Disconnecting lead to atria

Hi to everyone!!

I just joined with an interest to better understand the condition of my grandma who has been living with a pacemaker for 14 years.

This week she was rushed to hospital after having a rapid heartbeat. She stayed in the hospital overnight for observation.

Her cardiac doctor advised her to have surgery to disconnect one of the leads, the one that stimulates the atria, so that her pacemaker would just work on the ventricle.

Has anyone else experienced this?

I thought pacemakers have an upper rate limit of 120-130bpm to prevent it from beating too fast. Isn't this a safeguard to stop the heart from beating too quickly?

I gather experts debate whether dual chamber synchronous pacing is superior to single chamber ventricular pacing. The doctor said it's a small operation to disconnect the lead.

My gandma is concerned about any surgery. I informed her that pacemakers are very effective and failure is extremely rare.

It would be great to hear any thoughts and especially if you know someone who has experienced dual chamber to single camber pacemaker.

Thanks!!!!

5 Comments

leads

by Tracey_E - 2009-07-18 07:07:01

I don't understand why they'd want to disconnect it when they should be able to simply turn it off. Is it malfunctioning? That would be very rare. When they usually go bad, they stop working rather than work overtime.

Yes, it is true that pm's are programmed to only go so fast, to the upper limit that's usually set around 120-130, but if your heart goes faster than the upper limit on its own, the pm can do nothing to stop it. Pm's only generate beats, they can't prevent beats the heart does naturally. Why does she have the pm? I might be able to give you a better answer if I had more info.

Reply to TraceyE

by ladyi - 2009-07-18 07:07:11

Thanks for your quick reply and I appreciate your information. I'll gather more details and come back.

I hope it will be understandable

by mikki14 - 2009-07-18 10:07:21

Hi there,

yes, it would be better to know more informations about your grandma, but what is my opinion ..? There is one way why they maybe want to disconnect the lead - if she has AV block ... her atriums can go faster (as you said she had a rapid heartbeat and because of it she went to hospital for observation) and if the atriuns go faster on their own, the lead, which is on the ventricle goes at same speed as the atriums. And if she really has got the AV block and they will take out the lead from atrium, she will have normal pacemaker rate. After they will take it out, her atriums could still go faster, but her ventricles will have the rate as the pacemaker, not that fast as her atriums. I hope that it is understandable. It is a bit more difficult to explane it in English, so hope that you will underestand me ;-). Let me know, if you underestand that please... if not, I will try to explain it again but by another way.

Have a nice time,

Misa

Why Disconnect The A Lead

by SMITTY - 2009-07-18 10:07:35

Hello Ladyi,

Welcome to the Pacemaker Club.

Tracey covered your questions well, which I totally agree with but I would like to add a comment to what she said.

Let me start by asking a question or two. You say you mother has been living with a pacemaker for 14 years. Is her current pacemaker the original? Also do you have any idea what percentage of the time the pacemaker helps your mother's heart beat? Another is this doctor the one that implanted her pacemaker?

I'm going a little further on what Tracey said about a pacemaker not helping or controlling the heart beat when it exceeds the upper setting on the pacemaker. Our pacemakers have two set points, a low and a high. I see people report here that they have low set points as low as 40 and I have seen some report having high set points of 140, or above. There is no standard range and the one for a particular person is determined by what the doctor thinks is best. When our heart rate drops below the low set point the pacemaker is supposed to come on line and bring the heart rate back to at least that rate. As Tracey said, when the HR exceeds the high set point the pacemaker no longer assists the heart rate. It then becomes a monitor of the heart rate waiting for it to drop below the high set point before it will again help.

I have recently read articles about a pacemaker that is being developed or has been developed (my memory is on vacation today and I can't recall which) that controls A-Fib very much the same way a defibrillator controls V-Fib, except much lower voltage is applied to stop A-Fib than is used to stop V-Fib.

This is getting much longer than I planned, but I have one more comment. Just before reading your message I read a column in the local newspaper by Dr. Gott on the subject of A-Fib. In case you are not familiar with Dr. Gott, he is a M.D. that writes a daily newspaper column in which he answers questions from the readers on health problems. If you have not seen his column on A Fib, you can find it at http://www.whittierdailynews.com/weekend/ci_12853665.

I wish your mother the best,

Smitty

disconnecting leads

by bombay gal - 2012-12-21 02:12:47

Hello,
I was having issues of fast HB too, due to the PM triggering the heart to go faster, and the disconnected the upper leads to let the Heart do it own thing.
My point is, she does not have to have surgery to remove the leads, with todays PM and technology, they can just disconnect the lead you dont want.

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As for my pacemaker (almost 7 years old) I like to think of it in the terms of the old Timex commercial - takes a licking and keeps on ticking.