Pacemaker Advice – Improving YOUR Follow Up – 8 Top Tips

8 Top Tips – Improving YOUR Pacemaker Follow Up 

Pacemakers… You set the Pace.

Here I bring you my article first published in GUCH News Issue 75 the Somerville Foundation Newsletter for patients with Congenital Heart Disease.

Senior Cardiac Physiologist Carl Robinson specialises in pacemakers and shares his simple tips to help you get the most out of your follow up appointments for pacemakers and Implantable Cardiac Defibrillators (ICD).

I could start this article by telling everyone what a pacemaker is, describing the size and shape and some basics about how it works. That is not how I see a pacemaker though and I don’t think it should be how you see a pacemaker either.
To me, a pacemaker is an organ, a part of the recipient’s body that is just a new addition to their bodily systems. Consider that a pacemaker can affect blood pressure (kidney), increase or decrease heart rate in response to external stimulus (brain) and increase cardiac output (heart). Then perhaps you’ll start to agree it is more than a device, it is a part of you.
At pacemaker checks, someone who you may have never met before will take control of one of your organs and tell it how to work in your body so it is completely understandable why patients may be so nervous.
With all the advances in technology, pacemakers have become incredibly safe and what used to be a major procedure can now be completed in less than an hour. With the implant procedure becoming more straightforward, and more developed and intelligent pacemaker software available, I do feel this has given rise to a more relaxed attitude towards pacemaker follow ups. This is a good thing, provided two things happen.
Firstly, pacemaker technicians need to remember the responsibility they have. In essence they are prescribing a medication to manage a patient’s symptoms and have a huge impact on a person’s quality of life. I could quite as easily write an article for pacemaker technicians on how to communicate with patients during checks – but this article isn’t for them, it’s for you, the pacemaker patient!
The second and most important point is that you, the patient, take responsibility for improving the quality of your own follow up.
You may be wondering how to do this, so I have put together a list of helpful tips to improve your time with the technician.

Pacemaker Appointment Follow UP
Do you know which device you have? a VVI?

1. Improve your knowledge of your disease area and why your pacemaker is implanted. A little understanding is never a bad thing. It is even empowering. And it will help you have a more informed discussion with your pacemaker technician.

2. Make a list of any questions you may have because we’re not just here to check your pacemaker, we’re here to answer questions too.
3. Bring a list of your medications. It’s rare a day goes by and I don’t get asked about a beta-blocker or an anti-coagulant and it’s helpful to have it written down when people’s pronunciation of medications can vary so dramatically!
4. Don’t forget your pacemaker identification card, which has the exact details of your device. This is exceptionally handy if you have changed centres.

5. Diarise your symptoms. Your pacemaker will record anything irregular and store it with a date and time. Should we need to check if, for example, arrhythmia caused your symptoms, we won’t know unless you have a date and time of your symptoms too. It is always worth asking the technician to check the built-in date and time calibration of your device. It might be Wednesday morning but your pacemaker could think it’s Sunday evening.

6. Remember to speak up. Quite often a patient’s other half or family members will speak on their behalf. If you feel a certain way, you best speak up after all it is your body and that makes you the ONLY person in that room to know what you are feeling.
Pacemaker Appointment Follow UP
Maybe you have a DDD??

7. Pick the best time to raise any questions and concerns. I regularly become a terrible communicator during my check ups when I am concentrating on data or running tests. We cannot usually multitask when controlling someone’s heart rate – we need to be very focused. If you ask a question and the technician seems distracted, then ask it again later on.

8. Remember the manual of any electrical appliance/machinery that you want to check your pacemaker’s safety guidelines against. We hold a book of how different machinery or equipment interacts with pacemakers and ICDs. If your query is not on the list, we can contact the manufacturer directly.
I already know exactly what many of you are thinking, that some technicians are often monosyllabic and you try to have these conversations but they do not respond. I have no doubt that there are technicians out there who are not the best communicators but bear in mind we could be controlling your heart beat during a check so we may be distracted with good reason! 
Please take these tips on board, give them a go once and see if you get more from your follow up!
I truly believe it is essential that you are in a position to have a better conversation in your appointments and allow you to have more of an impact in your care. I hope your next pacemaker follow up is your best yet.

Further explanation around these topics and more is available in the book Pacemakers Made Easy by Carl Robinson.

Please feel free to email me at carl@thepad.pm if you would like me to write for your publication.
Please share this post if you know someone with a Pacemaker it may really help them!
Thanks for Reading

Time to go to work!!

Cardiac Technician

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