Two lead Pacemaker to a 3 lead CRT

[Nomis21]

Hi, I have a 2 lead pacemaker following pace and ablate 2 years ago, since then I have developed AF 100% of the time, heart failure and signs of cardiomyopathy with LBBB.

I'm struggling with to do anything and every day i get out of breath, chest discomfort, dizzyness lightheaded, nausea, aches pains throughout my body and I just don't have the energy or enthusiasm to do everyday tasks.

I'm 53 and I feel the AF is really punching me to the ground and with the other issues and the medication i just give in and go to bed.

Recent review with cardiologist stated I would benefit from a CRT pacemaker however he was going to discuss this at his next MDT meeting due to the complexity of my case.

Another ablation was also discussed and a cardioversion.

Anyone know what the surgical procedure is to upgrade a 2 lead pacemaker to a 3 lead pacemaker? How do they get additional wire into the L/H side ventricle?

[RufusScamp]

I started with a three lead job. It was the third that took the time, but I have since been signed off by the cardio tam, and just hear from the monitoring team every 6 months.

[Breesha]

I have had permanent AF for 18 years , I have a three lead cardio Resychonisation Device fitted , feel great , work hard and enjoy life .

Maybe meds need adjusting I have had 12 mg Bisopropol for 10 years , no probs .

Life is for living, go to a local community event, help in a charity shop, help others to help yourself .

[Sharpglo]

Hi Nom, I am awaiting having the bi-ventricular pacemaker (three wires) Was about ready, on Monday, to be wheeled into theatre and it was cancelled. I have dilated cardiomyopathy Ef 25 last screen. Anyway to your question as it was explained to me. The third wire goes around to the left top of the heart where a vein ( I think )is located, it is threaded up that vein and must go into an offshoot of that vein, as it won’t stay in the large vein. Not everyone has a decent offshoot for that. Anyway, it would then send its charge through to the left ventricle. Googled this “Standard pacemakers have two wires that send electrical impulses to specific areas of the heart—one wire is in the right atrium, and the other is in the right ventricle. A biventricular pacemaker has a third wire in the left ventricle, which allows timed, coordinated signals to be sent to the right and left ventricles.” I’m crossing fingers I have such an offshoot.

[Nomis21 in reply to Sharpglo]

Hi sharpglo,Let me know how it goes, hope the procedure goes well and your condition improves.

[Fred1954]

I had a 2 lead that was upgraded to a 3 lead. The procedure was done under local anaesthetic. Getting the 3rd lead in gave them a bit of trouble, but it depends on how your veins are apparently so everyone is different. The CRT-P box is bigger than a 2 lead pacemaker so that took a bit of time maneuvering to get in and stitched. Well worth the trouble for the improved EF that was achieved and now signed off from the HF team.

[Nomis21 in reply to Fred1954]

Hi Fred,

I've heard more positive outcomes than negatives in those who have upgrade to a CRT-P.

What was your reason for the upgrade?

[Fred1954 in reply to Nomis21]

Routine echocardiogram showed my EF had dropped to 32% so I was recommended to have a CRT-P and the usual cocktail of pills for HF. One year later EF was at 43% and I was referred back to my GP.