You Asked. We Answered.

LifeBeat Online Answers Common Questions

At LifeBeat Online, we receive many questions from our readers about living with a pacemaker, defibrillator, heart failure device, or stent. We've selected some common questions to answer in this issue.

Remember, the information you receive from LifeBeat Online is not a substitute for consulting with your doctor or nurse. If you have or suspect that you may have a medical problem, you should contact your doctor immediately.

Here's What You Asked:

1. Are carotid artery disease and coronary artery disease caused by the same problem?
Yes, and the problem is atherosclerosis, sometimes called hardening of the arteries. Atherosclerosis is caused when fatty deposits like cholesterol build up inside the arteries and form plaque. Over time, as more plaque builds up, it narrows the artery and slows the blood flow, which can be dangerous:

In the coronary arteries, it can block blood flow to the heart and cause a heart attack.
In the carotid arteries, it can block blood flow to the brain and cause a stroke.

2. After my heart attack I had a stent implanted, and later I had an ICD implanted. Why do I still have to be on heart medications?
It depends on what the medications treat. Devices and/or stents, when used together with medications, often give you the best treatment. Remember, your procedures were done to help very specific issues.

Your stent is meant to keep a certain part of an artery open.
Your ICD (implantable cardioverter defibrillator) is meant to prevent sudden cardiac death due to fast or abnormal heartbeats (arrhythmias).

But you might still have other cardiovascular problems that your device and stent can't eliminate, but that medications can treat. For example, you may have high blood pressure or abnormal heart rhythms in your heart's upper chambers, the atria. Or, you may have coronary artery disease, which might have been the reason the stent was implanted in one of your arteries, but plaque could still build up in other arteries.

Take a look at Medications Used to Treat Heart Conditions; it may help clarify what your heart drugs are prescribed for. And ask your doctor or nurse if you still have questions about taking the medications.

3. I haven't flown since 9/11 but have an upcoming trip. With all the new security at airports, I'm thinking about my pacemaker and how I can make sure everything goes smoothly.
Many of the new security rules at airports have to do with checking luggage. You might find the personal security measures like they were before. (However, now you may have to take off your shoes, so keep that in mind when deciding what to wear.)

Walking through the security archway will not harm your device. But any pacemaker, implantable defibrillator, or heart failure device contains metal, so it can set off metal detectors at the archway.

If workers want to do a search with a security wand:

Tell them you have an implanted device.
Show them your Guidant Medical Device ID card or Patient Travel card.

If it would make you feel more comfortable, ask the workers to do a hand search or pat-down to avoid using the wand altogether. Tell them that if a wand must be used, it should be passed over your device very quickly. The wand contains a magnet that, if left over the device, can temporarily affect its function. An ICD could possibly be turned off by the wand if it lingers near the device.

4. Since my husband's cardiologist recommended bypass surgery, I've read some websites about off-pump bypasses. But the doctors at our local hospital don't do this surgery. Any advice?
Off-pump surgery, also known as beating heart bypass, is a fairly new procedure for coronary artery bypass grafting (CABG), or bypass operations.

Previously, during all bypass surgeries blood was routed away from the heart and went to a heart-lung machine. This machine does what its name implies:

It does the job of the heart by pumping blood to all the tissues of the body.
It does the job of the lungs by adding oxygen and removing carbon dioxide from the blood.

In an off-pump bypass, the heart-lung machine is not used. New technology lets the surgeon operate on the heart without actually stopping the heart from beating. It's not recommended for all bypass patients, but it may be a good choice for some.

Whether this newer off-pump bypass is right for your husband depends on his cardiovascular health. You can begin by asking your husband's cardiologist for advice. And if you decide to find a surgeon who does this procedure, he or she can tell you whether it's a good option for your husband.

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