Hi,
I have a dual chamber pacemaker for complete heart block (rate response off). Years ago (before dual chamber pacemakers came out) I had a single chamber (ventricle) demand pacer set at a rate of 72 bpm.

If you had the option of having your dual chamber pacer set without the atrial wire function (single chamber demand), or have open chest surgery to have it removed and replaced, what would you do?

I did very well with a single chamber pacer and having the wire removed is extremely risky for me due to other health issues.
My age is 60.

I really could use some opinions.

Thanks!

Gellia

 

 

Hi Gellia,

I say have it turned off and left in place if it is not causing you any problems. Who knows, you may need that other lead some day and you will be way ahead of the game.

Now I'll tell you why I'm so bold with my answer. I got my pacemaker in 2000 and had nothing but trouble with from almost from day one. After almost three years I asked the electrophysiologist that implanted it to turn it off. He took my request as an affront to his work and got a little huffy and told me he could just remove it if I wanted to do that. Because I wanted no more surgery we reached an agreement for him to turn it off. It stayed off for 27 months when other doctors had gotten involve and convinced me that I needed it to help regulate my heart beat and it was turned back on. Within15 min. it was working without a hitch and in the end I was glad it had not been removed when Dr. so and so offered. Saved me a lot of trouble and my insurance company a lot of money.

Solet'sjust I've been there and done that and it worked fine for me.

Good luck,

Smitty

 

The early pacemakers treated AV block by pacing the ventricles at a fixed rate.

The more recent ones use the atrial lead to sense your natural intrinsic HR and use it to pace the ventricles. If it is set up properly it gives a much more natural HR. There is really no disadvantage and many advantages to using the two lead approach. Using it my HR varies from 55 when I am very relaxed and resting to 140 when climbing a hill. (I'm 79yrs so this is pretty much the natural range for me).

If you are having symptoms that appeared after getting the new pacer it is likely that it isn't adjusted properly.

frank

 

for the replies, Smitty and Frank. I SO value your opinions

I think my problem is that the atrial wire impedance has gone way up and is using the battery faster. If I leave it, the battery will deplete in just a couple of years.

I already have three wires in there. One is non functioning and looped in the ventricle. They all have been in there for way over 25 years (1982). My EP said trying to get them out with conventional means (laser) would be way too risky.

So, I wind up with the choice of open heart to remove the three (still very difficult with all the scarring around them), replace the battery more often, have a whole new pacemaker system placed on the other side with then a total of five wires, or shut the atrial wire off and go on single chamber pacing.

I know this is coming up soon. I am VERY reluctant to have the open heart surgery. With all the other medical problems I have it would be VERY high risk and I know my EP is loath to try to remove these wires (told me he wouldn't touch them with a 10 foot pole).

So, on a personal level, would you rather have your battery changed more often (about every two years), or go for the whole enchilada on the other side and a total of five wires?

Any opinions is really appreciated.

Thanks.

 

i have one lead wire removed, but it had only been in for 6 years. it had a short in it. with that many wires and the length of time they have been there i would opt for more batteries. they are have a hard time finding enough doctors who can remove old wires anyway. my doc was first in al. to be able to remove wires.
good luck with whatever decision you make!
have a blessed day, nelson