Need advice re pacemaker.

[Appelonia]

It was diagnosed with AFIB 2.5 years ago, & it has been persistent since Dec. 2018. I have had numerous conversions, been on and off a multitude of meds, & had an ablation in March of 2019. Nothing seems to keep me in sinus rhythm, & it's a struggle to keep my heart rate below 110. A pacemaker has been mentioned & from what I read it seems to be a low risk, highly beneficial intervention. I need to hear what others think, pros and cons. If it's so great why dont they do it sooner? I'm 73. Thanks for any in help you can offer!

[BobD Volunteer]

A pacemaker alone will not help you I fear if meds are not able to keep the HR low. It sounds like a pace and ablate procedure (once PM installed and working fine then ablate the AV node) is what they are thinking of. The down side if there is one is that a person then becomes PM dependent which is why it is not done willy nilly.

[Appelonia in reply to BobD]

Thank you Bob.

[Hidden]

Do you know whether the PM will be to prevent bradycardia due to medication, or the first part of a pace and AV node ablation strategy?

[Appelonia in reply to Hidden]

It's to prevent tachycardia. And I will ask about the 2nd part. Thanks.

[Jennyquilt0]

I had a pm put in just over a year ago I am 76 yrs it will not stop you having af but it can be programmed to activate if your rate drops below eg. 60 per minute this is what mine does so I no longer get dizzy I have not had any other treatment except medication. I understand that along with ablation then a pacemaker will be programmed to completely take over your heart rhythm and hopefully this would eliminate your af.

Good luck with whatever you decide.

[Appelonia in reply to Jennyquilt0]

Thank you. That's helpful.

[valg59]

Hi I had a two lead pacemaker 15 months ago ,in Barts still take meds but it was worth having it done, still feel little flutters now and again , but nothing compared to before. Had open heart surgery for valve repair and 3 TIA s but finger crossed feel optimistic now heart rate is controlled x good luck

[Appelonia in reply to valg59]

Thank you for info & good wishes. Same back to you.

[JudyMarieC]

Hello Appelonia, I'm a 72 year old woman in the US. I've had persistent afib since January, 2017, although my EP thinks I've actually had it much longer than that. I had an ablation in July, 2017, and a cardioversion in August, 2018. I'm on Pradaxa, flecainide and metoprolol. In spite of all this, I continued to experience episodes of afib every 5 - 8 weeks. These episodes typically lasted anywhere from 2 hours to 2 weeks and resolved on their own with the exception of one cardioversion. I'm one of those "lucky" people who feels every irregular beat. Since the ablation, my heart rate began to slow - typically in the 50s. I suffered from fatigue was constantly out of breath with minimal exertion. My EP indicated that a pacemaker would most likely be needed at some point due to sick sinus syndrome. On March 14, while monitoring my blood pressure and heart rate during an episode of afib that was going into it's second week, my heart rate dipped into the 30s and stayed there for a couple of hours. I went to the emergency room and wound up having a pacemaker the next day. When the pacemaker rep met with me, I asked him about its effect on afib. He said the pacemaker would try to override the afib if it can do so when it first starts. My afib was still going on when I was discharged but once I was home, I had some weird palpitations but a few hours later the afib had stopped. I don't know if that was due to the pacemaker or it just happened. At any rate, over the past 6 weeks since receiving the pacemaker, I have more energy, can actually take a walk for the first time in 2 years, and generally feel much better. Occasionally, I can feel afib start up, but so far the pacemaker seems to override it and the irregular beats only last less than a minute. It's such a change from what I've been experiencing for so long. I hope it continues. I'll see my EP this month and will be anxious to get some statistics on the functioning of my pacemaker. I have a bedside monitor that will alert my EP if necessary and there is also a phone app available. I can also send a reading if something feels off. So, long story short, my experience with the pacemaker has been nothing but positive. I wish I had had it sooner. Best of luck!

[Appelonia in reply to JudyMarieC]

Thanks JudyMarie. I'm glad it's been such a positive change for you. Very encouraging.

[JudyMarieC]

I forgot to mention that I also had bouts of atrial flutter during which my heart rate doubled. My EP said that the pacemaker would help with that also. I did not have an av node ablation.

[Journey1948]

Good evening, I had AFib for 18 years. I had two regular ablations - never helped. Flecinide for 18 years. That stopped working. My Electrophysiologist gave me two choices- pacemaker was his second choice and in his words a last resort. His first choice was a Convergent Hybrid Ablation. I had the surgery done last August 8th, 2018.

I have been AFib free since then. I was 70 last year.

My surgery was done at the Washington Hospital Center by my Cardio Thoracic Surgeon and my Electrophysiologist.

Hope this helps.

[Appelonia in reply to Journey1948]

It does help. Thank you so much for sharing your experience! Where is Washington Hospital?

[Journey1948 in reply to Appelonia]

Good evening, Appelonia, I had my surgery performed at the Washington Hospital Center in Washington DC

This is a MedStar facility and works closely with The Cleveland Clinic in Ohio. Both facilities are leaders in the Convergent Hybrid Ablation

If you live in the area, I can email you more information

Happy Trails

[Appelonia in reply to Journey1948]

Thanks for this info! I'll definitely research it. I'm glad the Convergent Hybrid Abaltion has been so successful for you!

[cuore]

Since you have had only one ablation when you were four or less months persistent, are you choosing not to have a second ablation? For various reasons, it is very common to have two or more ablations if you have been allowed to go into persistent. Furthermore, your ablation is barely two months old. I'm 76 and my EP told me I was too young to have a pacemaker. Of course, in a socialistic system, a pacemaker is a way to get rid of you if you are older. I would think carefully first.

[Appelonia in reply to cuore]

Thank you for your thoughts and concerns. I definitely plan to think this through very carefully. I know I need more information.