pacemaker time???


I was diagnosed with Idiopathic Cardiomyopathy in December of 1996. But doctors stabilized me with medication, found my arteries were clear, and cardioverted me back to a normal heart rythym.
For 9 years I was in generally good health, walking regularly and feeling good mentally and physically, with only occasional dips into atrial fibrillation.Cardioversion always brought be back out.

But four years ago, I slipped into atial fib and cardioversion no longer worked. Since then, I've gone slowly downhill. I was recently hospitalized and doctors discovered my 24 hour heart rates ranging from a low of 25 to a high of 190. I am 68.

After retesting, a doctor at the Heart Institute here said i didn't need a pacemaker because the second round of tests had shown some marginal improvments and that my ejection fraction was about 37. My own cardiologist says I should have the pacemaker installed now because a) I'll need one eventually anyway and b) a pacemaker will make it possible for him to safely give me higher doses of meds like carvedilol, which should help relieve some of the fatigue.

I've agreed to have the pacemaker installed in about 8 days. But I'm apprehensive about the differing opinions and concerned about what it will mean for my lifestyle, ability to exrcise, travel, etc. etc.

I'd appreciate any suggestions.

Ray

5 Comments

Pacemaker Time

by SMITTY - 2010-01-10 07:01:25

Hello Ray,

Welcome to the Pacemaker Club.

I say go with your cardiologist and forget what the doctor at the Heart Institute said about your not needing a pacemaker.

Frankly I'm surprised that they didn't want to implant one immediately after finding a low heart rate of 25. Of course, as you know, the 25 doesn't happen often, but a HR of 25 and an EF of 37 sounds like an invitation to a real problem. But then I'm not a doctor.

I got my PM 9 years ago at age 71 and I seldom needed it at the time, but when the need arose I'm glad I had it in place although I used it less than 10 percent of the time for the first 7 to 8 years. With pacemakers being "on-demand" devices they just go along for the ride until they are needed.

On the possibility you may not be familiar with the pacemaker being on-demand device, I'll take a minute of your time and tell you what I know about that. Pacemakers have a high and low setting and these settings are adjustable. In my case when I got my PM it had a low setting of 80 and a high setting of 120. What that meant was when my heart rate dropped below 80 (which would have been all time) the pacemaker went to work and gave me a minimum HR of 80. The PM continued to help maintain a steady HR rate until my HR reached 120. The PM then took itself out of the picture, except it would continue to monitor my heart function and in case its help was needed it would again step in. I never knew why I got the initial setting of 80 and after three weeks, at my first checkup, they lowered the low set point to 60. There it stayed until a few months ago when new problems caused it to be again raised to 80.

I'll comment a little on your concern about "what it will mean for my lifestyle, ability to travel, etc." In a nutshell, nothing after you get over the surgery which can take from a few days up to, in unusual cases, a couple of week. For me it was about week for the first one and my replacement a few months ago. After that you will be hard pressed to even notice you have a pacemaker. I was just a couple of years older than you when I got mine and I can truthfully say it did not then, and does not now hamper me in anyway. The only thing I do consciously avoid is a lick directly on the PM. Not that it would hurt the PM but I know it would hurt me and a such lick could damage the leads. What it really means is no more kick boxing or tackle football for you after the PM.

With an EF of 37% you could very well find that with a constant HR of well above the low of 25 reported, you may find that you will feel better and even have more energy. Can't offer any guarantees on that but it happened to me when they raised my low set point to 80.

One final word. Don't fear the pacemaker implant surgery. I've had dental work that was much worse. With the proper settings you will not even know the thing is there until you happen to feel the little lump where it is implanted. We never feel a PM when it is working anymore than we feel our heart when it is working normally.

I wish you the best,

Smitty

get it

by Tracey_E - 2010-01-10 09:01:51

25 is a low rate!! You will feel better if it's higher, more energy as Smitty pointed out. It will not slow you down. I've traveled extensively, never had a problem with the pm other than taking a bit longer to get through security at the airport. Everyone responds differently, but if anything it will give you more energy and ability to exercise because your heart will be more efficient.

I agree

by ElectricFrank - 2010-01-10 11:01:26

Mine was down to 25 before I got the pacer. I was awake during the implant and the feeling when they turned it on was great.

Another thing to consider is that with your current condition the other organs of your body, including your brain, are receiving marginal blood flow. It not only affects how you feel now, but also the long term health of your body.

Get it, you will like it!

frank

EF of 14

by cruz - 2010-04-10 12:04:59

Frank,
I'm 58 and my first echo showed EF of 14 and 3 mos later, after medication, showed 11. I got a PM 5 weeks ago and my shortness of breath is much better. With an EF as low as mine, it takes very little mediction to put me to sleep, so I slept through almost everything except them turning it on, which hurt for a moment. I'm just curious...what is your EF now/after PM? Did it improve? I feel very fortunate to have the PM.
Thanks,
CC

Type and EF in 1998

by greenlove - 2010-09-05 07:09:01

Hi,

So glad tp hear about someone like you who manages well! What was your EF When Diagnosed in 96?
What was the cause of your idopathic cardiomyopathy?
Sounds like you strickly followed doc's order regarding. lifestyle changes (smoking, drinking, limiting salt and exercising regualry). Did/do you have any heart failure symtoms? Have your doc's been adjusting your meds over the years.
Thanks in advance for anwering my questions. I am new (dx in July/2010) with ICD. Just wondering how you've been ale to survive all these years and with relatively good heath? God continue to bless you!

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