My question is who has experience with Pacemaker and/or ICD and can tell me more about positive and especially negative experiences? I know the Dutch restrictions for me.
1. Pacemaker can independently drive a car, motorcycle and truck
2. MRI drops 1 for me.
Furthermore, an ICD restricts less normal enjoyment of life and a Pacemaker less. Risk: Risk of premature death without an ICD? doctor's language.
Ask what is early? That chance also exists with ICD.
My preference is for a pacemaker. Then comes the last question, in connection with serviceability (1x per half year) am I looking for a type that is widely known in Thailand? It must be readable from a distance and without much pompous technique. Which brand fits best in Thailand and in general South Asia and is best known here?
1. Abbott
2.Medtronic
My preference is 1. The Dutch cardiologist states 2. Abbott has most hospitals in Thailand and Malaysia.
Other brands are:
a. Boston Scientific (formerly Guidant)
b. Biotronic
c. Micro port
The last 3 have less access in my opinion. The latter being c is an outsider even in the Netherlands.
I have had an ICD for 10 years after a heart attack that was mistaken by the doctor for a stomach problem. Due to non-intervention/too late intervention, a large part of the heart has died and only 20% heart function remains.
I have it read out twice a year and sometimes skip once. Except for extending the driver's license (code 2) and the scanner at airports, I have no further problems with the thing. 100 more years of battery to go and then replace if insurance approves.
So: little to no limiting things with an ICD in my case.
Thanks for the responses thus far.
Find user experiences in Thailand and advice on brand and technical experiences.
Also in the rest of South Asia (Laos, Cambodia, Malaysia and the Philippines).
I live most of the time area 50 km north of Uttaradit (family house wife and our company). Also in Jomtien (holiday condo) and near Cha-am and Hua-Hin (both 30 to 4 minutes away (teak vacation rental).
2 Thai brothers-in-law also live in and around Bangkok.
What the functions of a 1 a PACEmaker is I know. (counteracts sinus bradycardia)
2. ICD with me to prevent or at least correct VT ventricular tachycordia.
I know that sword 1 has been hanging over my head since 2008 and sword 2 since 2017.
I have 3 books about Pacemaker, S-CDI and CDi from the Catherina Eindhoven.
I know what kind of ailment I have. Also what it can do to me -> end up dying of heart failure. Is genetic: father 68 and also an uncle at 68. I myself am 67???
My concern is info from carriers regarding “problems” with ICD and Pacemakers in Thailand. In addition, an advice or guideline for the best hospital. and what manufacturer.
Medtronic is preferred in the Catherina and the MMC.
In the uttaradit military hospital on Biotronics and the Phitsanuvej hospital on the Abbott.
When I'm on the site http://www.stin.nl look and then. to ICD and Pacemaker on holiday, importing cities such as Uttaradit, Bangkok, Jomtien, Hua Hin, Cha-am, Udon Ratchatani and Chiang mai.
In addition to Kuching (Mh) and Manila and Laoag imports, I come to the fact that Abbott has the most inputs.
I see only Medtronic mentioned so far? So this raises questions???
I am concerned with complaints with one or the other manufacturer. What are the user experiences. So far I am under treatment or control in Belgium, Germany and the Netherlands. As also in Thailand.
Now in Thailand I will most likely have a pacemaker implanted either in Phitsanulok or in Bangkok. Or and that is also a consideration in the Netherlands.
Costs not important will be reimbursed.
So the questions are more concrete:
1. Problems with yes or no.
2. ICD or Pacemaker –> for me actual pacemaker while advice is ICD (OWN choice).
3. Which brand???? Are there more or less issues with one or the other.
4. Which hospital is recommended? MY facade bangkok heart hospital?? BUT??
There is also a CRT-D, a combination pacemaker and ICD. Has acted on me before. No problems given. Have a St. Jude, readable from a distance, also from E'hoven.
I had pacemaker surgery in 1991 in Bangkok hospital Pattaya Dr Manoon fantastic, go there for advice and surgery it will all work out, strength and stay healthy
If I were given the choice, I would choose an ICD. I would prefer a Medtronic , there are very good experiences with that in the Netherlands . Furthermore, Daily Blind has an ICD and if you are talking about enjoyment of life, it does. It's still lined up. But I do not want to compare you to that because you may be more wrong . Khon Kean has a good heart center. Otherwise, ask doctor Maarte.
Beats. Yes in the Netherlands. Is a German manufacture. However, I also want to be able to go well in oa. Uttaradit, Phitsanulok and Jmatien (Thailand), Malaysia and the Philippines. Thailand and Kuching on Sarawak are leading.
Khon Kaen is a bit out of whack BUT thank you very much
I myself received an ICD in 2013 because I had a capacity of 19% in my left ventricle.
The 60% refers to the pumping of blood back from the heart to the body.
After placement of the Boston Scientific I have come all the way back to 59% and continue to live a normal life.
The ICD is of course safer because the third wire is there to tap and can give you a shock when standing still which makes me feel safe.
What is the difference between a pacemaker and an ICD?
Pacemaker
A pacemaker is a small device that is placed under your skin. The pacemaker prevents a heart rate that is too low. If necessary, the pacemaker speeds up your heart rhythm. This may sometimes be necessary, for example when you are exercising.
Implantable Cardioverter Defibrillator (ICD)
An ICD is slightly larger than a pacemaker and can do everything a pacemaker can do. The ICD can also intervene in life-threatening cardiac arrhythmias. This is done using electrical pulses or by delivering an electrical shock (defibrillation).
The implantation is also a piece of cake (4 hours) where you are not put under anesthesia.
The Boston is a world known product and also known in hospitals in Thailand.
Reading is now also done remotely via a box linked to the telephone, in the beginning he read every week and now only once every six months by appointment.
All in all, I can wholeheartedly recommend the Boston because of my experiences.
I have also been in Thailand for 15 years and all this is not a limitation for me because in the event of an emergency, intervention can also be made in a hospital in Thailand because I carry a card with data in my wallet.
I don't understand why an ICD would limit your normal life.
If you have any questions, I'd love to hear from you.
See my earlier explanation.
Know the function.
However, I would have wanted to return to the Netherlands in April 2020.
Stuck here in the first lockdown and have no visa issues. that is no problem with bank, income, age and wife.
Before Christmas panic phone from the Netherlands. Measurements very bad. So now what to do and how?
Checks here do not give 100% solace. Well, something has changed.
Dutch cardiologist (don't know better) says I'm better off in the Netherlands and I know that's NOT the case.
I also have ICD after diagnosis Heart failure, pump power 25 to 30 percent instead of 60% normal. The conclusion is various Heart medicines such as Ace inhibitors, Beta blockers and blood thinners, but also the installation of an ICD. I got the first one in 2011 at the AMC in Amsterdam. Was then under general anesthesia and remained for observation for 1 more day. Go home and do not shower for several days because of Wound Healing or Plaster. Then left a nice small scar but never had any problems with it, at a certain point you don't remember that you have it. Fortunately, my condition has not deteriorated in those 9 years, but has improved slightly and the ICD has never been activated. Because of this I also had it for 9 years and the new one was put in in November 2020, now with local anesthesia. Morning recording and evening home. Why AMC, because I still work and am registered in Europe, I do have a house and wife in Isaan, but I am still happy with Dutch care, it is in the top 3 of Europe, nothing to the detriment of Thai care, I also think this is fine. be well insured, which will cost you up to €19.000 for complete installation. Also received a modem with a new ICD, which connects to the ICD every night and sends the data via mobile network to the AMC. Asked and this also works in Thailand. Mine is also from Medtronics and on their site you can find a lot of information. Anyway good luck and don't worry too much about it.
You don't want the list of the MMC and also the Catherina hospital in the Netherlands.
In total with 14 days (MUST) a small 200.000 Euro.
In Aachen a 150.000 Euro.
In Phitsanulok a 12.000 Euro. Pacemaker
Dear Pacemaker Patient,
I myself have been running with a Medtronic since 2011. The experience I have with this is fine and in Thailand the hospitals are also known by the state, so it is fine to do the check
Although it differs per hospital with regard to the time between the check-up at one time per year and at the other 1x.
Replacing the battery costs less at a state hospital than at private individuals. If insured, the insurance company has the right to send you to a cheaper one.
Experience with the cardiologists are all good. I live near Pattaya .
Good luck Josh