sick sinus syndrome & new ventricular pacing

[ScoobyDoo71]

I went for pacemaker check yesterday, following generator change in July. I’ve only ever needed atrial pacing but download showed I’d also begun ventricular pacing now also.

I know that sick sinus disease can progress but it really knocked me.

My settings have been altered to see if that can reduce the need for ventricle pacing and also advised to use my arms more to help rate response.

I’ve not felt as good over last couple of months but put this down to work/ stress and getting over battery change, I’m now wondering what’s occurred to cause change? My leads are fine and wound healed well.

Has anyone else had similar ?

[Lezzers]

Have you had a changed of meds recently? My husband had his bisoprolol increased from 1.25 to2.5 in October to help with VT's & his ICD has increased from 4% to just under 50%. Unlike Atrial pacing too much pacing of the ventricles can damage your heart, they've now reduced the bisoprolol dosage back to 1.25.

[ScoobyDoo71 in reply to Lezzers]

hi thanks for the reply, tbh that’s my concern about potential damage with Ventricular pacing. Nothing has changed all meds the same all settings were the same literally like for like replacement battery, leads ok too.

Gosh that’s a significant leap for your husband with the pacing following increased Bisoprolol you would have thought if anything it would have been less. Hope it settles back down for him.

Thus us the worry with heart probs things can change quickly and it can really impact on futures for good and bad.

[Lezzers in reply to ScoobyDoo71]

Bisoprolol slows the heart rate down hence the increase in the pacing, the dosage has been reduced so hopefully that'll help with pacing issue & he's having an ablation soon so hopefully that'll help the VT's issue. My husband's cardiologist & nurse have always resisted increasing it as his HR is very low anyway but it was suggested to combat the VT's which sadly didn't happen but instead increased the pacing amount. What dosage of bisoprolol do you take & do you know how much pacing your ICD is doing?

[ScoobyDoo71 in reply to Lezzers]

hi sorry I was meaning reducing the VT burden but yes not surprising the pacing increased in response to slower heart rate.

I don’t have an ICD just a dual chamber for Sick sinus syndrome. Have had pacemaker for 10 years since 40 but only now starting Ventricle pacing. My worry is if things starting to progress worse and the long term impact on overall heart due to increased risks with V pacing

[Lezzers in reply to ScoobyDoo71]

From what I understand it's the amount of pacing that's the issue. Don't hold me to it but I think any % under 40 isn't an issue. There had been talk of introducing another lead to my husband's icd to make it dual chamber so that he's paced from the Atrial as that doesn't cause any damage no matter how much you're paced. Perhaps your settings have been changed so that the atrial is pacing more & the pressure has been taken off the ventricles. Maybe have a word with your pacing team, when is your next appointment?

[Mged in reply to ScoobyDoo71]

Hi I am just wondering if you are on meds such as bisoprolol or other ones for atrial fibrillation issues? but otherwise I guess as you mentioned SSS is often a progressive condition that can worsen over time. I am your age and and am a border candidate for getting a PM - In that regard I am hoping the new dual chamber leadless PM from Abbott could maybe be something to consider in the near future. How has your hearbeat been since you had your PM and what was your base when you got it if I may ask?