Pacemaker

[tysylph]

Happy New Year everyone, I had a Cardiologist appointment before Christmas, he recommended me having a pacemaker for AF, has anyone else had one?

[tibetan36]

I'm not sure getting a pacemaker for AF is necessarily right!

I have AF and a pacemaker however it's for Bradycardia.....low pulse rate.

I don't believe there is any device that's made for AF.

Perhaps reclarify with your Cardiologist?

[Nutmeg42]

Hi tysylph

I have just recently had a pacemaker fitted as I was tacky/brady. When my AF was really kicking in, I would get fainting spells. I had a halter fitted for 24 hours and I prayed that it would play up and it did. The results showed that my heart paused for up to 6 seconds and while conscious, hence feeling like I'm going to pass out. Apparently there is concern if the heart pauses for 3 seconds. Now when my heart goes into AF, so far I don't get the fainting spells. I had trouble with drugs that slowed the heart rate due to this. So it doesn't stop the fast heart rate, but gives the heart a kick if it decides to have too long a rest. I think down the track my cardiologist wants to do an ablation and hopefully have me off all drugs.

[pottypete1]

For a pacemaker solution for AF, they ablate the AV Node and the pacemaker then takes it's place providing the electrical impulses.

It is a radical solution in my view, as once done you rely solely on the pacemaker.

For me, despite the fact that I have had 5 unsuccessful RF ablations, I have decided that it is not an option I am prepared to accept as I fear relying on a mechanical device.

I also have severe skin allergy problems that are caused by numerous triggers such as cardioversion and ECG pads and I am worried that my immune system will kick in and cause an allergic reaction.

Having offered my personal feelings I am very aware that an AV node ablation and pacemaker have been successful for many so I hope you get some feedback from others who have first hand experience.

Best wishes

Pete

[Harboreyes63 in reply to pottypete1]

I have a pacemaker as I had Sick Sinus Snydrome....my heart would go up in the 200's then stop. You have to be careful when having a PM, that you have a great electro physiologist cardiologist. Mine set my pacemaker incorrectly and almost killed me. I am not certain who your companies are there for pacemakers but here in the states most use Medtronic. When one is put in one of their reps have to be in the operating room. They are experts and thank God I had a Dr in one of my intensive care visits who called them in...They immediately saw the problem and fixed it. Reset the PM. The Dr had talked to me about AV node ablation which I said no! However I did have a cyro ablation a year and half ago and knock on wood no AF since.

It is a comfort in having a PM as I know my heart can't stop beating if it goes crazy again time after time. Best of luck to you. I know how difficult these decisions are.....

[tibetan36 in reply to pottypete1]

AF still happens in the Atria and never goes away. What does happen is the Ablation allows the Ventricles coupled to the pacemaker pump the blood in a "normal" manner therefore getting the blood around nice and easy. End result is much more energy and feeling like doing things.

My EP told me they leave a tiny piece of the AV Node as a backup in case of any problems with the pacemaker.

Cheers

Barry

[CDreamer]

I think you need to clarify between a pacemaker which would not be fitted for AF but for something like sick sinus syndrome (Brady/Tachycardia) and the Pace and Ablate for AF which is as Pete describes. A regular pacemaker may help preventing AF starting but it rarely stops episodes altogether and is never the reason for fitting one, is my understanding. My husband had one fitted for SSS and it improved his QOL and he had no AF for about 18 months, then he had some episodes with reduced symptoms.

The first is a 45 min procedure with a local anaesthetic, the second is much more involved as Pete described. My understanding is that it doesn't stop the AF but it does control the ventricles so that quality of life is improved as that will reduce symptoms.

[BobD Volunteer]

A pacemaker may take over running the ventricles but the atrium will continue to do what it likes and you may well still feel it as many people do.PMs are usually used for bradycardia when the heart runs very slowly or stops from time to time. Pace and ablate as described above is a last resort when ablation has failed. I would be inclined to ask for a second opinion from a specialist in arrhythmias such as an electrophysiologist.

[jossikins]

Hi Tysylph,

I had a Pacemaker fitted almost two years ago, for persistent AF that was not responding to cardioversions. So, it was recommended that I have an AF Node Ablation done and the PM fitted. I am now totally PM dependent, but It has been nothing but a miracle worker for me.

I have just been in hospital with septicaemia, brought on by a bout of pneumonia. In an attempt to determine the source of the septicaemia, I had an echocardiogram. All is absolutely fine in that department, PM notwithstanding, and I have now made a full recovery.

During the first month after the PM was implanted, I had no energy and was dismayed at how exhausted I became with minimal effort. What they failed to tell me was that they set the PM response at a low level (80bpm) to give the heart a chance to heal fter the procedure. At the end of that month, I had the upper level of the PM set athi120 bpm, the lower at 60. A bit later the upper limit was set at 130, which suits me absolutely fine. If my heart rate were to go above that, I would simply tire out until my pulse fell to below 130, allowing the PM to kick in again. However, I have never put that to the test because, although I hill cycle and swim and walk a lot, my heart rate never seems to go significantly above the limit. I know that it can be set higher. I had mine at 155 for a while but it was decided that wasn't necessary because I am 77 years old, and although a very fit person in spite of my AF, I am not a competitive athlete so it was reset at 130. For a younger, more active person, it could be set higher.

I cannot speak more highly of my Pacemaker. Whatever AF still exists, I am unaware of it and can go blissfully about my comparitively active lifestyle. The PM is checked regularly so I am not at all bothered that anything could go wrong with it.

The only medication I now take is a daily dose of Warfarin, which is a very small price to pay for the resumption of a rewarding life style, and the assurance that I will never go into a debilitating and scary bout of AF again.

I wish you well.

Jos.

[Buffafly]

When I started having pauses in my HB while on meds for AF and Flutter my cardiologist said that 10 years ago he would have recommended a pacemaker but now ablation was an option, if successful I could come off meds except anticoagulant. So I had the ablation, it has been very successful so the pacemaker has been put off. If I have a troublesome episode of AF I will have to go to A&E because I am not allowed to take any meds except under medical supervision and if the pauses reoccur the I guess the pacemaker will be necessary.

You don't say what your history is but if you 'simply' have AF then perhaps you should see an EP in case your Cardiologist is not up to speed on developments in AF treatment?

[Mike11]

If your AF is known to be restoreable to sinus rhythm using cardioversion you might like to consider having one of the new cardiac defibrillator ICDs instead. It is like a pacemaker but sits there doing nothing until it detects you are in AF for about 10 minutes, then gives you an electrical kick to put you back in sinus rhythm. It was only approved last year so I suspect most cardiologists aren't aware of it, so advice is to see a proper electrophysicist and ask what he/she thinks best.

medtronic.com/us-en/healthc...

[Buffafly in reply to Mike11]

Very interesting! Though I should think you would not be eligible for one of those unless you were first having long pauses or in danger of cardiac arrest?

[Mike11 in reply to Buffafly]

I suspect that will indeed be the case.

[jackonly]

hi i had one in august my heart rate was to slow not painful and feeling ok

[walker66]

I had a pacemaker fitted and then a fortnight afterwards had an AV node ablation for af. I wasn't given any other options and from finding out I had heart failure, then af everything was like a whirlwind and within 2 months all completed and have felt better with my af controlled (?) than beforehand. I have just spent 2 weeks in hospital over Christmas with my heart failure playing up badly so I wish now there was some cure for that! Want everything us don't we! Good luck and a healthy new year to you whatever happens!

[Polski in reply to walker66]

You could try reading Dr Stephen Sinatra's 'The Sinatra Solution: Metabolic Cardiology' which suggests ways of helping heart failure.

[walker66 in reply to Polski]

Thank you very much for this reply, I shall certainly give it a try.

[Dramlouie in reply to walker66]

I also recommend Dr Sinatra and other natural health publications, ie Hushed up natural heart cures. Supplements are recommended. I had a heart attack and found Dr Sinatra and his recommended supplements after a heart attack, I take them daily to look after my heart, the ones I take are D-Ribose, Taurine, L-Carnitine, CoQ10, magnesium. He also sells good supplements for the heart and has a good website.

[tysylph]

Thank you all who replied re pacemaker, I should have also mentioned Cardiologist was worried following 24hr monitor reading, bradycardia was shown during sleep, immediately stopped Digoxin, but still on 75mg Bisoprolol + Warfarin & Statin.

Your replies have been a great help, thank you.

[Hidden]

Im on my 2nd pacemaker in the last 12 years

Still have episodes of AF

[Lisajack1 in reply to Hidden]

Hi. I have been advised I have to have a pacemaker in the next week or two. Am scared re the whole thing. Can you outline your thoughts pls as having bed. Through it ?

[Hidden]

Hi after major heart surgery my heart kept playing up bradycardia tachycardia SVT . After a holster test showed I'd had 70 pauses for up to 8 seconds a pacemaker was discussed. Due to the surgery to remove benign tumour and a cox maze procedure it was decided the heart needed more time to recover. All drugs were stopped and as long as I did beggar all I was fine. However just walking made me very bradycardic quite quickly. After 8 months we all decided my heart wasn't recovering to pre op status . A pacemaker was fitted set at 60 beats it was wonderful. After a while another part was activated so if my breathing rate increases I am paced up to 125. I'm now on bisoprolol and flecainide which is reasonably controlling my AF and other odd beats and arrythmias. I go to the gym 5/6 times a week for an hour at a time. As others said not used for AF but good for other reasons .