Conduction System Pacing

[SMwils]

Hello All

After having an AV node ablation a few months back, the right hand lead in pacemaker is a problem for me I am sensitive to and cannot not be turned on, hence left hand leads pacing on on left hand side of heart which is causing me quite severe breathing problems which the hospital know about (Barts)

They have lowered the pace to 70 bpm which has not helped

They are going to lower it again

Which I know will make it worse

The hospital are going to do a range of tests

However Barts Hospital say the end result will more than likely be Conduction System Pacing

I think that this is good but don’t know anything about it

Does anyone?

Thank you

[pottypete1]

I have conductivity disease. I have been told it is a lengthening of the time between the beat of the atrium and ventricle in my case 400 milliseconds ( normal timing should be 200 milliseconds.

My cardiologist wants to implant a pacemaker to deal with this and reduce the time lag.

I assume therefore your conduction pacing is designed to achieve a similar result.

Hope this helps.

Pete

[Ppiman in reply to pottypete1]

Hi Pete

Is what you have similar to a bundle branch block? I have LBBB and it's far from symptomless.

Steve

[pottypete1 in reply to Ppiman]

I have RBBB.

I have Bradycardia and get breathless when walking up hill or when doing physical exercise.

Otherwise I feel fine and haven’t had AF since March 2022 following the last of 7 ablations having had PAF for over 30 years. The last one was for Atrial Tachycardia.

Pete

[Ppiman in reply to pottypete1]

Thanks Pete. That's a lot of ablations. My son's colleague is similar, but has just started having it and flutter again, although he's fine. My own feelings vary from hardly noticing the LBBB to having lots of palpitations. I don't really get breathless, just feel "wrong" somehow and anxious with it. I also haven't had AF for a few months since starting 1.25mg bisoprolol daily.

Steve

[Gumbie_Cat]

You would need to register (free) to read this article, but it does look as if it works well.

medscape.com/viewarticle/97...

It seems to involve pacing either the ‘HIS bundle’ or the Left Bundle Branch (LBB) rather than the chambers of the heart, and is thought to result in a more coordinated heart beat. (Not that I truly understand what half of this stuff means, I hasten to add.)

The pacing seems to be a bit more like a natural heart beat, allowing the impulse to travel through the ‘normal’ system.

[CDreamer in reply to Gumbie_Cat]

As I have RST pacemaker I was very interested in this article, very technical when it came to the detail and I didn’t understand most of that but I did understand the principles. At the moment RST works well for me, without which I would probably be in HF but always useful to see find the alternatives.

[Gumbie_Cat in reply to CDreamer]

I think that DawnTX has this type of pacing to the HIS bundle. I looked at a few articles about it, in case I do need a pacemaker in the future. At the moment I’m doing ok on rate control (bisoprolol) and anticoagulant. I’ve been told that if rate control doesn’t work, my remaining option is pace & ablate.

It does sound like things are developing in this area!

[Caratacus]

After 3 hours on the table they gave up trying to get the lead into the left ventricle. Five weeks later left bundle branch area was successful. Now the pm fires into the LBB and the LBB fires into the left ventricle. Hence conduction not mechanical. I'm 82 and powered by conduction pacing. Afib is locked up in atria. QOL has improved (some)

[SMwils in reply to Caratacus]

Hello

Thank you

I have read a bit now and with your explanation I understand it a bit more

What is QOL?

Thank you

[SMwils]

thank you all

I am getting an understanding now

But still a bit wary as it is a relatively new way and not as tried and tested

Any insight would be great