Advice on pacemakers

[Kendalghost]

I am going to see my EP tomorrow and am getting my list of questions ready. The GP and Cardiologist have both suggested a pacemaker due to my low heart beat - usually in the low 40s but has been know to go into the 30s. Are any more suitable for people with AF than others? Any advice welcome.

[BobD Volunteer]

A pacemaker alone will not normally stop AF. If subequently the AV node is ablated then the pacemaker will take over controlling the left ventricle and your pulse woulde be regular even though the fibrillation may still continue in the left atrium. In a few cases a re synchronising PM with three leads may help but these are not normally used for bradycardia. Mine is a two lead one (fitted for heart block) which would normally be used for bradycardia.

[CDreamer in reply to BobD]

There are pacemakers with algorithms which do control AF in some people - modern pacemakers do so much more, unfortunately it’s more likely that there isn’t enough EPs with the expertise and skill sets to implement. That seemed to be the message from the webinar.

[CDreamer]

Yes - ask about RST - resynchronisation pacemakers - info on their effectiveness for AF on Arrythmia Alliance site.

I’ll post a link for you.

[Kendalghost in reply to CDreamer]

Thanks CDreamer, I will ask what this PR thinks and if a pacemaker can raise my hb sufficiently to take other medication. At present I may be able to take a low dose Bisoprolol when in AF but then again may not be able to as my bp has dropped to 74/46. I am just happy to have an appointment.

[CDreamer in reply to Kendalghost]

I also had very low BP - Pacemaker stabilized it and my QOL improved dramatically.

Good luck with appointment.

[opal11uk]

It depends on cause and yourEP/Cardiologist will advise. I had mine in 2015 and am told they are much smaller now, mine is a 2 wire pacemaker and was fitted after ablation, I also take Bisoporal. Good luck x

[Kendalghost in reply to opal11uk]

Thanks I will see what advice I get. My appointment didn't happen yesterday as Patient transport didn't get here to take me. Might have to fork out a couple of £100s for a taxi so that I make it to the next one. My husband has his hand in splint so he can't help, talk about bad timing!

[Clarrie]

I had a pacemaker fitted in 2020 as I was passing out when returning to NSR. It doesn't stop AF but stops my heart rate going too low.

[Jock68]

Mine is a 2 lead and it is set to run at 60bpm if my heart rate falls below that number, it used to be around 45 during the day hence the PM. Mine is set to go down to 50 when my body is at rest for a while so that I can get to sleep. It does not stop the AF , I am on Bisoprolol and Rivaroxaban. It is set to cut in at 150bpm if I get fast AF over 150 to try and bring the rate back down to 70. It does allow the heart to go up to 150 for normal exercise to take place. The PM will stop you passing out, my experience is all positive.

[Tapanac in reply to Jock68]

Hi Jock68

Do you have a 2 or 3 lead PM? Sounds good that it stops your tachycardia as well

Pat

[Jock68 in reply to Tapanac]

2 lead.

[Tapanac in reply to Tapanac]

Thank you. I obviously didn't read your post properly when you started off saying 2 lead. Senility strikes again, eh! I had a 2 lead inserted in September, but it only stops my heart going too low.

[Sewnknit]

The type or make of Pacemaker will be decided by the cardiologist. It's not like going to Sainsburys, the team needs to be trained to fit it and monitor it. Anyone using a medical device has to go through the manufacturers training etc. and it has to be approved by the health board. At leastr this was all true 3 1/2 years ago when I worked in clinical enginerring.

That said, i had a pacemaker fitted just after I retired as i have tachy/brady. I was on Bisoprolol which really dropped my heart rate. The PM has been great, i'm set like a little clock at 60 bpm. At my last download I was told my AF burden is 3%, which is fine by me.

The thing with me is that I didn't think anything was wrong. I was sent to my GP for an ECG and next thing there were doctors standing round asking if I felt OK as my HR was so low. I think you get so used to things you don't appreciate how 'not right' you are. My EP set up an adjustment to respond to my breathing in August, and I'm astonished at how much that has helped.

Sorry to ramble, good luck!

[2learn]

Hi, first of all what's causing your low HR, has that been investigated. Mine was due to a badly leaking mitral valve which needed repairing.

I have a pacemake, the type was decided by the consultant who said it was the most up to date and MRI compatible. However seems it is too advanced for my local hospital and won't work with their old MRI. bugger.

You are told about not using induction hobs but they are the ones most shops offer. If you have one you will no longer be able to use it. But I was also told at my PM check ups that anything electrical with a battery, mobile phones etc should not be held closer than 1ft to PM. So you find there's lots of things that maybe unsafe, eg MRI, airport scanners, electrical muscle massagers use by physios, certain dental equipment, even electric cars are a risk. However it seems to work and doesn't let my HR go below 60.

[Kendalghost in reply to 2learn]

Hi, my heart rate has been low for years, I've been aware of it for at least 25 and nobody is concerned and I managed okay. But with the AF I can't take much medication so that is why the GP and cardio are suggesting it. I have a gas hob but like my Kindle and tablet.... Will see what I get advised. My appointment slipped to the end of November as Patient transport didn't arrive in time to take me.