New to forum- Medtronic Cobalt patient

Hi folks,

I hope everyone is doing well today! I have one of the new Medtronic Cobalt ICD's since Oct 2022. I have CHF and Afib. I also had the AV Node Ablation done at the same time. I felt better immediately after the procedures!!


I had an EF of 20 and it has gone back up to 32 since Oct. Just had a recent echo. Afib is gone. My low setting is 70bpm. I am young for a device. Just turned 60. I do have the bedside monitor device which reports every 90 days I guess. 

At any rate, I'd be pleased to chat about the experience and I'm hoping I'll have plenty of replacmenet devices installed in the future! I guess battery life is around 7-8 years..maybe 10?

I take a lot of meds. Entresto, Farxiga (for HF), Eliquis, Metoprolol (switched from Carvedilol). Spirono. Also cholesterol meds.

Hoping everybody does well here and looking forward to participating!!

Jim VD


Hi Boltman

by AgentX86 - 2023-06-01 22:13:25

Welcome to the club.  Wish you didn't have the need to find us.

I wonder if your Afib is really gone.  I can't imagine why it would have just gone away.  I too have had an AV ablation, but for flutter.  I can still see the flutter on my Kardia Mobile but don't feel it.

I don't have CHF, so I only have a pacemaker (not ICD).  It is a CRT (only the two ventricular leads used) ,though.  I've had my PM for five years. It reports 2-1/2  years left.

Though I don't have CHF, so don't have the drugs to mitigage that, I take a potfill of drugs for other reasons. Getting old isn't for sissies.

AV Node ablation

by Gemita - 2023-06-02 00:35:59

Jim, hello, I am not sure what you were told about an AV Node ablation, what it can and cannot do to relieve your AF? 

My doctors told me an AV Node ablation is usually carried out when a fast atrial arrhythmia like AF cannot be controlled with other treatments like medication, cardioversions, pulmonary vein isolation ablation.  The AV Node ablation is then done as a last resort, to disconnect the top chambers from the lower ones permanently, preventing the signals from a fast arrhythmia like AF from getting through the AV Node to push our ventricles too fast.  I note you have heart failure, so you would find a fast heart rate difficult to tolerate in any event. 

Patients immediately become pacemaker dependent following an AV Node ablation, but they should feel better since they will no longer feel the irregularity of rhythm and more importantly, their ventricles can then be paced at a steady rate set by your doctor.  The AF however would still continue in the atria either intermittently or permanently. An AV Node ablation cannot stop this from happening.

The other type of ablation, mentioned above, called a pulmonary vein isolation ablation has the potential to stop AF at least in the short to medium term, but this is not the purpose of, or possible with an AV Node ablation.

Having said all of the above I note Jim that your new device has some very clever programmes running which can help detect, reduce and respond to AF, so these programmes are clearly helping to “control” the AF, but stopping it permanently, unlikely I am afraid.

Both my husband and I have Medtronic pacemakers, implanted in 2018 and also have Atrial Fibrillation.  I have some clever programmes running too which help control my AF but the pacemaker cannot stop my AF.  Effective permanent treatment for AF is still some way off I suggest! 

I hope you continue to make good progress and that your ejection fraction will improve further.  So far very good news.  Welcome to the Pacemaker Club.  Look forward to your future contributions.

Great info

by Boltman92124 - 2023-06-02 01:42:25

Thanks for the replies! Yes, I have more to learn about what comes next. But the fast heart rates are gone. In the first 6 months after the procedures, I had one VT episode that lasted under 10 seconds. Other than that, no irregular rythms aside from the occasional PVC's. Doctors said that was normal. I'm also aware there may be a need to do another ablation down the road.

Yes, I'm well aware I'm 100% dependant on the device at this point. I had/have a team of 3 cardiologists. It is the Scripps Healthcare group in San Diego. Knock on wood but I'm hoping I can get my EF back into the 40's. 

As for the therapies this device does, it is very interesting indeed. My reports seem to read all zero's next to the different categories. I look forward to learning more here. Best wishes to all and thanks for the feedback!!


Jim VD

Hi Jim!

by Lavender - 2023-06-05 09:14:13

You sound upbeat and are doing the right thing in researching your new buddy/device. I am 100% dependent too. It took me seven months to get used to this-physically and mentally. I was reluctant to get this but my heart protested and dropped me in dead faints to get my attention. 

My EF improved a while after I got it-it's normal now. 

Hi Lavender!

by Boltman92124 - 2023-06-05 11:59:39

Congrats to you too! Boy, I hope I get that EF back in the mid 40's(or higher!) like you. I started real low around 20! You're right, first echo 3 months later only showed small improvement. But 6 months later up to 32. I have been in the low 30's for over 10 years before the afib kicked in. I put off getting a device because I felt "OK" I guess. Let's go 40's!!! Best wishes to you and thanks for the reply! 

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