צום יום כיפור עם בעיות לב

Rav Mordechai,

A patient of mine has hypertrophic cardiomyopathy with a malignant family history (grandfather who dropped dead, father s/p cardiac transplant) The patient is a Ger Tsedek now learning in kollel, who I had a implanted cardiac defibrillator implanted.. We alway tell such pateints to have their children screened (genetics is AD). He wants to know what is Daas Torah about that. The usual presentation in his family was in the 20's with arrhythmias that caused sudden death.

2 He wants to know about fasting on Yom Kippur. Fasting will worsen his volume status and his stroke volume. However, with an ICD the worse case is that he will get a shock from the ICD from a lethal arrhythmia and /or will be more short of breath. What would you say?

Gut gebenched yohr

Hillel Steiner