atrial fibulatiom

does anyone know the answer to this question i have an irregular heartbeat and it skips. my doctor said i have atrial fibulation and need a pacemaker. will a pm make my irregular heartbeat beat regular. my doctor is going to set it at 50, does that mean it will not go on until my heartbeat is 50 if i have the pm put in and my heartbeat is still irregular and skipping beats what do they do. do they give you medicine for that.



by SMITTY - 2007-04-12 10:04:00

I can only tell you what the electrophysiologist told me during his interview before he implanted my pacemaker. Among the several things I had problems with were periods of skip beats and PVCs. He said the PM would not stop either of those, but that it would give me more uniformity in ny heart beat when the skip beats and PVCs were not present. This more uniform heart rate would make me feel better and stop the syncope that I had occasionally.

He was right on target with what he said. I got no relief from the skip beats or PVCs, but I did realize I felt better most of the time and syncope is a rare event now. The skip beats and PVCs became very infrequesnt after about a year. I still have some but they usually come after too much physical activity for the rest of my body,

As for your question about a low setting of 50 that means, generally speaking, your pacemaker will just be along for the ride until your heart rate drops below 50. However, while the PM is just along for the ride, it is constantly monitoring your heart function and if you have enough skip beats in a row to make the PM think your HR has dropped to 50 or below it will kick in even if it is for only a few beats.

There are medications for PVCs but none that I know of for skip beats.

The following is an excerpt from an article on pacemaker treatment for A-Fib:

"People with atrial fibrillation may require a pacemaker for a variety of reasons. With paroxysmal atrial fibrillation, you may need a pacemaker because you have a fast heart rate during episodes of atrial fibrillation and a slow heart rate when not in atrial fibrillation. These rates may be even slower than normal because of medications used to treat atrial fibrillation. This is called tachy-brady syndrome."

Last but not least, if you have serious doubts about what this doctor is telling you, see another before going too far. Once you get a pacemaker you probably have that little jewel for life.
Good luck,

Atrial fibrillation

by Vai - 2007-04-13 03:04:49

Just to add a few comments:
1. The pm does not cure the a-fib.
2. The pm constantly monitors the heart beat. If it detects a irregular beat that makes it think you're going at under your preset minimum (in your case 50 bpm), then the pm will intervene to regulate the heart. This action could also contribute to reducing the incidence of a-fib episodes.
3. Medication such as a beta blocker could be prescribed to suppress the heart rate and hence avoid the potential of atrial fibrillations. Dosage could be maintenance dose. This is highly dependent on individual response and subject to some trial and error.
4. If the medication suppresses the heart rate below 50, then the pacemaker kicks in to support you & avoid the dizzy spells and syncope.
6. WIth afib, some blood thinners could be prescribed as a hedge against blood pooling (& coagulation) that may lead to stroke. A daily minimum dosage of aspirin is likely.

I had paroxysmal afib leading to persistent a-fib. Since implanting the pm, the pm kicked in 93% of the time to regulate the atrium. Result - minimized afib to 8 episodes last 3 months - 6 lasting less than a few seconds, and 2 lasting from 1 hour to 4 hour. I hardly felt them although I was aware of it. I was set at minimum 60 bpm (my confort zone).

Hope this help.

A fib

by Suze - 2007-04-13 10:04:50

I had borderline bradycardia plus very intermittent bouts of A Fib with long sinus pauses after every A fib episode.... I'm on Toprol and Flecainide for the A fib. Because these medicines slowed my heartrate even more they inplanted a pacemaker. . .I'm glad to say I haven't had even one episode of A Fib (and subsequent sinus pauses) in the nine months since. So far, so good. And my energy level is WAY better!

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