I will be going to the Cardio Dr. at the end of May to talk about my options. Are there differ kinds of Pacemakers. I have Afib with a rate of 140-160 resting. With any movement it is over 200.
I need to reseach more and have some questions ready.
Any suggestionss?

 

 

Hey,

why a pacermaker? It won't help with the fast heart rates. Does your cardio want to ablate the AV-node and then implant a pacer? In that case a dual-chamber pacer with one lead in the right atrium and one in the right ventricle would do.

Best wishes
Inga

 

Inga, in A-Fib the heart quivers rather than beats and the pacemaker regulates the beat. It's not necessarily about ablating a node. It's about making a regular, even beat. Also, if the A-Fib is controlled with meds, if the rhythm is restored to sinus with those meds, some can make the heart's actual beat too slow (remember, in A-fib the heart quivers rather than beats) and the pacemaker will regularize it, give it a normal beat. A-Fib can wear the heart out, because of the quivering to produce a beat. And it can wear you out too.

I've been there, done that.

Lovelsu, I don't think you have to research and come in with questions in hand so much as you should merely listen to the doctor, what s/he has in mind, and then see if you have questions naturally generating from that discussion.

 

In a newer form of treatment, a pacemaker may be implanted without ablating the AV node in an attempt to keep the patient in sinus rhythm, sometimes by pacing from more than one location in the atrium.

 

INGA, Thanks for making the above statement you made. That basically is the same question you "commented" to me almost a year ago. I should have taken your advice Inga, when you asked, "Why a PM?".

Inga, I know you remember, you asked me why a PM and to get another opinion, etc. Now, after the fact, that is exactly what I should have done. I did not have any of the symptoms the Dr. asked, "was I short of breath, dizzy, passing out, etc. I just had A-fib &, me not knowing what my "flutter" in my chest was, I have had it for years. NO, back pre-PM, I did not have these dizzy, sob, etc.. Now, after PM, I get "lite headed" once in a while and am getting more so as days go by, short of breath.

I did have the ablation/PM implant on 10/09. I have the Boston Scientific/2 leads. I still have A-fib, but I do not feel it nor does it register on my heart/blood pressure monitor like it used to. My PM is doing its job ~

I have just finished a visit to the cardio for a regular 6 month check, ran the PM check & said I was fine ~ "see ya' in a year".

Thanks Inga for your input, and yes, anyone with A-fib knows it is a "quiver" and will wear out your heart muscle, according to my EP/Cardio Dr.

Bear Hugs to All,
Carolyn G. in TEXAS ~ Sooooo beautiful in TEXAS ~

 

Hi Renee,

I haven't heard about that new approach but otherwise, treating AF with a pacer without ablating the AV-node doesn't make much sense. The AV-node will just continue to let the irregular impulses from the ventricles pass. The only thing it could do is prevent bradycardia which some AF patients have (but not lovelsu) by pacing the ventricles at a steady rate. But if a AF patient has, for example, an irregular heart rate somewhere between 80bpm and 100bpm the pacer won't slow that down. It could only pace at a even higher rate to make a regular beat. The pacer won't be able to control a fast AF like Lovelsu's with rates around 140bpm unless it would pace her at 150bpm or something like that.

Sure some meds to prevent AF and keep you in sinus rhythm can slow the heart down, and then a pacer might be needed. But that wasn't the question here. Lovelsu just stated that while being in AF she is running a rate of 140bpm or even more, and she wondered what type of pacer could help. And the answer is: none, if the AV-node isn't ablated.

I have lots of rhythms that are faster than my pacer is set, also have short episodes of AF but the pacer can't do anything about them so I have to take meds to slow these rhythms down.

Best wishes
Inga

 

Hey Carolyn,

I am sorry that you regret your decision. I still think it was irresponsible by your cardio to talk you into getting this pacer. "Ablate & pace" is a last resort therapy in very symptomatic patients with permanent or persistent AF, and you didn't fall into that category. I mean what you did was after all just normal: you followed the doctor's advice. So many people do that without questioning the doctor's competence at all, and of course one would always expect that a doctor wants to help you, make you feel better and would, therefore, not suggest any treatment that is not really necessary.

So, what happened, happened, you can't turn back time. But what you can do is tell your cardio how you feel and that you regret the decision. I think I said that before: Maybe after listening to you, he won't talk the next asymptomatic patient into having this whole procedure done.

Hugs
Inga