A few weeks ago, I continued to get an irregular heartbeat icon when I took my blood pressure.  When I took my pulse and felt in the area of my heart, it seemed like I was detecting an extra heartbeat.  Oh great, just when I thought I was making progress on my treatment, my heart decides to go rogue.  I guess it was tired of doing the waltz and wanted to insert some extra beats for a samba. 

So what is a heart patient to do?  Avoid the tendency to be anxious and procrastinate as this might cause even more heart disruption.  Instead, I decided that I needed to use the extra beats to spring into action!  I got in contact with the office of my electrophysiologist (the doctor who put in my cardiac device) and they set up an appointment.  He also requested that I wear a holter monitor for 24 hours so he could get a snapshot of what my heart was doing.
​​

I think I have a love hate relationship with my cardiac device known as a cardiac resynchronization therapy defibrillator (yes, that is a mouthful).  I love it because it keeps my lazy little heart beating at a steady rate.  Without it, I would have an incredibly low heart rate and be subject to intense bouts of dizziness and lethargy.  In other words, I would be an uncharged Energizer Bunny.

But I also hate it because it also can function as a defibrillator.  The plus side is that if it works as described, it will keep my heart from going into cardiac arrest.  In other words, it will keep me from dying which right now is my ultimate goal.  But it also scares me because I don’t know what I will feel when the defibrillator activates.  Will it be painful?  Will it be so bad that I will live in fear that it might activate again?
​

​As you may have noticed, there are alarms and alerts everywhere.  Almost all of them, if not all, are impossible to miss.  When you are watching television, there is occasionally a test of the Emergency Alert System.  This alarm has been around for years, and when I was little it was referred to as the Emergency Broadcasting System.  The test produces an alarm sound that is at ear piercing levels, as the FCC admits below:

• This is only a test.” You’ve no doubt heard or read those words countless times during local tests of the Emergency Alert System, accompanied by the familiar attention-grabbing sounds on your television or radio. Testing is an essential part of ensuring that emergency alert systems work, both by validating operational readiness and by uncovering areas for improvement.  While local tests of the Emergency Alert System occur frequently, the system has also been tested three times on the national level. 

When I was a teen in the 1970s, listening to a lot of music and watching a lot of television, there was a company called Memorex.  It made audio tapes to record music on.  (Yes, I lived in the age of the dinosaur, long before iPods and iPhones).  There was a very popular commercial that instantly became a classic.  It showed Ella Fitzgerald singing a note that shattered a glass while being recorded to a Memorex audio cassette tape. The tape was played back and the recording also broke a glass.  A narrator asked the question: "Is it live, or is it Memorex?" This would become the company slogan which was used in a series of advertisements released through the 1970s and 1980s.

So when thinking about heart transplants, one wonders if there is an option to transplant a mechanical heart versus a human heart.  And if there is, which option would be better – live or the heart version of Memorex?  I recall that years ago there were some experiments with artificial hearts.   But I lost track (and at that time probably interest) in whether there was any progress made with artificial hearts.  But now that the heart (and the threat of worsening heart failure) basically rules every minute of my day, I have become extremely interested in this topic.  
​

It is a provident and good thing that I was such a workaholic in 2012 that I was too distracted to watch much television.  I never found the time to watch the popular series Homeland.  Why is it a provident and good thing that I never turned on a show that many people would never miss or would Tivo?  Because according to a December 6, 2012 article I found on the Forbes Magazine website, the character of the Vice President in this fictional series “is assassinated by a group of terrorists that have hacked into the pacemaker controlling his heart.  In an elaborate plot, they obtain the device’s unique identification number.  They then are able to remotely take control and administer large electrical shocks, bringing on a fatal heart attack.”

According to the website of the American Congenital Heart Association, the episode certainly resulted in some increased patient phone call volume in physician’s offices at the time, with people asking, “Can my pacemaker be hacked?”  But you’re saying to yourself “this is just fiction, right?”  Well, according to the website for Engadget, Dick Cheney had been warned his defibrillator could be used to assassinate him.  I have said this before in blog posts and now I say it again:  YIKES!!!!!  
​

I was watching a show on television recently when one of the characters said that the heart is an organ.  Someone else replied, "No, the heart is a muscle."  I found that response to be confusing because I would think that the term “organ donor” (which includes heart donors) means that the heart is an organ.  So what is the correct answer?

I googled the question:  Is the heart an organ?  The answers that came back reaffirmed the complexity of the heart and suggested that the heart performs a number of functions.  I continued to ask google similar questions over the next few days and confirmed the importance of each of the multiple roles the heart performs in our lives.
​

I hope you are not getting tired of all the acronyms.  In some of my initial posts, I began to use the acronym ICD, which is shorthand for Implantable Cardioverter Defibrillator(the little device I have in my body that paces my  heart and keeps me from going into cardiac arrest).  In a more recent post, I wrote about NSAIDs, the class of pain relievers that doctors tell patients with certain heart conditions to avoid.

So now I am asking you to get familiar with another acronym known as LVAD.  LVAD may bring to mind the term HVAC, an acronym for heating, ventilation and air conditioning systems.  Indeed, LVADs do bear some similarities to HVAC systems which contain a heat pump.  You see, LVAD means Left Ventricle Assist Device.  According to the St. Jude Medical website, an LVAD is a heart pump, a mechanical device that helps people when their hearts are too weak to pump blood.  So maybe the comparison between LVADs and HVACs isn’t so zany after all!
​

The evolution of the pacemaker device provides evidence of a truly international achievement which began around the turn of the 20th Century.   It is a testament to the persistence and commitment not only of the inventors and doctors who made the device possible, but also to the patients who were the guinea pigs for the initially cumbersome devices.  Frankly, I do not think I possess the fortitude that was demonstrated by the first patients, nor do I think I could have tolerated some of their challenges.

I found a number of items on websites providing timelines for the development and Implantation of the first pacemaker, such as medical journals and even obituaries.  The information below was gleaned from these sources, including items listed on a timeline found in the Daily Mail obituary for Wilson Greatbatch.  The side comments throughout the post, of course, are mine.
​

I initially had a pacemaker but now an implantable cardioverter defibrillator (ICD_ resides in my body.  The first pacemaker was made in 1958.  The first ICD was implanted in February 1980.  It is pretty amazing when you look at those initial cardiac devices and consider how they evolved and became much smaller in the last 60 years, to the benefit of me and my fellow heart failure patients. 

An ICD is a small electronic device that I suspect will reside in my body in some form for the rest of my life.   It is like the pacemaker I had but with some extra features to address additional heart issues.  The ICD monitors my heart rhythm, to include the speed and the pattern of the heartbeat.  If the rhythm becomes to slow (my initial problem in 2013), the ICD sends out electrical signals to bring it back up to a normal level.  This is referred to as “pacing” the heart.  If the rhythm becomes dangerously fast, the ICD may send impulses to slow it down, or it may briefly shock the heart, to return the heart to a normal rhythm.  (Happily, my ICD has never shocked my heart).
​

I went home from the hospital after my pacemaker/defibrillator upgrade and started the process of getting used to having this new heart device inside me.  During the first week, I began exercising on a gradual basis.  Even though I was still scheduled to see the advanced heart failure specialist, or maybe especially because I was going to see this specialist, I needed to make sure that I kept up my cardio routine to hopefully improve my heart.  My physical fitness was a priority during this chapter in my life.  Fortunately, I had some monitors helping me fulfill this priority. 

​When I say monitors, I am referring to two types:  (1) an actual monitoring machine and (2) the observers who will keep track of the results of the machine on a daily basis.  Both the hardware and the people are critical to my heart health.