Pacemaker

[Unregistered]

My regular phycian has refered me to a cardiologist who recomends a dual lead pacemaker. They say my heart is beating on the slow side. Mid to high fourties while at rest. How will this affect my third class, and what if anything can be done to keep it?

 

[Gary F]

My regular phycian has refered me to a cardiologist who recomends a dual lead pacemaker. They say my heart is beating on the slow side. Mid to high fourties while at rest. How will this affect my third class, and what if anything can be done to keep it?

What? A low resting heart rate by itself is not a good reason to implant a pacemaker. I hope that there is more to this than you are reporting. In general symptoms should be present that can be attributed to the low heart rate. If someone has a low resting heart rate I will often put them on a treadmill to see if the heart can speed up adequately.

 

[bbchien]

Well, a low rate beating heart if it's associated with sick sinus syndrome, which is more complicated, is a good indication.

Third class pilots are now even allowed to be pacemaker dependent.

For the first two years the electronic monitoring report of the pacemaker is annually. Then six monthy, and what happens after that depends on what the report readout sez.

 

[douglas393]

Well, a low rate beating heart if it's associated with sick sinus syndrome, which is more complicated, is a good indication.

Third class pilots are now even allowed to be pacemaker dependent.

For the first two years the electronic monitoring report of the pacemaker is annually. Then six monthy, and what happens after that depends on what the report readout sez.

Bruce:

Why does the need for monitor reporting become more frequent after two years? I would think it would be less frequent.

Also correct me if I am wrong, but pacemaker/defibrillators are still a disqualifier.

Doug

 

[Gary F]

Well, a low rate beating heart if it's associated with sick sinus syndrome, which is more complicated, is a good indication.

Third class pilots are now even allowed to be pacemaker dependent.

For the first two years the electronic monitoring report of the pacemaker is annually. Then six monthy, and what happens after that depends on what the report readout sez.

Only if symptomatic. The definition of sick sinus syndrome is a little ambiguous.

Sinus Node Dysfunction: Class I: There is general agreement that permanent pacemakers should be implanted.

• Sinus node dysfunction with documented symptomatic bradycardia. In some patients this will occur as a consequence of long-term (essential) drug therapy of type and dose for which there are no acceptable alternatives.

Class II: Conditions in which permanent pacemakers are frequently used but there is some divergence of opinion about whether they are needed.

• Sinus node dysfunction occurring spontaneously or as a result of necessary drug therapy, with heart rates <40/min. when a clear association between significant symptoms consistent with bradycardia and the actual presence of bradycardia has not been documented.

Class III: Conditions in which there is general agreement that pacemakers are not necessary.

• Sinus node dysfunction in asymptomatic patients including those in whom substantial sinus bradycardia (heart rate < 40/min.) is a consequence of long-term drug treatment
• Sinus node dysfunction in patients in whom symptoms suggestive of bradycardia are clearly documented not to be associate with a slow heart rate.

http://sprojects.mmi.mcgill.ca/heart/cgpmINDI9702.html

 

[bbchien]

Yeah. There have been about a dozen report of the BIG THUMP occuring in flight even though the defib side is shut off.

You would think also that the surveillance would decline after two years- but guess what- I have a couple that are really starting to get marginal after-three years. FAA does it by their experience, which I'm amazed to admit, it considerable....

MEDTRONIC to the fore! Their batteries are good- not so much.
The Other mfr. has lead troubles....

Gary, the FAA doesn't try to second guess cardiologists for indication. They just want the installed thing to work once committed.

 

[Gary F]

.

Gary, the FAA doesn't try to second guess cardiologists for indication. They just want the installed thing to work once committed.

I know but sometimes it is good to get a formal second opinion. I have noticed that some physicians have developed a hair trigger for doing procedures to increase volume to compensate for declining reimbursements.

 

[bbchien]

I think I have remarked, that physicians for a generation have been locked in the Pavlov cage. There is a lever at the end of the cage marked, "insurance company". The pill that was dispensed after the lever is pushed used to be nutritious. Now it has become bitter and small. So the dogs push the lever more often. Go figure.

 

[JHW]

Yeah. There have been about a dozen report of the BIG THUMP occuring in flight even though the defib side is shut off.

You would think also that the surveillance would decline after two years- but guess what- I have a couple that are really starting to get marginal after-three years. FAA does it by their experience, which I'm amazed to admit, it considerable....

MEDTRONIC to the fore! Their batteries are good- not so much.
The Other mfr. has lead troubles....

Gary, the FAA doesn't try to second guess cardiologists for indication. They just want the installed thing to work once committed.

My dad god a recall letter on his. It gets your attention a lot more than a recall letter from toyota.

 

[Diana]

I have a pilot friend who recently had a pacemaker insertion for sinus bradycardia (rate on occasion drops to upper 30's but usually in the upper 40's or 50's) with the only symptom being a feeling of being very tired. He is not pacemaker dependent according to the cardiologist.

Is this the latest information from the FAA?

He said he can no longer use a chain saw...that is too bad since we often need those around here for various reasons (tornadoes, ice storms, derechos, etc.)

 

[bbchien]

I have a pilot friend who recently had a pacemaker insertion for sinus bradycardia (rate on occasion drops to upper 30's but usually in the upper 40's or 50's) with the only symptom being a feeling of being very tired. He is not pacemaker dependent according to the cardiologist.

Is this the latest information from the FAA?

He said he can no longer use a chain saw...that is too bad since we often need those around here for various reasons (tornadoes, ice storms, derechos, etc.)

Yes. But irritatingly, the webpage does not mention the requirement for the actual non-faxed tracings that have to be submitted with the report of the stress treadmill, nor that it has to be to 90% of (220-YourAge) at 9 minutes (70 and under) or prorate between 70 and 80 to 6 minutes and 85% of (220-YourAge). So airmen look at that, get a treadmill that doesn't "cut it", and then medicare won'lt let them run for another year.

I get these when airmen think they are being smart, economical, and contact be the day before the run. They do the run no matter what I say....and then when the tech cuts them off at 7.5 minutes, it's a foof.

sigh.

 

[Diana]

Yes. But irritatingly, the webpage does not mention the requirement for the actual non-faxed tracings that have to be submitted with the report of the stress treadmill, nor that it has to be to 90% of (220-YourAge) at 9 minutes (70 and under) or prorate between 70 and 80 to 6 minutes and 85% of (220-YourAge). So airmen look at that, get a treadmill that doesn't "cut it", and then medicare won'lt let them run for another year.

I get these when airmen think they are being smart, economical, and contact be the day before the run. They do the run no matter what I say....and then when the tech cuts them off at 7.5 minutes, it's a foof.

sigh.

Thank you, Bruce.