Question about pacemakers

Shaken1976
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I am going to try to keep this short and have it make sense.

A few weeks ago my cousin's FIL had a stroke. He was released from the hospital and then he had two more strokes. He is now in hospice. He can't eat or drink. His living will says no artificial hydration or nutrition. No extraordinary measures. At this point, he has not had an IV or hydration since Friday.

He has a pacemaker. Is that keeping him alive at this point? If they turned if off or whatever would he die?
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Sassy762
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Im so sorry
BUT that sounds like a painful way to go
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The pace maker simply keeps the heart beating at a normal pace. When he is brain dead they doctor will use a magnet to stop the pace maker. It in and of itself isn’t keeping him alive.
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I'm sorry. Is he even conscious?
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Shaken1976 wrote: Wed Apr 10, 2019 3:09 pm I am going to try to keep this short and have it make sense.

A few weeks ago my cousin's FIL had a stroke. He was released from the hospital and then he had two more strokes. He is now in hospice. He can't eat or drink. His living will says no artificial hydration or nutrition. No extraordinary measures. At this point, he has not had an IV or hydration since Friday.

He has a pacemaker. Is that keeping him alive at this point? If they turned if off or whatever would he die?
Likely not, pacemakers are programmed to send an electrical stimulus to stimulate the heart to beat when it does not on it’s own accord. This improves the quality of life for the person, as a beating heart sends oxygenated blood to the brain consistently preventing dizziness, and passing out like symptoms. There are few patients whose hearts will not beat if the pacemaker is turned off, but majority of patients just use their pacemaker occasionally OR the patient has slow irregular hear rate that would keep the patient alive, but just not feeling as well as they would with the pacemaker.

It is a myth people cannot die when a pacemaker is still functioning. The heart muscle can still die from lack of oxygen, blood pressure can go so low or electrolytes can be so abnormal, that the heart will not beat even with the electrical stimulus from the pacemaker. So in fact, one can die without turning off the pacemaker.

I have on the behalf of families turned pacemakers to not function in end of life, but it is rare.

I am sorry your family is going through that.
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Probably not, but it’s possible if he’s completely dependent. Some people 100% rely on the pacemaker to keep them alive, others have one as back up that they rarely use. The only real way to know would be to interrogate it and see how much he’s using it. If his pulse is 100% regular at the pacemakers lower limit (usually 60, but not always), then it’s pretty likely that he’s 100% paced. But again, the only way to know for sure if he’s totally paced or if he has a rhythm that’s slower than the pacer is to have it interrogated by a medical professional.

He will die even with a pacemaker, it’s probably not going to have any role in delaying his death. It won’t stop a lethal rhythm, and once he has a lethal arrhythmia the pacing won’t be effective. If it’s an ICD also they may consider turning off the shock therapies since he’s at the end of his life, but if it’s not they probably won’t make any changes. Pacemakers can help improve quality of life at the end of life for some people, and it won’t prevent death.
Shaken1976
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SolidlyAverage wrote: Wed Apr 10, 2019 4:46 pm Probably not, but it’s possible if he’s completely dependent. Some people 100% rely on the pacemaker to keep them alive, others have one as back up that they rarely use. The only real way to know would be to interrogate it and see how much he’s using it. If his pulse is 100% regular at the pacemakers lower limit (usually 60, but not always), then it’s pretty likely that he’s 100% paced. But again, the only way to know for sure if he’s totally paced or if he has a rhythm that’s slower than the pacer is to have it interrogated by a medical professional.

He will die even with a pacemaker, it’s probably not going to have any role in delaying his death. It won’t stop a lethal rhythm, and once he has a lethal arrhythmia the pacing won’t be effective. If it’s an ICD also they may consider turning off the shock therapies since he’s at the end of his life, but if it’s not they probably won’t make any changes. Pacemakers can help improve quality of life at the end of life for some people, and it won’t prevent death.
I found out he passed away not long after I posted this.
https://www.vettix.org/ref/230481

If you or your spouse is a Vet, check out this link. They offer really cheap tickets to local events and concerts. I have done a lot of cool stuff through them.
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My condolences.. : (
Shaken1976 wrote: Wed Apr 10, 2019 5:48 pmI found out he passed away not long after I posted this.
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Shaken1976 wrote: Wed Apr 10, 2019 5:48 pm
SolidlyAverage wrote: Wed Apr 10, 2019 4:46 pm Probably not, but it’s possible if he’s completely dependent. Some people 100% rely on the pacemaker to keep them alive, others have one as back up that they rarely use. The only real way to know would be to interrogate it and see how much he’s using it. If his pulse is 100% regular at the pacemakers lower limit (usually 60, but not always), then it’s pretty likely that he’s 100% paced. But again, the only way to know for sure if he’s totally paced or if he has a rhythm that’s slower than the pacer is to have it interrogated by a medical professional.

He will die even with a pacemaker, it’s probably not going to have any role in delaying his death. It won’t stop a lethal rhythm, and once he has a lethal arrhythmia the pacing won’t be effective. If it’s an ICD also they may consider turning off the shock therapies since he’s at the end of his life, but if it’s not they probably won’t make any changes. Pacemakers can help improve quality of life at the end of life for some people, and it won’t prevent death.
I found out he passed away not long after I posted this.
I'm so sorry
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Who has spent the night crying.


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