Wenckebach (pronounced: Winky-Bock)

I was diagnosed with Wenckebach yesterday in the ER after thinking I had the flu for 2 weeks. It is second degree heart block. When I hit 100 BPM, is when I experience the problems. I get sweats and feel out of breath, mostly when I either climb stairs or walk for a little while. When I had my pacemaker placed in July, They only put in 1 lead because of my Persistent Left Superior Vena Cava. Not too sure what they are going to do, as I may need the other lead put in. I see the EP on Thursday. Has anybody had experience with this diagnosis? I was just curious to find out more about it.

4 Comments

Epicardial leads

by golden_snitch - 2009-11-10 02:11:35

Hi Jimmy,

so you've got an atrial lead only?

I have had surgery for superior vena cava occlusion in 2008, and when I had the surgery I only had a single-lead atrial pacemaker because my sinus node had been ablated completely. Since last year I have arrhythmia again and it turned out that I also have some heart blocks which get worse when I'm on antiarrhythmic meds (which I need at the moment). So, I decided to get an upgrade to a dual-chamber pacer. My new, ventricular lead was placed epicardially. The surgery is minimal-invasive but still more invasive than the normal pacer surgery. General anaesthesia is required, two incisions are needed. The surgeon made an incision below my left breast, and through this incision he placed the lead (epicardial means that it is attached to the heart muscle from outside of the heart); actually he placed two, one for the left atrium and one for the left ventricle: the atrial one is not connected, he just placed it in case my transvenous atrial lead fails somehow. The leads were then "tunneled" to the new pacer unit below my left collar bone.

So, that's one possibility to place leads if you can't use the superior vena cava.

Best wishes
Inga

Yes

by jimmy412 - 2009-11-10 04:11:48

Thanks Inga,

Yes I do have just an atrial lead due to the fact that they could not put in the second lead due to my heart setup. I just wondered how they could put in a second lead if needed. I thought they could do it somehow on the exterior, but was not sure how it would be done. I will probably be discussing it with my EP on thursday. It at least gives me some insight to it. He said if he did it the same way it would leak is what he told me before. That was why they did not do it in the first place. Thanks for your information. It is most helpful.

Jimmy

Total superior vena cava

by Shirley - 2009-11-10 06:11:04

Hi Jimmy,
My story is that after a mibi test (nuclear heart scan/stress test) I was diagnosed with right bundle branch block. That coupled with freuqent fainting, weakness & a heart rate of 28 (confirmed with an overnight Holter monitor) & complete AV block, I was sent to emergency where I underwent an urgent cardiac cathertherization & temporary pacing.
When that failed, I received a 2nd replacement via the right femoral vein, during which they confirmed a complete occlusion of the superior vena cava. Finally a permanent pacemaker was placed via the abdominal approach. This required general anaesthesia, the PM is in the anterior abdominal wall in the left lower quadrant (right near the leg joint) and 2 leads go up to the atrial (triggered) and ventricular (paced 100%)and as mentioned above, are epicardial (on the o utside of the heart.

Not sure how much this has helped except to say there is always a way. The hospitalization time is significantly longer or was for me.(7days). Thank God for our Canadian health system. Didn't cost me a penny & I was in a private room right beside the nurses monitoring station. I also find it difficult at times to determine whether my breathing problems are because of my lung obstruction or due to something with the PM. Quite a number of folks have commented on here about their PM slipping under their arm pit. Myself, I feel it moving around from time to time and rubs against my upper leg joint when I am exercising or such. It will also require a slightly longer hospital stay for replacement I am told.

AV Block

by braves09 - 2009-11-14 08:11:20

I would have problems when I exercised, climbed stairs,hills, etc. My heart rate would get to a certain point say 110 bpm and then all of a sudden the rate would go to half of what it was causing the sensation you describe plus near passing out. They finally saw what I was doing on a stress test (AV heart block) and decided to put a St. Jude PM in--two leads . Took awhile for them to get me dialed in but have been doing well for the past 1.5 years. Had a PM test less than a month ago and technicain said my bottom chamber was 100 % dependent on the PM. Works great for me. All I can say is if you have problems don't hesitate to contact your doctor. Asheville Cardiology takes care of their patients ASAP.

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