Pacemaker v Ablation

[PeterGabriel]

I've had A/F for 7 years, had 3 ablations, the first just a PVI, the second totally relieved A/F for 2.5 years, the third for 9 months. Since then I've had two cardioversions that gave relief for 5 months and 3 months.....not long, but I was totally A/F free and fully active.

My EP says I need a pace and ablate, and doesn't think a fourth ablation is of any value. I'm worried about p and a. First, it makes you totally dependent on your pacemaker.....is that a risk? Second, the possible effects on day-to-day life. I have longstanding lower back issues and sleep on my side. I need to switch sides numerous times during the night. Is this possible with a pacemaker? I also use my iPad throughout the day for reading and research, and prop it against my chest, especially when in bed. I've read that this can interfere with the pacemaker. Anyone have any experiences of my concerns?

Is a fourth ablation a valid option I wonder, or a waste of time, with maybe some risk? Anyone have experiences to offer on a fourth or more ablations? I actually think continuing the cardioversions is maybe a good option, they may not last too long, but if it keeps me A/F free for months...... but that hasn't been offered as an option.

Any advice/experiences to offer would be most gratefully welcome.

[Identiy]

Perhaps research for the new form of ablation which is now starting to be available in multiple countries. It is called pulsed field ablation and is apparently safer than thermatic ablation. It may offer you some safe ablation and that is helpful

[Identiy in reply to Identiy]

Another thought. If you consider just having the cardioversion when required, if your weight is back to what it was as a young man and your alcohol and caffeine consumption is zero, the atrial fib may stop returning

[PeterGabriel in reply to Identiy]

Thank you, I'll look into it.

[PeterGabriel in reply to Identiy]

Thank you, I'll look into it.

[BrackenBT]

In relation to sleeping on your side, I have a pacemaker and once everything had healed and bruising from the operation had gone I was able to sleep on my side without issue and change sides throughout the night. It is advised that mobile phones are not kept in a chest pocket near the implant so I would suggest that prolonged use of an iPad positioned on your chest would be the same. A pacemaker has no affect on my day to day life, I mountainbike and hill walk regularly.

[PeterGabriel in reply to BrackenBT]

Thank you. How long was it before you could sleep on your side? I don't know how I will sleep if I can't sleep on my side.

[BrackenBT in reply to PeterGabriel]

It took about 2 to 3 weeks before I could sleep on my left side, prior to that I was sleeping half on my side using a pillow for support. I find it very difficult to sleep on my back but it was fine sleeping on the right side again using a pillow to support my left arm as it became uncomfortable if it dropped down.

[Sharpglo]

Once I got over the op, say it took 3 months, (installed last August a by ventricular pacer) I can sleep on all sides, including stomach. I often place a soft small cushion over the pacer area. I use an iPad on a pillow over my stomach, unsure about this question but haven’t noticed anything. Not recommended to use a necklace alarm I have one on a hook on bag and a watch version around home, which I don’t use much as have a husband. I have noticed an ache if I accidentally went in front of microwave. I recently underwent an MRI of an ankle (this newer version permits this) A cardiologist (cardio-electrophysiologist) increased my heart beat to 80 bpm (ached a bit) then after it he returned it to 70 bpm. I was experiencing an ache in my upper chest knock, that has gone but my EF remains at 20-25%. My condition is Dilated Cardiomyapothy mild regurgitation. None of this is easy for us alright, quite a journey we must travel. I did find there was hope when I thought all was lost. All the very best.

[PeterGabriel in reply to Sharpglo]

Thank you. 3 months is a long time for me not to be able to sleep on my side? Can I ask, what was it that was holding you back from sleeping on your side? And how did you know when it was ok/safe to do so? Many thanks for your good wishes.

[Sharpglo in reply to PeterGabriel]

Hi, I would automatically turn on to my left side, this would only last for a short period as I experienced an ache (pain initially) This time gradually increased. I now still place a beady cushion (neck rest type) beneath my left breast area and over the site for support. I always slept heaps on my stomach, this took a long time and even now don’t do that as much as I did. Yes all based on the pain experienced.

[L8Again]

Both my wife and daughter have pacemakers. My daughter has a congenital heart defect and is fully paced.

After a couple of months to allow the pacemaker wound to heal properly, I can say with husbandly certainty that my wife can turnover in bed without any calls of ‘ouch’.

Advice on magnetic fields and pacemakers is understandably cautious; however, modern pacemakers come with built in protection:

‘In general, consumer appliances and electronics don’t affect the performance of ICDs and pacemakers. On rare occasions, some of these devices may inhibit pacemakers by a single beat. But the pacemaker’s regular signals are quickly restored.

Even though these devices may pose little known risk, you should still try to keep all motors and antennae at least 6 inches away from your ICD or pacemaker. Speak with your health care professional about whether it’s safe to use any item.’

My wife’s cardiologist put the risk into perspective by telling her she could lie across an induction hob and if she turned on one of the rings she might feel a little strange. The pacemaker could in extremis revert back to its factory settings if the magnetic influence was strong enough. It would though re-establish the pacing team settings once the magnetic influence was removed. My wife has both an IPad and Kindle which she happily uses with no unpleasant effects.

My daughter’s heart has been 100% paced for many years. She has a standard 2 lead pacemaker. If the pacemaker or a lead fails, she has been told that her heart would cope until medical assistance arrived: that said, all patients are different.

Two myths. One, you shouldn’t wear a smart watch. The truth is that you can safely wear a smart watch PROVIDED it does not use Bioimpedance to gain data. Two, pacemaker owners cannot be defibrillated. The truth is that a defibrillator can be used on a pacemaker patient: the pacemaker implantation site should be avoided for pad placement.

[PeterGabriel in reply to L8Again]

Thank you. Yes, I've heard conflicting views on magnetic interference from appliances. There is the official caution, and then there are the experiences of users. Based on the advice of your wife's cardiologist on induction hobs, it suggests that propping your iPad against your chest shouldn't be a problem, and if you felt something then removed your iPad your pacemaker would automatically restore to its settings.

If the pacemaker or leads were to fail then your heart can cope until medical assistance arrives is a worry. Given the delays in getting medical assistance, how long would your heart be able to cope? What if you were overseas? Or on a cruise?