The interrogations of my PM show that it's pacing more than it used to. Is High Grade AV Block progressive?
Thanks!

 

 

It can be progressive. The incidence of High Grade (third-degree) AV block can increase with age. The incidence of third-degree AV block is highest in people older than 70 years (approximately 5-10% of patients with heart disease).

However don't conclude this is happening to you based on the results of one checkup report. Like all things heart related, there can be peaks and valleys. Wait until you get at least one more report and if it too shows you are pacing more ask the doctor the significance of this increase.

 

It could be that your block is getting worse, it could be that they've adjusted the settings so that you're using it more efficiently so your numbers are higher. It doesn't really matter one way or the other. As long as it's there when you need it, it doesn't much matter how much you use it. Many of us with av block pace 100%, not at all uncommon.

 

Thanks Bill and Tracy. Bill, the last increase made me return 8 months early from China - I could feel the pacing (has to do with the wires being close to my vaso vagal nerve) and the increase. At the interrogation, the doc said, "Yep 50% increase. Come back in 5 years." Huh? A 50% increase and I should come back in 5 years? I protested but he placated me with "Fine, come back in a year if it's still bothering you." This condition ruined my once-in-a-lifetime experience and he blows me off! I'm trying to get back to China, but due to my condition, I can't. And if the condition is getting worse, I want to know why. I want to know what's the worst? How much more will it affect my life? Nothing was adjusted, so I don't think that affected the amount of pacing, but it was definitely a good thought. Thanks for listening to me spew, but also in answering my questions.

 

Pacing more should not have any effect on your life. Whether you pace 1% or 100%, you should feel the same. With an av block, our atria beats normally so our natural pacemaker (SA node) is setting the pace and the pm simply completes the broken circuit. The signal is always or sometimes blocked and doesn't get through to the av node in the ventricle (that's the block). The pm always watches. If the atria beats and the ventricle doesn't follow, the pm generates a signal to cause a beat. It doesn't matter what generates those beats; you should have a normal hr and feel good either way, whether the beat is generated by the pm or by your own av node.

I'm not understanding why this affected your trip.

I'd get another doctor. Five years for follow up is crazy. You should be seen at least once a year, many of us have checks every 3 or 6 months.