a fib

does any one have their pacemaker set to interrupt or treat a fib?  


5 Comments

Not Posted for Many Years

by Penguin - 2023-09-27 04:01:56

Hi Trish, 

Just looked at your profile / bio and I see that you haven't posted for around 7 years.  Is the a.fib new for you and do you still have the same pacemaker? 

A pacemaker can detect an a.fib episode and mode switch to a different pacing mode to ensure that pacemaker doesn't track the fast, arrhythmic beats down to the ventricles.  If it tracked the fast beats it would cause symptoms.  The setting is called 'AMS' Automatic Mode Switch.  There are other settings which may help but those may be dependent on the make / model of PM that you have. Is your bio up to date? 

As far as I know, A.Fib is mainly treated with medication.

Welcome back. 

Oh to find a cure for AF

by Gemita - 2023-09-27 05:56:11

Trish, you specifically ask: does any one have their pacemaker set to interrupt or treat Atrial Fibrillation?   I would answer yes with three particular settings which I have given below.  The first thing I would do is to ask your pacing team which settings you have available on your pacemaker to help with your AF and whether these have been optimised for you?

While our pacemakers can “help to interrupt or to treat AF", a pacemaker as most of us will know, is certainly not a cure for AF (if only) because AF has so many causes and triggers.  Without finding the cause and “successfully” treating it, I am not sure that we can ever rid ourselves of this pest.  For example, ageing itself can be a cause for AF and we cannot do much about stopping the ageing process, can we?  

Nonetheless a well adjusted pacemaker has certainly helped to “control” some of my AF symptoms and even helped to prevent me from sliding into AF on occasions.  My most important settings are as follows (in no particular order):-

Automatic Mode Switch:  This setting is set to activate if it detects an atrial tachyarrhythmia like AF, Flutter above my set rate of 171 bpm, when it will automatically switch me from my current atrial pacing mode (AAI) to a non atrial tracking mode (DDI) until the arrhythmia ends when it switches me back to AAI.  This successfully prevents any fast atrial rates from getting down to my ventricles, the main pumping chambers of my heart and pushing the ventricles too fast which would be dangerous.  

Atrial Preference Pacing (APP):  (works rather like Rate Smoothing/Atrial Rate Stabilisation which is available in some pacemakers).  APP responds to changes in the atrial rate by accelerating the pacing rate until it reaches a steady paced rhythm that is slightly faster than my intrinsic heart rate, up to a programmed maximum rate.  This often helps to overdrive pace the slowing atrial ectopic beats which frequently lead to my AF episodes.  APP is designed to reduce the incidence of atrial tachyarrhythmias and this setting certainly works well for me.

Lower Rate Limit or Base Rate:   I have consistently found that a higher lower rate limit/base rate is immensely helpful in controlling my slower, irregular ectopic beats which always trigger runs of AF.  My LRL setting is 70 bpm.  

Other treatments for AF would include Medication, Ablation, Cardioversion, lifestyle changes, but in my experience it will be a combination of treatments, including pacing ones for those of us with pacemakers and of course finding your triggers/causes (another subject) to successfully treat AF.  

Good luck Trish and when you find your personal cure, please let us all know

Pacing for Atrial Fibrillation

by Selwyn - 2023-09-27 12:50:22

Rather than repeat a lot of stuff, can I refer you to:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1767518/

The long and the short of this is that it depends on the causation of your AF.

The vast majority of people with AF, pacing will not be effective for control. 

Please note the age of this paper. I have no personal experience, though like you asked the question. I think you will also find something if you use search ( top right corner) , though I haven't tried.

afib

by new to pace.... - 2023-09-27 14:52:02

For me my triggers are food related.  If i eat something that i am sensitive my reaction is to quickly fall asleep. Which causes an A-fib epsiodes. You might want to keep food journal for a couple of weeks.  Then compare those days and times to your pacemaker report.  Mine is quartely.  I have to call an ask for the report.

Make sure you ask for the log events(not all appear but maybe 2 pages) and summary page. 

new to pace

Selwyn's Article

by Penguin - 2023-09-27 16:02:51

I know this doesn't directly answer Trish's question but having (tried) to read and fully understand the article that Selwyn posted, this subject seems rather more complicated than just setting up a PM to interrupt AF.  You need to know what you're dealing with and what your chances might be Trish. Sounds like you need to discuss it with your EP to see what may and may not help in your case. 

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