When is the decision to insert a pacemaker made?

[Love100cats]

Some months after diagnosis with heart failure I asked nurses if I would need a Pace maker and they said probably yes. I'm struggling a bit with breathlessness, very tired and extremely pale. I have an appointment with my g.p. in 10 days. I want to ask about a pacemaker but looking online it implies that it's for those with plumbing issues rather than electrical. I have left ventricular failure and atrial fibrillation. I have been thinking of going private as there is a very good hospital not far off. So would like to hear from others with similar condition who have had pacemaker fitted. My husband had on but after heart attack!

[Prada47]

Hi Love100cats

Difficult question . I to have Heart Failure with a lower40s EF and Shortness of Breath for no apparent reason. On the NICE guideline I would " qualify " for a pacemaker as I have NYHA Symptoms like Limited in Ability to do quite a lot of everyday tasks. Also QRS gap is widening. But Cardiologist has wrote to my GP that currently my pacing is OK so lets wait, and go to Maximum Medication. In my case Bisoprolol 7.5mg & Entresto they do tend to get you to maximum medication before going down the pacemaker route. I have had the conversation with GP and Cardiologist just to say I would rather have a Pacemaker sooner rather than later as I am now 72 and don't want to be needing one at 80 !!! Not much help but just trying to let you know some criteria they follow.

HNY to You and wish you well for the future

[Love100cats in reply to Prada47]

That was some help. Thankyou. I don't know what my ejection fraction is right now but I'm discharged from heart failure nurses forcsome months so no one is checking. I just know I don't feel right and am more breathless than usual and considering I'm only looking after myself and the cat my symptoms are going in the wrong direction. I'm on 7.5 bisoprolol as well as the usual, losartan, furusamide, apixaban, spirolactone. I'm close to Max on these I think. Thank you again.

[VelvetSky in reply to Prada47]

Hi, I wouldn’t worry about needing a pacemaker at 80, my aunt had one fitted at 95 and now is six months on and seems OK, she still lives alone at home with the help of Carers 3 times a day.

[Lezzers]

Hi Love100cats, hope you're OK and that you managed to enjoy Christmas & new year to some extent.

My husband has heart failure, his last EF reading was 30 & he's considered moderate to severe HF. At his recent hospital check up it was noted that his heart rate was low. His cardiologist wants to increase his bisoprolol but as this will probably lower his HR further they're looking into all his ICD readings and if his HR has been consistently low then they will adjust his ICD to start pacing him. Not sure if this info is of any help to you.

Take care x

[Love100cats in reply to Lezzers]

Yes thank you. The numbers help. I know I was at 43 EF last year but don't feel the same. On N.Y. scale have been between 1-3. But as no longer been seen by anyone in cardiac care it's anyone's guess where I am! So the plan is to ask g.p. for ecg as a starter to compare. My heart rate is down to 35-45 in the mornings. Not good! Thank you again.

[Prada47]

Hi

Not an expert on this but I think if you have been diagnosed with Heart Failure NICE recommend that you have a Care Plan agreed by GP or Heart Failure Clinic depending on whom you come under for Care. It may be worth checking with your GP practice.

Regards

[Ianc2]

Has anyone mentioned an implantable recorder to establish what is happening and provide evidence for future action?

[Love100cats in reply to Ianc2]

No, no offers of anything. Because they have been closely monitoring my husband I have been a patient they assess by observation when the see him. Now he is no longer with us I need to be assessed using usual technology. I'm going to discuss with g.p. in 10 days.

[Ianc2]

I am very sorry to hear about your loss and I hope you will able to summons up the ability to concentrate on yourself. With a bit of luck you will get your GP's full attention. ECG, blood pressure and bloods sound like a good start. Will he be referring you to a cardiologist, and if so what is the waiting list like?

[Love100cats in reply to Ianc2]

Yes I agree. You have to start somewhere and back to the beginning sounded good to me as it's not muddled with anyone else. I did get tired of my poor husband getting the blame for my poor health! We don't have a good system ere as cardiology is small and patients have to be referred to another hospital even for an angiogram so you have patients clogging up beds here waiting to be transferred not going home because they lose their place in the queue! Which is why I'm inquiring about a private hospital the same distance away which would put me in the control seat.

[Sunnie2day in reply to Love100cats]

Not sure this will help any but I went private and still had to deal with NHS queues as many investigative procedure equipment is shared here. For example, I had echocardiograms and an angiogram at the teaching hospital as the private one doesn't have the equipment.

Owing to surgery patient loads, I do feel going private has been beneficial despite the procedure equipment sharing.

[Ianc2]

I am fortunate in that my local GP has 2 surgeries, one of which is by Marks and Spencer, and is always packed out,(better class of germs). The other is in a less fashionable area, not so packed and has an ecg, good turn round on blood tests, etc. I think in your case I would get the initial ecg done privately. I have paid into the NI insurance for 44 years and it annoys me greatly to say this but we are where we are. Look after yourself.

[Sunnie2day in reply to Ianc2]

I'm going to be laughing about that '...better class of germs...' part the rest of the evening, thank-you for that!