Friend had one ten years ago and swears it is the answer?
Has anyone had a Pacemaker to regulat... - Atrial Fibrillati...
Has anyone had a Pacemaker to regulate their AFib?
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Hairem
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As I understand it pacemakers are for certain types of afib. and heart conditions. You would need to check out with your EP or cardiologists if the cause of your afib. would benefit from a pacemaker. A friend had one for slow heartbeat.I was told I was not suitable because I have a problem with my tricuspid valve .
BobDVolunteer
A pacemaker will not affect AF. Even if you had the pacemaker and then your AV node ablated the AF may still continue in your left atrium whilst the PM regulates your ventricular rate. You will of course then be dependent on your PM.
Thank you, it seems a no win at this point. Ablation is in my future it seems.
I am thinking about this too. Had PAF for many years (18?) and episodes getting worse and several times a week for over 12 hours. Then I had to do high dose intravenous cortisone therapy and went into permanent AF since then, now 18 months. Since then also diagnosed highly hyperthyroid with TED, thyroid now removed after 20 years of hypothyroid. Plus BC thrice. I just want some more years with some QOL. Have asked here about having the pacemaker, that was before permanent I think. Some people said they still feel AF when its on, in spite of heart rate at 70 or so, as dictated by pacemaker. I asked my cardiologist if mygeneral condition might improve and he was doubtful as has also seen the opposite, as pacemaker does something with the heart "wave"? which ist unphysiological. Right now I manage, when in PAF took Sotalol for heart rate and converted by myself, nothing to do with Sotalol. But it did not take heart rate under 100-110, so always very exhausted after PAF attack. Then a cardiologist at a hospital changed me to bisoprolol 10, when hyperthyroid and permanent AF and at least I could sleep again, heart rate in the 90s. I have since managed to reduce to 3,75 without higher rate, every step takes 4-6 weeks. I manage, but feel not very fit, but keep on doing what I have to.
I wonder too, if a pacemaker would feel good. I think it is clear by now I will probably not make old bones, but i would so like to feel more fit for the rest.
Yes I had pacemaker inserted in 2017 in preparation for Pace & Ablate - last remaining treatment option. Pacemaker worked SO well for me that I did not go ahead with the ablation of the AV node. I have had some AF episodes, especially when I have infection but only 3 since 2017 - until I caught the dreaded COVID last month but even so, resolved very quickly.
I am unable to have any medication for AF.
That’s good to hear
Hello again CDreamerVery interesting about you not needing to go through with the AV ablation. My last post in August (do look it up) described how the EP was not able to proceed with an implantation from the left side because of a rare anatomical anomaly "Persistent Left Sided Superior Vena Cava" - do look it up if you haven't already done so. I am now lined up for a single lead insertion into my RV, rather than a bi ventricular job, from the right side of my chest in a couple of weeks. I am concerned that permanent pacing from the RV will result in cardiomyopathy in the LV, but I am assured that if there is any evidence of this occurring they will consider inserting a His Bundle Pacemaker (more homework for you, perhaps) . I would love to avoid the AV node ablation stage, as you appear to have done, but we will have to see what happens after the single lead insertion. Fun and games, eh?
Certainly not the fun and games we would prefer! I actually remember your post and will follow your progress with interest. Sounds as though you have someone who is on the ball. Never heard of His Bundle Pacemaker so let us know how you get on. Best wishes.
I don't think my Cardio Guy would have mentioned it if I hadn't done so in my written list of questions, after researching alternatives to bi ventricular pacemakers. Locating the lead into the His Bundle is, apparently, technically very difficult so they don't carry it out unless there really is no alternative.
My EP was rather emphatic that Pacemakers won’t cure, fix, or prevent Afib episodes. I was interested in the latest model, the size of a vitamin capsule, implanted inside the heart and controlled digitally. He has put me on the schedule for a cryo ablation, projected to be some time in January.
I know that’s the official line but when I talked to my EP explaining why I had cancelled the AV node ablation because I’d not had any AF episodes - after 3-4 week lasting more than 12 hours - he told me that he had a few patients when pacemaker seemed to have stopped AF episodes - maybe not entirely but enough to make life liveable again. When I do have AF I am usually not nearly at symptomatic and it self converts much faster. Last pacemaker check revealed my AF burden was less than 1%.
I suspect that if your AF is triggered by bradycardia, it may be helpful but my husband had a similar experience.
Did you have bradycardia?
Only at night which triggered nocturnal AF but I also had sleep apnea which was treated by CPAP. The main reason for PM was because I’d run out of treatment options as couldn’t take any drugs, especially rate control & had 2 ablations which had given 3 years of AF freedom and had shown signs of more dangerous arrhythmias developing.
Hello Hairem from Canada, hope you were not caught in those terrible conditions.
Yes I had a pacemaker fitted and my AV node ablated, the PM is set at 70/120 heart beats per min, so far has been brilliant. Have now got all my strength back and playing golf 3 times per week. I am 76 and live right opposite the beach.
The only doubt i had was when the AV node is ablated it can not return so totally
dependant on the PM. I did ask what would happen if the PM stopped working, the answer was it will not.
What I have found out is if the PM did break/stop/ then my heart rate would drop to 40 giving enough time to reach the hospital
I would in my experience go for it, when i measure my BP at home very occasionally it will show AF but otherwise i am pretty stable
Best of luck
Dave
Thanks Dave. The storms were not in our direct area but close enough. Devastating!Your reply gives me some hope. 😊
Hi Dave,did you have permant AF or PAF before pacemaker?
Hi, yes i was in permanent AF and passed out on the golf course. Suggested a pacer and ablate would stop any more passing out episodes. so far so good
Dave
I have had a CRT (cardiac resynchronisation therapy) pacemaker implanted for over 2 years’ now but it is for heart failure. I have permanent AF but am asymptomatic. At the last echo, my ef had gone from about 35% to 54%.
Hello, I had a Pacemaker fitted for fast permanent AF at the end of June. AV node ablation was scheduled for 4-6 weeks after but due to backlogs it still hasn’t happened. It was made clear to me that I will still have AF but the AV node ablation will allow the PM to pace me properly. From the things I have read from people who have had it done successfully I can’t wait as at the moment I’m feeling rubbish unfortunately.
I am having a pm fitted on the 15th of next month and AV node ablation 6 to 8 weeks later. My worry is that because of the ‘way things are’ it will be a much longer wait than that. Sorry you are feeling so poorly.
I had a pacemaker fitted in June 2020 because I was passing out when returning to NSR. I still get frequent attacks of AF.
You feel them or you know from your doc?
I feel it immediately I go into AF. Been in AF now since 7pm on Saturday evening and still am.
What exactly do you feel? as can't be your heart rate any more, as that is set. I read that your heart rate in AF with PM is 100-120. Isn't the pacemaker set to a steady rate?
I can feel my heart beating fast. My pacemaker is set at 60 so that my HR does not fall below that. The pacemaker does not stop my heart going fast and going into AF.
But it should not be beating fast with PM, as heart rate regulated. If you have 60 set, what is your upper limit? I suppose you feel the fluttering of Afib? Because the irregular heart rate caused by AF should be gone.
It is the irregular heart rate from AF which I feel. Having a pacemaker does not stop you having AF and feeling the symptoms. I have a home monitor and had a telephone conversation with my cardiologist last week and he said he knows my heart rate goes fast when I am in AF as he can see from the monitor. My next step would be ablate and then I shouldn't feel the symptoms but I would be reliant on the pacemaker so need to carefully consider this.
But your heart should not be able to be irregular when you have a PM . Or is this different as not ablated yet?
As Bob D said a pacemaker will not affect your AF.
PM with AV node ablation does not stop AF and you can’t set a PM to not exceed a HR. I think you are misunderstanding the purpose and what a PM does & not do.
There are lots of different types of PM but they address rate, not rhythm.
I do know that. But you can set a PM to regulate upper heart rate, it is done every day. And the troubled feeling in AF comes mostly from the irregular heart rate, which is CAUSED by AF indirectly, not directly. If you have a normal PM with node ablation, your heart rate should be rather regular. Question ist, whether you can still feel the atrial fibrillation which goes on (in the atrium, and only there), which I do know. Some say, you don't, some say they feel it. But they CANNOT feel an irregular heart rate caused by AF, as that is impossible after node ablation. I hope I have explained now.
Have Afib since 2016 .I had a pacemaker fitted after complete heart block during valve replacement in 2019. Has not helped Afib, having ablation 7th Dec.
Do you still feel AF or was it measured? And I have never heard of ablation AFTER pacemaker? I thought they just let it go on then....
There are SO many factors with this subject that there are no definitive answers. There is no problem ablating after PM that I know of & in case of AV node ablation (which uses same catheter method & equipment) you couldn’t Ablate AV node before PM could you? You’d probably be bedridden or die!
2 lead PM for Brady will only kick in when HR falls below programmed tolerance. 3 lead Re-synchronization therapy PMs do so much more & will pace the ventricles, prevent them from going out of sync & causing HF but in UK you NICE guidelines advice only fitting IF you have HF but who wants to wait for that. Downside is the cost is x3-4 times a 2 lead so getting it done on either NHS (UK) or via health insurance is very difficult - but IMHO & experience absolutely worth.
What you feel has nothing to with what is happening in your heart as palpitations are only sensations, uncomfortable & scary as they can feel. You still feel those with a PM or if you have AV node ablation but your ventricles will be paced with 3 lead resynchronisation therapy so your pulse will remain stable thus limiting symptoms such as breathlessness & fatigue. It’s not a cure, not found anything that is.
Ablation of V node?
AV node Ablation = knocking out the Atrial/Ventricle node which transmits the chaotic electrical impulses through to the ventricles. This means the ventricles are controlled by the Pacemaker whilst the atria are left to do their own thing and fibrillate to their own beat whilst the pacing of the ventricles ensure a steady pulse so not affected.
Everyone I’ve met who have had had this procedure say they continue to feel the AF but they are less symptomatic from the affects simply because the connection between atria/ventricle is severed. Only in this instance are lower and higher rates programmable. My PM ensures my HR doesn’t drop below 60 but it often goes to 180 in AF simply because I didn’t go through with the AV node ablation so the chaotic signals still get through to the ventricles.
I have a 2 lead pacemaker. It does not help AF but because my heart tends to go too slow, it helps regulate it. The pacemaker is of no use if an attack of AF starts. Take advice from the professionals in cardiology.
A pacemaker cannot stop or prevent AFib.It can in some circumstances be used to prevent AFib caused by bradycardia if bradycardia precipitates it.
Yes I have a PM - back up only and I'm not pacemaker dependent. It's a long story as are many!
Before AF I had a slow heartrate (often a precursor to AF). My AF was never mega fast but made me feel rotten. Two ablations have improved my quality of life beyond recognition. But I am also still on Flecainide and Bisoprolol and when I stopped them I started getting more AF again.
Bisoprolol - only 1.25 - slows my heartrate down, Flecainide lengthens the QR interval. Result - my HR once measured 36bpm (I felt fine but apparently it's not good). So the PM was recommended to stop it going too low especially at night.
It doesn't bother me. It is set very low at 50bpm and can boost me up to 110bpm when needed, so I still feel the slowing effects of the drugs occasionally. But various cardiologists have told me that ablating the AV node can be a neat solution for AF in my case. The atrium still fibrillates but the ventricle ignores it, obeys the Pacemaker and stays steady. But frankly I feel pretty good. My AF has effectively gone for the time being, QOL feels good, so I am not ready for that yet.
The good thing is that the pacemaker monitors the activity of the heart non stop 24/7 , and the pacemaker clinic can see you within days at short notice if needs be. It feels safe.
I had a friend who had one and it made no difference to her.
Hi Hairem I am on my second pacemaker and they have worked fine and still do. Even the overnight op. In hospital was no Problem. Go for it !
I had a CRT pacemaker fitted in March with a AV node ablation in May (failed but rare) and again in June. I was suffering reduced LVEF (30%) and permanent rate of 140 bpm which led to heart failure.
Drugs failed to get the heart rate down and lifestyle choices were not working fast enough. So my heart rate became completely out of control.
The PM and AV node ablation has broken the connection between my atria and ventricles so the ventricles are now paced by the PM. My heart rate is under control so that pulse readings will give you a range 60-110bpm. I am set to 60-130bpm but was told I would struggle to get it anywhere near 130. I never go below 60bpm even at night and have no breakthrough AF.
Pacing clinic can see that my atria are still running at over 200 bpm but I feel absolutely none of this. Completely oblivious.
My LVEF is now at 55% which is normal and many of my symptoms have gone. I am back at work full time and building back some normality with walking etc. This is the best I have felt in 2 years.
No nausea; lack of appetite; liver and kidney pains; severe sob; low energy etc etc all gone. Life was proving very effortful to get through each minute of each day.
I still have some issues with fluid retention so need to continue to take a diuretic but other than a blood thinner that is it. No more high doses of 3 different heart medications and no more drug side effects.
Although I wished I had never had to have this, I did not really have a choice and it has transformed my life.
Hopefully I will continue to move onwards and up wards. 😊
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