Has anyone had a pacemaker for af - Atrial Fibrillati...

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Has anyone had a pacemaker for af

Julia59 profile image
14 Replies

I had cardioversion done 2 weeks ago and it only worked for 3days now I'm back in af, I don't want ablation as I've heard only bad things about it. Someone told me a friend of theirs had a pacemaker fit for af. I'm due back to clinic in about 2 weeks and wondered if I should ask about it.

Thanks julia

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Julia59 profile image
Julia59
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14 Replies

Hi Julia59 I can only give you my experience of what I was told.I,ve had both done,I was told I needed to have a pacemaker fit as my heart missed a beat every so often so this could cause a clot to form and I had to have the ablation this is to do with the electric signals going all over the place causing my symptoms heavy heart beats tiredness breathing problems etc.Niether procedure was at all bad and I certainly feel a lot better now

jennydog profile image
jennydog

My EP is yet to decide whether I should have ablation or a pacemaker. The latter procedure is called "pace and ablate" and involves destruction of the AV node thereby making you totally dependent on a battery. That needs some weighing up. I am hoping that the new insert pacemaker will be an option.

mumknowsbest profile image
mumknowsbestVolunteer

Hi

Pacemakers actually stop the heart beating too slowly, they dont actually stop the AF. When I had mine it was so that they could give additional meds without the heart going dangerously slowly, I still had bouts of AF and in the end I had a pace and ablate, it has helped a lot but it is not something to rush into, I would say it is the last resort especiallty as you are young and at present pacemakers have to be changed about every 10 years so that all has to be considered. I cannot imagine them doing a pace and ablate untill they had tried and ablation, I dont know what you have heard, there are always bad stories about everything but a lot of us on here have had ablations. So mine didn't work permamently but they gave me a few years in normal rate before I had the pace and ablate. Talk to your EP and see what he recommends but I certainly wouldnt rush into pace and ablate cos it cant be undone

RRegards

Eileen

Julia59 profile image
Julia59

Thanks everyone x

lizwright profile image
lizwright

It's hard to understand why you would take notice of the bad things you have heard about ablation rather than the arryhmmia specialist. You won't see many bad things on this site. Most of us have had one, two or even three ablations and I wouldn't hold down a full time job and look after 12 ponies if they hadn't have done this. I'll never be right but I am loads, loads better than I was. You have to be ablated for a pace maker anyway.

BobD profile image
BobDVolunteer in reply to lizwright

Great post Liz. Couldn't agree more.

lizwright profile image
lizwright in reply to BobD

Thanks, once I was referred to Papworth then I took their word for it and we worked together. Personally I didn't want to have a pace maker although they really work for some people, because I am 57 and my heart functions acceptably on its own now thanks to the ablations so I wanted something in reserve...

I have had a pacemaker implanted, and then 3 ablations, over a period of about 3 years. The last one has been brilliantly successful. At my pacemaker checkup last week at the hospital, the reading was 0.0?% fibrillation since my 3rd ablation last August 2013. I feel really well and no nasty episodes. If I was a bit younger (70) I might try for a half marathon! Best wishes to you and from my own experience an ablation has really helped me.

realdon profile image
realdon

Hi Julia

I start with the usual caveat that what I have no medical qualification and can only speak to my personal experiences and what I have read on this site or the AFA website.

No reason at all why you should not ask your EP about the role of pacemakers in dealing with AFand whether in your particular circumstances a pacemaker could be helpful, but it is important to understand that a pacemaker on its own does not cure AF and is not an alternative to other forms of management including ablation and medication. And it is not true as Liz states that you necessarily have to be ablated before having a pacemaker, although it is true in the case of "ablate and pace." I have not had an ablation but I do have a pacemaker because I was having dizzy spells and blackouts, and the 7 day tape revealed that my heart was stopping beating for between 3 and 10 seconds when I was coming out of an AF episode. My blood pressure is low and my resting heartbeat before the pacemaker was below 60 unless I was in an AF episode when it rose of course, so the combination of all these factors was the indication for a pacemaker in my specific case.

I had the pacemaker fitted in January 2013 but have not yet been ablated, and I continue on medication. I have had no blackouts or dizziness since I got the pacemaker. One of the EPs in the arrhythmia clinic I attend did suggest an ablation, but at my most recent visit another EP thought it better to wait and see and to consider ablation only if things get worse. At the moment I get short episodes of AF every 2 weeks or so but they don't really bother me much, so I am waiting and seeing but if things get worse I will review the ablation option.

So as I understand it, in my case the pacemaker will kick in if my heart rate falls to a level low enough to trigger a faint or dizzy spell, which otherwise might happen in view of my natural low resting heart rate and blood pressure, coupled with the effect of the bisoprolol which can further reduce the rate.

The pacemaker seems to keep my resting heartbeat at 60 bpm (of course the rate rises during an AF episode) and has the advantage that it records the episodes of AF, so that there is concrete evidence for the EPs to review when necessary.

This is all quite different from "ablate and pace" which I understand involves completely destroying the AV node by ablation and then installing a pacemaker, following which the heart is entirely reliant on the pacemaker to control pacing. "Ablate and pace" is of course different from "AF Ablation" which is what many posters on this forum have had, which does not involve complete destruction of the AV node and therefore does not require a pacemaker.

Michael

37Polly profile image
37Polly in reply to realdon

Absolutely agree with all. I have never been ablated. Have had pacemaker for two years. It functions about 88% of the time…keeping my hr at 60. But when I have afib can go to 200! The pacemaker allows me to take major beta blocker to bring it down but not too low!

Patricia1 profile image
Patricia1

I am at present waiting to be fitted with a pacemaker to hopefully stop presyncope (near faint) when I go from AF back to normal rhythm

37Polly profile image
37Polly in reply to Patricia1

Sounds like a perfect fix…has worked for me. Good luck.

doramar38 profile image
doramar38

Hello, Julia.

I had an ICD defibrillator device implanted in 2015. It doesn't stop AF. My cardiologist put it in because I just happened to be going through a particularly severe episode of AF on my appointment day for an echocardiogram. He was so concerned at the rate my heart was beating, he had me admitted to hospital immediately. After 5 days, he advised me to have the implant. So a later date was sent to me for the procedure to take place. I was to have a 3 lead connection, but during the procedure, he slightly perforated my heart and I was instantly in such agony, he had to halt the operation! He'd only connected 2 leads when it happened, so it was left at that. I'm happy to say I recovered from his error. None of the various medications have been helpful. I experience AF every day, sometimes more than once a day, so I will be having an av node ablation sometime in the next few months. Thousands of ablations are carried out and very many are successful. So I'm going for it. Don't be put off by negative reports. All the best.

skybluepink profile image
skybluepink

I have a Reveal Device not Revealing anything except Pre-Capillary PAH - the alarm went off .All I have had as a result is diuretics & rivoroxaban.Meanwhile all other conditions are becoming more disabling yet having no monitoring or assistance as I have to return to London once a year for appts.

For last 5 yrs been here in Stroud, Glos .Are You nearby?

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