Did anyone here have a special pacemaker implanted to stop AF episodes quickly and did it work? I do NOT mean the normal pacemaker implanted after AV node ablation. Would be grateful for information.
I just found that possibility online a few days ago and a cardiologist in my hospital said it still is done but does not work on everybody (what does??).
Can you give us a link to this procedure ? I'm seeing my Cardio on Weds and I'm going to ask for a PM+ meds rather than the ablation I'm on wait list for.
ncbi.nlm.nih.gov/pmc/articl...
The important words are dynamic atrial overdrive. My AF is not caused by brachycardia, where the pacemakers usually were implanted. I have a rather fast heart rate.
I also run a bit fast average around 80 but apparently also have bradycardia as well so they can't give me any medication, complicated further by Wenckeback and MVA. Thanks for the link, off to read it now.
My information was wrong it seems, the cardiologist talking to me just a young assistant. Her boss told me weeks later that this pacemaker is no longer used for this intent as it did not work well.
I have only skimmed the article as
1. It seems this article is very old & PM technology is now much more advanced.
2. It is very technical & I would need to research to fully absorb all the nuances as I’m not medically trained
3. I would hope, in fact I know, that PM would ALWAYS be implanted after AV node ablation.
Personal Experiences
I had 3 lead ReSynchronisation PM implanted prior to AV node ablation in Oct 2018 - the LV lead had to be deactivated due to poor placement so I ran on dual atrial pacing for 8 months. From having very symptomatic AF 3-4 x week - I had no AF episodes for several months. My experience was no AF - until I had a virus or infection & that now is my norm. So for me, it was partially successful.
My understanding that success is as much to do with getting the right PM and getting algorithm correct for the individual - which is sometimes trial & error - sometimes to do with knowing underlying cause of AF & sometimes just pure luck (currently unknown reason).
I had a PM revision & Resynchronisation therapy is now working & my situation is much the same - when well no AF. I have had a few episodes recently as I have had a persistent cough for 5 weeks but all have been much less symptomatic & short lived.
I go for my 6 month check in a week or so which will show the % of time in AF so that will be interesting.
My EP told me that he had a few patients who had PM in preparation for AV node ablation which had stopped AF so, like me, then postponed AV ablation. My understanding is that pacing as a treatment for persistent AF is being reviewed, but it’s not generally offered as treatment for AF, especially fast AF, which what I had.
Interestingly - I can now be in slow AF which is big change ie:- HR 70-75 which is far more bearable.
Hope that helps.
I just reread my post - my apologies - sentence 3. should read “PM is always implanted PRIOR to AV node ablation”.
I’m really sorry if I misled anyone.
That sure helps a lot, thank you very much. Especially your remark about the slow AF being bearable. I read about a few people in another forum, who still felt the AF after AV node ablation, which one of the younger docs I talked to denied being possible. But I think I believe the patients rather than a doc.
Have PAF now over two times a week and always about 24 hrs. Just too much. Have to do something.
I must ask you something, as have had new information. What exactly do you feel now with pacemaker when you are in Afib? Do you feel it or do you just know it is on because the doc tells you or the pacemaker somehow?
Because my doctor told me that basically one can still geht Afib on the pacemaker, but should not notice?! He explained as follows: In Afib your atria go at a pace of about 300 or more per minute. THAT is NOT what you feel or I feel, definitely not. What we do feel is the arrythmia"transported" to the heart (via the AV node I think) and the irregular heartbeat caused by that, which is much slower than the basic fibrillation causing it, even though still too fast in many cases. And AFTER a pacemaker is in, the chambers of your heart can only do the rhythm of that pacemaker, so cannot be irregular any more and one should only feel that.
So please tell me if he is right or what is going on in your case. Thanks.
I've had my pacemaker for just over a week and I still feel the irregular rhythm, it's only set to kick in when my heart rate drops to low so won't help with the Afib, I'm taking Bisoprolol to lower the rate but still getting ectopics and Afib.
Was your AV node ablated?
No not yet, they want to see if meds will work, if not then node ablation at some stage.
My PM is called ReSynchronisation therapy so is different to Bantam’s which I believe was to treat Bradychardia.
At the moment my PM paces LV - left ventricle + RV - right ventricle - to keep them synchronized & the point is that once the AV node is performed - the PM paces the heart therefore THE PULSE remains regular whatever the atria does it won’t affect the ventricles.
At present PM has stopped most of the AF & seriously reduced the symptoms I experienced with AF ie: HR 180-200, BP dropping to less than 60/40 making it impossible to sit up never mind stand a lot of the time.
P M doesn’t always stop the AF and you still feel the palpitations, I just don’t feel ill with it nearly as much.
I wrote that post some 2 months ago & things have changed slightly as I have not been very well - persistent cough since Dec - which always affects my heart so had more AF episodes but even so I am much better than I was prior to the PM.
The modern PMs are very sophisticated & can help AF sufferers- but they don’t always stop AF so yes, your EP is correct.
Was your node ablated?
Sorry, I should have been more precise. Question is, can one still feel AF AFTER AV node ablation? After PM alone, that is quite clear to me that you should still feel it. But very interesting that your AF burden got less and slighter with PM alone.
Yes
Sorry, yes to what?
Yes - to the direct question you asked - if you have AF you will still feel it (if you do) after the AV node ablation. It won’t stop the sensations of AF - all it does is disconnects the electric connection from atria to the ventricles so the atria may still be going at 300 beats per minute but the PM will control your ventricles so your pulse will be regular at whatever it is set at. The settings are usually adjusted for tolerances so your HR will increase when exercising - Ie: the pulse will remain steady and regular as explained in my first reply so it may reduce symptoms of AF but not the AF itself.
CDreamer- I do not understand HOW? If what I feel now are the ventricles getting irregular, then I should feel nothing when they are regualr. And one definitely does not feel the 300 beats from the atrium, at least I do not. So AF might be on but should not be felt? How do you know if your node was not ablated? Do you know someone who had the whole procedure done?
Yes, I know several people & that was the information I was given - I repeat - both the ventricles will be paced by the PM so the pulse will be regular and the atria will do it’s own thing and you may still feel the palpitations but your pulse will be regular.
I’m sorry you don’t understand - perhaps you should talk again with your specialist.
Thank you. So you were told that they still feel AF, that is bad. I still wonder how palpitations can be felt which are not reflected in your pulse. Specialist told me, I could not feel them after AV ablation. I do not believe in docs any more, but still...I wonder, his explanation sounded logical.
I have found several people here who say they do not feel AF any more, they are just told it is still on.
Everyone is different - many people walk around not knowing they have AF so never feel it. There is no one for all.
Hi Jon,
if you read the link you will see that pacemakers are (or were?) also tried on patients with normal heart rate.
I am sorry Jon, but I beg to differ! I had an implanted defibrillator and pacemaker for a different reason than AFib, but later experienced AFib so my device will provide therapy for that if needed. I've never had an ablation, but my sister has, and it did NOT cure her AFib as she continues to have it afterwards. For some, a "simple" ablation may be an effective and permanent fix, but not for all.
Not so, I haven't had an ablation and not on any meds but a pacemaker is one of my options as my EP thinks an ablation is unlikely to resolve my symptoms.
I have never had an ablation. My problem was I would go into AF maybe once a month and pass out when I converted to normal rhythm. My pulse would drop to 38 bpm. The pacemaker was installed March 4, 2019, so my heart would not pause and I would not pass out. Only one short AF since then. They tell me I can still go onto AF but I haven't.
What drugs and why?
Try this - it might stop your afib without meds or an ablation.
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After 9 years of trying different foods and logging EVERYTHING I ate, I found sugar (and to a lesser degree, salt – i.e. dehydration) was triggering my Afib. Doctors don't want to hear this - there is no money in telling patients to eat less sugar. Each person has a different sugar threshold - and it changes as you get older, so you need to count every gram of sugar you eat every day (including natural sugars in fruits, etc.). My tolerance level was 190 grams of sugar per day 8 years ago, 85 grams a year and a half ago, and 60 grams today, so AFIB episodes are more frequent and last longer (this is why all doctors agree that afib gets worse as you get older). If you keep your intake of sugar below your threshold level your AFIB will not happen again (easier said than done of course). It's not the food - it's the sugar (or salt - see below) IN the food that's causing your problems. Try it and you will see - should only take you 1 or 2 months of trial-and-error to find your threshold level. And for the record - ALL sugars are treated the same (honey, refined, agave, natural sugars in fruits, etc.). I successfully triggered AFIB by eating a bunch of plums and peaches one day just to test it out. In addition, I have noticed that moderate (afternoon) exercise (7-mile bike ride or 5-mile hike in the park) often puts my Afib heart back in to normal rhythm a couple hours later. Don’t know why – perhaps you burn off the excess sugars in your blood/muscles or sweat out excess salt?? I also found that strenuous exercise does no good – perhaps you make yourself dehydrated??
I'm pretty sure that Afib is caused by a gland(s) - like the Pancreas, Thyroid (sends signals to the heart to increase speed or strength of beat), Adrenal Gland (sends signals to increase heart rate), Sympathetic Nerve (increases heart rate) or Vagus Nerve (decreases heart rate), Hypothalamus Gland or others - or an organ that, in our old age, is not working well anymore and excess sugar or dehydration is causing them to send mixed signals to the heart - for example telling the heart to beat fast and slow at the same time - which causes it to skip beats, etc. I can't prove that (and neither can my doctors), but I have a very strong suspicion that that is the root cause of our Afib problems. I am working on this with a Nutritionist and hope to get some definitive proof in a few months.
Also, in addition to sugar, if you are dehydrated - this will trigger AFIB as well. It seems (but I have no proof of this) that a little uptick of salt in your blood is being treated the same as an uptick of sugar - both cause AFIB episodes. (I’m not a doctor – it may be the sugar in your muscles/organs and not in your blood, don’t know). In any case you have to keep hydrated, and not eat too much salt. The root problem is that our bodies are not processing sugar/salt properly and no doctor knows why, but the AFIB seems to be a symptom of this and not the primary problem, but medicine is not advanced enough to know the core reason that causes AFIB at this time. You can have a healthy heart and still have Afib – something inside us is triggering it when we eat too much sugar or get (even a little) dehydrated. Find out the core reason for this and you will be a millionaire and make the cover of Time Magazine! Good luck! - Rick Hyer
PS – there is a study backing up this data you can view at:
https//cardiab.biomedcentral.com/a...
How much sugar do you need to stop your afib? The answer is about 1/2 of what your daily sugar limit (threshold) is. My sugar threshold is about 80 grams a day right now. So if I go over that (and it's sooooo easy to do) my heart will start to afib. Then if I cut back to about 40-45 grams of sugar for one or two days, then the heart goes back to normal rhythm and stays there until I exceed my daily threshold of sugar again. (moderate exercise will shorten that time frame). I have gone 30 days under my sugar threshold with no afib once just to prove it is the sugar. And I have consumed my daily limit of sugar every day after going into afib and it stayed in afib for a week - just to prove that worked. So - as long as you know what your sugar threshold is you can control it, but that takes several weeks of experimenting to figure out. I use the following WEB site to know how much sugar is in different foods:
I have a 3 lead synchronisation pacemaker. Unfortunately, it didnt stop
my af and I had to have an av node ablation. I was quite devastated but
to get any relief from the constant af ect it had to be done. It took some
getting used to but Im ok now.
Can you tell me what was difficult? And is AF still on and do you feel it?
This is very interesting information for me. Only I can't do the drugs for arrhythmia.
Thanks, yes, very interesting. That would fit what I was told by specialist.
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