Wrong Device Installed?

I feel fortunate to have discovered this forum and the people on it. There are few people who you can talk with about pacemakers, and, it seems, almost none who have had two entirely different models. As background, I am a male in his late ‘60s who was healthy until January of 2008, when I contracted MRSA. I stayed there for about one month and was released with both lung and heart problems. The lungs have cleared, but the heart has gotten worse. I was diagnosed with atrial fib and CHF. I followed all the instructions – limit salt, no cranberries, no smoking, avoid leafy greens, etc.

After several trips to hospital, it was determined that my discharge fraction was down to 20-30 percent and I was showing indications of ventricular tachycardia. This led to the decision to install a pacemaker in July of this year. Nothing has gotten any better. After two more trips to hospital, they came to the conclusion that the lead to the left atria was not working, so it was turned off. In addition, I was told I had renal failure. I was still extremely dizzy, weak and running out of gas virtually all of the time.

Last month I decided I wanted a second opinion and scheduled at trip to Mayo Jacksonville. It was their recommendation to remove the two lead pacemakers and replace it with a three lead, biventricular pacemaker. Has anyone who chooses to comment had a pacemaker replacement/upgrade? Certainly nothing got better after the pacemaker installation in July. Has anyone seen an improvement with a biventricular pacemaker was used to replace a two lead model? Any and all comments will be appreciated.

5 Comments

bi-ventricular pacer (CRT)

by golden_snitch - 2009-11-01 03:11:34

Hi!

I haven't had this upgrade, but I would say that with your problems you should have been fitted with a bi-ventricular pacer/ICD-unit right away, and not with a dual-chamber pacer. With heart failure and probably ventricular tachycardia, a bi-ventricular pacer combined with an ICD is in my opinion the best choice. A pacer can't do anything about ventricular tachycardia; if it's a fast one the ICD can do anti-tachycardia stimulation and shock you out of the tachycardia.

A friend of mine was diagnosed with complete heart block at first so she got a pacer, but later on they added CHF and then she got the bi-ventricular pacer. Her EF went up from 27% to 45%, and she is doing sooooo much better.

Regarding the atrial lead: if you are in atrial fibrillation all the time, the lead is almost of no use. It can sense what's going on, but it can't pace you because the rate in the atriums is so much faster than the pacer can go. However, for the bi-ventricular pacer it's better to have a working atrial lead so that it can check what's happening in the atriums. But it's not that this pacer will not work when the atrial lead is not working; it does (the friend I mentioned has tried this since her atrial lead is a bit broken).

Best wishes
Inga

THANKS FOR THE RESPONSES!

by BbqMan - 2009-11-01 06:11:56

I appreciate all that you have shared with me. Peter, since our conditions are so similar, your post in particular encourages me.

bi-vent

by Tracey_E - 2009-11-01 06:11:57

I agree with Inga that a bi-vent will probably help you significantly. It sounds like they were trying to take the conservative route first, but it's not working so adding the third lead is the next step. Other members here have had the same results as Inga's friend, a good increase in EF.

QUITE RIGHT

by pete - 2009-11-01 12:11:02

What the hell are they doing to you? They should have fitted a Biventricular Cardiac Resynchronisation pacemaker with only two leads fitted. One to each ventricle and no atrial leads fitted. Six weeks later after to allow for lead fixation they should have given you an AV node ablation. I had Afib CHF and Vtach same as you. So I know what I am talking about. I had worked out myself before the doctors what type of pacemaker I should need and that I was also insistent on an AV node ablation. I am approximately the same age as you and I have gone from not being able to turn over in bed, hovering at deaths door, to being able to climb a mountain.Kick up a stink. Cheers Peter

Bi-vent Implanted

by BbqMan - 2009-11-06 08:11:44

Had the bi-vent put in Wednesday and am feeling better already. Still trying to cope w dizziness, but much better otherwise. I go back next week for a checkup and then again in six weeks for PM adjustments and a cardioversion. I've only felt this puppy kick-in about half a dozen times, but boy do I know it when it does. Once again, thank you all.

You know you're wired when...

You fondly named your implanted buddy.

Member Quotes

I am just now 40 but have had these blackouts all my life. I am thrilled with the pacer and would do it all over again.