Pacemaker

[farmerwalt]

Visited Pacemaker EP today at Royal Jubilee Hospital in Glasgow to discuss Cardiac Resynchronisation Therapy (CRT), pacemaker. This is a dual chamber, (ventricular) pacemaker. Had ecg and echo done first. Ecg shows still persistent AF and echo now showing both atria dilated due to the af. So the heart failure continues to progress. The EP also showed me an ecg from just over a year ago showing a short burst of self terminating VF. My Alivecor traces occasionally show what I thought was just noise but am now wondering if it is the bursts of VF. Will need to email the traces to the EP and see what he says. He was very interested in my monitor and initial comment when I showed it to him was "oh! you've got one of these"

He discussed the two types of pacemakers, pacing only and pacing with defibrilator. My problem is - he is leaving the choice of which one to me. Anyone have experience of either type?

After explaining the pros of both types he then explained the cons.

Pacing only :- no driving for two weeks after fitting

Pacing with de-fib :- no driving for one month after fitting plus, if the defib kicks in while driving then no driving for anywhere between six months to a year. Not a very good option since I live on a slightly remote farm and need the car to get around.

He reckons a maximum wait of three months to have the pacemaker fitted.

Would welcome any comments.

Walter.

[CDreamer]

Difficult choice but it is not all about your driving, it is also about your health and prolonging your life and quality of life. If you are showing signs of VF that has far more serious consequences than AF anyway.

I can only sympathise as I don't have a pacemaker, nor have to make that difficult choice, although hubby does but he has the none defibrillator kind as it is for bradycardia.

[farmerwalt in reply to CDreamer]

Hi CDreamer,

Thanks for your reply. One thing at the back of my mind is the saying that AF begets AF and wondering if the same applies to VF. If that's the case then I think the CRT-D will be the one to go for. Been trying to contact a friend of my son that lives in London to get his comments on it. He had the pacing only pacemaker and then had to upgrade to the one with the defib. Hoping to find out more from him.

Walter

[cyrilbarnes]

Hi Walt, as CDreamer says, VF is dangerous; if the pacemaker doesn’t control your rate and it isn’t self-terminating, then you go into cardiac arrest and there is no return. The defib bit gives you an extra safety net, and if needed you literally can’t live without it. I have an ICD due to a diagnosis of Brugada Syndrome; AF reared its ugly head a couple of years later and is more of a pain due to beta-blockers and warfarin now being necessary. The pacemaker side doesn’t always manage to control the rate and I have had a couple of ‘inappropriate’ shocks which they say were AF rather than VF related – but with a pulse of 225bpm, whether it’s the atria or ventricles at fault it obviously needs to be stopped! If it were me I would go for the CRT/ICD option. Better to be safe than for others to have to show their sorrow.

[jossikins]

Hi, Walter,

I only have the experience of a pacemaker because of AF in one atrium only. From the little I know, AF is an inconvenience with potentially dangerous consequence, ie; stroke, but Warfarin deals well with that. VF, on the other hand, NEEDS to be dealt with, immediately and, even if you have had only one self-terminating incident, I would, personally, go for the defbrillator. You might have the inconvenience of not being able to drive for a while, but at least you will live to tell the tale. If the GP or EP is leaving the choice up to you then that would suggest that VF is not a likely threat, but I would get a second opinion on it. Good luck, really! Let us know the outcome.

Jos.

[BStanding56]

I had Pacemaker fitted 2 years ago, I am a new woman, my heart is now almost normal , 6 years ago I was told it was seriously damagedxx

[JMM7]

I've had 2 ablutions. Still had to take medications and still had with severe AF.

My heart was stopping for up to 10 seconds to try and reset itself correctly. (As shown live feed to my cardiologist via monitor.) Scared everyone. Finally agreed to a pacemaker and had the procedure the very next day. Duel chamber - pacer only. Set with parameters of low 60 and high of 100. That was a year ago next month. Tests have shown AF is happening still but lasts a second or less and I don't even know. It's like a new life! I only wish I hadn't let vanity (you can see it under my skin :/ ) hold me back 10 years ago!

[farmerwalt in reply to JMM7]

Hi JMM7,

Thanks for your reply. From the above posts, looks like it's time I was paced and looks like probably the CRT-D one.

Walter.

[PeterWh]

No brainier from my perspective. Go for one with defibrillator. In may not be of much necessity in the next year but what about in the future? If you are in the wrong place defibrillator option could very easily save your life!!!!

[farmerwalt in reply to PeterWh]

Hi PeterWh,

Yes, looks like that's the way I will be going. My son was saying that if the cardiologist, (the pacemaker one), didn't think it was necessary then he would not have mentioned it. Since he gave me the option he obviously thinks it is fairly low risk at present but could progress in the future. Going to see my EP on the 8th, June to quiz him about how it's likely to progress. So the final decision will be taken then.

Walter.