Pace part of pace and ablate

[dedeottie]

Ok so I have been told by the pacing department that I will be called in for pacemaker insertion in the next month. The ablate part will not be done for at least another 2 months.

Although I know this is the right and infact only way forward, I can’t help but be a little nervous. Because of covid, I have had little chance to talk things through with my consultant and the arrhythmia nurse is very busy and doesn’t really know the answers to my specific questions. I am sure I will get answers when I go for a premed but I need time to precess things!

So, for any one who has had this done or knows the answer anyway here is my first question….. there will probably be more in the next week or too( sorry in advance):

Will the pacemaker be left inactive till the ablate procedure or will it be programmed to do something? I know some of you have said the pacemaker alone has helped but then I read somewhere that it would only be activated when the final bit was done,

Thanks in anticipation x

[Palpman]

I don't have a pacemaker but I'm sure someone who had a Pace and Ablate will answer soon.

The pacemaker will be inserted first for the wires to permanently attach themselves to the heart muscle.

Only then will the ablation be performed and the pacemaker switched on and programmed.

They need to be certain that the wires will not move out as the AV Node will no longer operate.

It sounds scary to think that your life now depends solely on the pacemaker.

This is not so as should the wires detach or the pacemaker fail then the heart has an emergency pulse that will keep the heart pulsing until you get to hospital. This pulse is slow but is good to know that you have a failsafe system.

[dedeottie in reply to Palpman]

Thank you Palman, I really appreciate your reply. Yes that all makes sense. Hopefully I will get as date for a premed soon and then I can bombard them with my questions but till then I will be pestering folk on here ! X

[Prettyorchid in reply to dedeottie]

I had a pace & ablate at the same time in April. 3 lead PM. Overnight in observation, I was very concerned about the AV node ablation. I was assured, like the other post, that there is a backup system. You will feel poorly, but will be able to get to ER. My PM is monitored by Bluetooth on my phone 24/7 and each month a report is sent to CC. I had a few bouts of AF during the first month, (per the report), but no symptoms. My app says I have 7 years 11 months of battery life left. Getting more high tech each year.

[BobD Volunteer]

My understanding is that the PM is fitted and activated fiirst. ONLY when they are satisfied that it is working correctly will they consider the ablate part of the equation.

[dedeottie in reply to BobD]

Thanks Bob. I’m glad they are giving time to make sure it is working I must admit. X

[Eliza2]

Hi dedeottie

I had this done. You will get first setting after pacer inserted than they will change it after being ablated. It’s all good. Finally my tachycardia gone after 3 unsuccessful ablations. I know it’s distressing to think about but really it was the the best thing! Feel free to PM me if you care to chat more about it. No one worries more than me and I’m here to tell you it works great!

[dedeottie in reply to Eliza2]

Oh thanks Eliza, you have made me feel much better. I have a few questions swimming round my head so I will take up your offer of sending a PM sometime soon. Many many thanks for that offer. X

[Barb1 in reply to Eliza2]

My tachycardia has obviously gone as well but I am still breathless. Do you have that?

[Diddyd]

Hi I had my pacemaker, a CRT-P, implanted in March this year. It was left switched off until the Ablate part which although they told me would be 4 weeks, it ended up being 8 weeks later.

In this period all my symptoms stayed the same as before implantation and I remained on all my medications. After ablation, I was immediately taken off all my medication apart from apixaban and I started to see symptom improvements slowly. I am four months on and now feel better than I have in two years. Still have a few issues but they are minor in comparison to how ill I had become. My favourite part of recovery was losing 2.5 stone in a week due to fluid and my left ventricle ejection is now at 56% from 30%.

I was in and out of hospital for 10 months during some of the peak times of Covid and I have to say that I felt very safe and well protected. So I would not worry from that point of view.

Happy to answer any further questions you may have 😊

[dedeottie]

Thanks for your reply Dyddid. That is reassuring. As I don’t seem to have problems with low heart rate I can imagine that I will be in the same position as you were in that the pacemaker will not provide any function until the ablate is completed. I have been told there will be a gap of at least 8 weeks to make sure all is ok. You are all making me feel much more confident. More questions may follow at a later date! X

[Barb1]

It is active from the onset but I had mine for high heart rate, so it was not needed until the AV node was ablated.

[dedeottie in reply to Barb1]

Ah ok . Yes that makes sense. X

[Skertchly]

Hospital puts it in and turn it on. Batteries last about 9 years I’m told.?I’ve had a pacemaker for 3 years. No prob. It’s checked each year.

[Geoffa1]

PM provides knowledge to yout medical support team that really informs critical decisions in your health care. Extraordinary bit of technology.

[ETFCfan]

Hello, I had the Pacemaker part of my Pace and Ablate for fast AF on 30th June with the Ablate meant to happen 4-6 weeks after. I had a PM check on Aug 5th . All was well and as I understand it the PM is in and on but will only kick in if my heart rate was to go too slow which it never does. Unfortunately I don’t feel any better with the PM but it was explained that I wouldn’t until the AV node ablation. Going for another PM check next week and hoping to get the ablation soon, Good luck and PM if you want to ask anything.

[dedeottie in reply to ETFCfan]

Thank you. The delay between the pace and ablate part is one reason why I decided to go for it and to stop prevaricating, as there may be a longer delay than they hope because of waiting times and as we know, AF doesn’t get any better, not by this stage at any rate. I will be interested to hear how things progress for you. X

[ETFCfan in reply to dedeottie]

Thank you I will post when I have any news. Good luck .

[dedeottie]

Hi Eliza. I thought I would update you on the pacemaker and as usual nothing went according to plan!

I was done by a different more experienced consultant. He made the incision but couldn’t get the wires down the vein because it was squashed probably as a result of a previous shoulder injury.

He said he would have to abort and if I still wanted to go ahead he would go in from the other side. While he was stitching me up he asked me lots of questions about the last disastrous ablation and eventually said that he would like to take over my care and try another ablation but this time under GA so that they could be more proactive and keep an eye on everything easily. He is sending me for scans and angiogram to make sure everything is in the right place! Because I am 65 he thinks it is worth having another go and then if that is unsuccessful, we have always got the pace and ablate to fall back on.

I have decided to go with this but not without some trepidation as you can imagine.

At least I do trust this guy which is more than I can say for the last one.

Watch this space!

Thank you so much for being a buddy ,I really appreciate it.

Jane x

[Mazza23]

My pacemaker was put in and turned on three weeks later had a v ablation it is set at 80 in three weeks it will be set at 70 then another tree weeks 60

[dedeottie in reply to Mazza23]

How are you getting on. Do you feel a lot better than before the whole procedure?

[Mazza23]

It’s only been a week so still very new but I do feel better thank you

[TracyAdmin Partner]

Thank you for sharing - I hope you are feeling okay? it is completely understandable to ask questions ahead of the procedure. If you would like more information or advice - please do not hesitate to contact our Patient Services Team [e-mail] or visit afa.org.uk and download our Treatment Options for AF

booklet