2:1 av block before dual chamber ICD/Pacemaker, but gone 2 weeks after implantation

It happens

by Good Dog - 2017-08-04 20:21:07

We had someone post here recently that had his PM and leads removed due to a case of Primary HyperAldosteronism (Conn's disease) with his left adrenal gland playing havoc on his body/hormones/heart (as he put it). He had the adrenal gland removed and no longer needed the PM. His story is on the previous page of posts....titled "it's out"

Last year I had a friend that underwent a PM change after 10 years. Had an infection after the change-out surgery and needed to have the PM and leads removed to clear the infection. The Doc then told him that he no longer needed the PM. I tried to find out why, but the only thing he could tell me was that the Doc said he no longer needed it. I was beside myself trying to understand, but never could.

So while I always figured that folks received a PM and had it removed due to malpractice, I guess that I have learned that there are legitimate reasons for it to occur. However, I do think it is rare.

I am happy for you and wish for you to enjoy your PM-free life!!! 

Sincerely,

David

adapting to pacing

by Tracey_E - 2017-08-04 22:24:39

Did you get a pacemaker or icd? If you have an icd, then there is more going on that simple av block. ICD's shock the heart out of dangerous rhythms, not a risk with av block.

AV block can be a fluid thing, the heart can go in and out of it. I've been considered 3rd degree block all my life but every once in a while when they hook me up, I'm only in 2nd degree block. That's normal. NNot being in block when they tested you today doesn't mean it's not still happening. 

The lower limit refers to atrial pacing, how slow it'll let the heart get before it kicks in, and doesn't really apply to us. With av block our sinus node usually works normally so we have an atrial lead but that's not  how we pace. Our sinus node tells the atria to beat and goes up and down normally, but sometimes the signal does not get to the ventricles. The pacer watches, every time the atria beats it gives the ventricles a fraction of a second to get with the program, kicking in with pacing when necessary. The pm is playing follow the leader with the ventricles, not setting the pace with the atria. It's possible to also have atrial problems so you may feel a difference with a lower atrial rate, but most of us rarely if ever pace atrial so that number is irrelevant.

It took me a while to sleep well at night and get used to the faster (normal!) rate, but it eventually became my new normal. I started sleeping again and I stopped noticing it all the time. Now, I barely give it a thought. 

Your energy probably isn't good because you had surgery two weeks ago and it takes the body time to recover. It's minor surgery, but it's still a shock to the body. Give it 4-6 weeks before making any judgments on your energy level. 

How much have you been pacing? In theory if you are in 2:1 block all the time, you'll pace about half the time ventricle, none atrial. They can tell you your pacing numbers. The time the tech noted that I was in 2nd degree instead of 3rd, I got all excited and asked for the numbers.... I'd dropped from 100% to 98.5%. If you do the math, that's a lot of beats my heart worked on its own for the first time ever, but in the grand scheme of things it's barely worth mentioning.

If you truly don't need it, they can easily take it out for the first year. The first thing to do would be confirm that you aren't pacing at all over a period of months. Not weeks, months. Next would be to turn it down very low and see how you feel for a few more months. The worst thing you could do is do it too quickly, end up needing it and having to get another one. Of the thousands of members here, I can only recall removal happening 2 or 3 times. Doctors don't pace us lightly, insurance doesn't cover it if there isn't adequate reason.