Pace and Ablate in 5 weeks time.

After a lot of discussion and analysis I have decided to go for a cardiac resynchronisation therapy (CRT) (Pace and Ablate with an extra wire). CRT resynchronises the contractions of the heart's ventricles by sending tiny electrical impulses to the heart muscle, which can help the heart pump blood throughout the body more efficiently.

The hope is that this will take some of the strain of my heart and improve my QOL. It wont fix my AF but should make the symptoms more bearable.

It means that by Christmas I should be off Amiodarone and Bisop. and on Anti Coag and Ramipril.

One comment from my EP that surprised me was the question of risk. My EP wasn't worried about issues surrounding battery life. Risk, as far as he was concerned was more concerned with the times when the battery was changed and the risk of infection to the wound. I just hope they wash their hands before they start cutting !!

[azriverrat]

I think they leave just a bit of connection so if pacemaker gives out heart may still beat even if slow. Still need hospital then urgently.

[farmerwalt]

Hi Ogilvie,

It's two years since I had my CRT-D pacemaker fitted. I didn't require the ablate since I have left bundle branch block, LBBB, and my HR was always low, even with my persistent AF. With the CRT the pm is pacing continuously so the expected battery life is between 5 and 7 years. With the regular clinic checkups they will be aware when the unit requires replacing well before the unit stops working. When the pm is replaced, it is only the unit that is replaced, NOT the leads that go in to the heart so the risk is lower than when the original implant is carried out. Even if the unit did fail, there is a natural pacemaker in the lower part of the heart that will keep the heart beating, albeit at a rather low rate. It would still be an emergency situation and would call for the "blues & twos" to A&E.

Since I am a candidate for SCA, and paramedics wouldn't get to me quickly enough, because of where I live, I opted for the CRT-D.

I have the St. Jude pm and there was a problem with premature battery failure with some of their units so I now have a remote monitor at my bedside that automatically sends in reports if it detects anything unusual. (The wonders of modern technology, I'm being spied on 24/7).

I had my pm fitted at The Golden Jubilee hospital in Glasgow and the staff there were excellent. Where are you having yours done?

Please do pm me if you have any further questions.

Walter

[Hidden in reply to farmerwalt]

Hi Farmerwait,

I have read all your posts. Like you I'm also a candidate for SCA (Ventricular Fibrillation (VF) or Ventricular Tachycardia (VT)) and will have the CRT-D fitted.

My EP told me that CRT reduces the impact of all arrhythmia's and although no formal data is available he thought it highly likely that it would also reduce the possibility of VF / VT.

I have heard that the St Judes unit had issues over battery life. Apparently, in Scotland, we always use high end Meditronic or Biotroinic kit. I'll keep an eye open for what they plug into me!

I'll certainly drop you a line to let you know what happens.

Cheers

Ogilvie

[azriverrat in reply to farmerwalt]

One reason besides my younger age was risk of pacemaker failure. We live in Southwest US. Tend to camp and hike in the forest. Air evac would be needed and would hate to see the bill.