HF and pacemaker

[IanMK]

Hi

I was diagnosed with HF (with an EF of 25%) and LVSD late last year which is thought to be a consequence of a high ectopic burden. I had an ablation a couple of months ago but it was not successful in stopping the ectopics. I am now awaiting a biventricular pacemaker and subsequent AV node ablation which I am hoping will allow my EF to recover and resolve my HF. Has anyone else gone through a similar journey? If so, what was your experience?

[Serg12]

Any news on pace and ablate? I have just got pace date of early December then ablate later and am also wondering about experiences.

Also does anyone know if this procedure means you can come off bisoprolol as EF improved due to LVSD improvement or are we kept on it for protective etc purposes.

[IanMK in reply to Serg12]

Hi Serg12

When I posted my message I was 2 months post ablation with my ectopics suppressed by medication (Amiodarone) to allow my heart to recover post-procedure. After another month, my cardiologist confirmed that my ejection fraction had improved considerably, confirming the theory that my heart failure was attributable to the ectopics.

My EP wants to be 110% sure that a pace and ablate is absolutely necessary so I have now stopped the Amiodarone and have to wait to see whether the ectopics return before he will proceed. It takes a long time for the Amiodarone to wash out of my body so it could be some time before I know what the future holds for me. Needless to say, my preference is to avoid the pace and ablate if possible so I consider myself fortunate that there remains a good chance I will be able to avoid it.

Regarding the Bisoprolol, I am still taking it under sufferance but would expect to be able to come off it soon. I would expect that it wouldn’t be required in the case of heart function recovery after the fitting of a pacemaker.

I hope it all goes well for you.

Best wishes.

[Serg12 in reply to IanMK]

Hi, was on amiodarone for about six months after post-AVR bout of AF in hospital, glad to be off it frankly. Wish that I was not on bisoprolol but due to HF and LVSD am still on it. Getting bi ventricular crt to counter HF and LVSD, with a later ablation to counter (hopefuly) ectopic and long standing svt and wpw, the crt means that I no longer have to worry about the LBBB or the fact that my bundle of his pathways are knackered (1 out of 3 works ok) due to congenital vsd (now repaired).

One of my problems is antidepressant based tachycardia unless I am on flecainide, which I can't take until heart structurally sound again. So to allow antidepressants, which I need, I must have flecainide or ablation but given the overall number of electrical problems we are looking at ablation and being reliant on pacemaker.

Am hoping (ie want) to come off bisoprolol after procedures.

Have noticed that there is very little pace and ablate experience written about on this site.

[IanMK in reply to Serg12]

Depending on my progress, I may be following-on behind you 🙂.

It sounds like you’re having a tough time but I feel sure that you will benefit from the p&a procedure. I can totally empathise with you wanting to stop the Bisoprolol and, on the assumption that your heart function recovers after the p&a, I wouldn’t see why you would need to remain on it (although I am not medically qualified).

You will find others in a similar situation on the AF forum on HealthUnlocked but remember that post-procedure comments will tend to be rare considering that people tend to drift away from the forum after a successful procedure.

[Serg12 in reply to IanMK]

Just had pre-op earlier today.

Seen the demo model of Medtronic, it's small and light, relatively thin as well. Seemingly they don't do leadless crt-p, that's a pity. All looking good otherwise. The reality hit me a bit on the way back as for the last 20 years it has just been something at some point on the future.

You never get quite used to it all, had my first angiogram aged 3, 50 years ago. All we can do is keep going and look positively on it. It makes us who we are, and gives us a different perspective, generally for the better.

Good luck with yours.

[IanMK in reply to Serg12]

I've got no problem with the idea of having an ICD (other than minor complications regarding insurance, DVLA, etc) - they are mature and well-proven technology now - but leadless technology I'm less sure about.

All the best,

Ian