AF and Pacemaker

[Bluejkm]

I have AF diagnosed 3 Years ago , last year I had complete heart block and had a pacemaker fitted. I had 3 days where I had long periods of AF should my pacemaker have kicked in? I know it regulates my HB when it is too fast but how about when it goes slow. Glad to know any one else’s experiences

[Hidden]

Sorry, does HB mean heart beat or heart block? Presumably the former.

What sort of pacemaker do you have, single or dual chamber, is it programmed for atrial overdrive pacing?

[Bluejkm in reply to Hidden]

Sorry HB meant heart block I have dual chamber pacemaker. Don’t know what it’s programmed for only that it’s supposed to be 60 heart beats per minute

[Hidden]

I wonder if you have misunderstood your pacemaker. The main function will be to manage any current or future symptoms of your complete heart block. These are associated with slow heart rate. You may have another wire to attempt some control of your AF.

A second advantage of a pacemaker is that it allows your EP to prescribe rate/rhythm control meds for your AF which might otherwise make your heart go too slowly.

Clearly, only your doctors know the specifics of your case. Your GP should be able to answer the question about your pacemaker controlling your AF.

[opal11uk]

The Pacemaker does not mean you will no longer have A/F, when I had mine fitted I was given drugs to control the A/F, that was 3 years ago and the combination now means no more A/F (keeping fingers crossed!). The Pacemaker will keep you at 60 beats per minute and to my knowledge will not go lower than that (duel chamber) the drugs are to help prevent it going higher with A/F

[JonathanPittsCrick]

If you still get episodes of rapid irregular heartbeat it means that either:

1 – your heart block isn't complete all the time, or

2 – your pacemaker is getting confused by the AF

You should have a pacemaker check which will show what the problem is. If (1) you could take more slowing medication of have a "complete AV node ablation"* which is relatively simple and usually very successful but may leave you dependent on the pacemaker (which is OK as they are extremely reliable). If (2) the pacemaker can be programmed to "DDIR mode" so it won't get confused.

*If you already had AV-node ablation it may not have been completely successful in your case and it can be done again quite easily.

[Bluejkm]

Thanks everyone you have all been a great help.