Atrial Fibrillation after Implantation of Pacemaker

On December 18, 2018, a Medronic pacemaker was implanted. I apparently had bradycardia with a pulse of 28 bpm at night with 7 second pauses. But I was asymptomatic. Five days after receiving the pacemaker, my chest began hurting and deep breaths were painful to draw. I was told that my heart tissue was inflamed, and that Ibuprofen was the answer. I took it for several days, and the benefit was amazing. No more such pain. Today, December 27, I went in for a wound check, feeling fine, and the technician also monitored my pacemaker. She stated, "You are in atrial fribillation." Now, my EP has prescribed Pradaxa until my heart is back into rhythm. Again, NO SYMPTOMS, FEELING FINE! Here is what I want to know: is this new revelation of AFIB a result of irritation of the heart, and will the condition correct itself? Or will I be living with AFIB and Pradaxa forever? I would appreciate some advice on this from those of you who may have experienced similar events.


4 Comments

Afib

by Theknotguy - 2018-12-28 11:53:34

Having a pacemaker has nothing to do with having afib.  The tendency was there before you got the pacemaker.  All of the activity concerning your heart may have  pushed the afib activity to the surface and finally the afib has shown itself, but the tendency was there all along.  Or, as I tell people, there isn't too much you can do about the fact your grandparents swam in the wrong gene pool.  

Once afib surfaces, risk is risk and you'll need to take Pradaxa, Eliquis, Warfarin, and/or aspirin for as long as you live.  Doctors can't predict the next time you'll have an afib session.  Afib sessions can cause a blood clot in the heart and the heart pumping can pump that clot out possibly causing a heart attack or stroke.  And, from past painful personal experience you don't want a blood clot in your heart.  Not to mention the heart attack or stroke.  You can negotiate which of the medications you'd like to take, but not taking the medications isn't an option.  Sorry to be the bearer of bad news but that's reality.  

The pacemaker can do nothing for your afib.  You'll need to rely on heart drugs or an ablation to fix the afib problem - if it can be fixed.  I'm on what is called rate control.  That's where I'm given heart drugs to slow my heart and limit afib, then the pacemaker is used to keep my heart rate at a livable level.  As it is, I'm in afib between 15 to 20% of the time.  I also have two programs running on my pacemaker to pace me out of afib but most people don't have that model of pacemaker.  

In your place, I'd have a serious discussion with your cardiologist and map out future strategies on how to live with afib and your pacemaker.  It can be done as I've had my pacemaker for five years and have successfully held off needing an ablation for that amount of time.  My EP says I'm not "sick enough" to have an ablation.  

Hope you can get some good answers.  

AFIB and PACEMAKER

by JoyfulLSS - 2018-12-28 15:37:55

Would you respond the same if I were to tell you that I wore two ZIO patches and a patch with an electronic monitor (I forget the manufacturer's name) for over a month in toto and that there were no signs of AFIB? One of the nurse practititioners on my case told me that she has seen AFIB result from irritation of the heart muscle resulting from the implanatation of a pacemaker. I am aware of what the conventional wisdom is on this subject, (and you have expressed it aptly), but was wondering if anyone out there had had the kind of experience to which the nurse was referring.

Afib

by marylandpm - 2018-12-28 15:54:50

  I am going to disagree with the first comment. If you are 100% paced and the right ventrial lead is in the apex you can get AFib from the way the heart is beating.  I have be dealing with this since I received my pacemaker in 2015. I take eliquis and have had two ablations. I did not have Afib before I received the pacemaker. I also would not be here if I was not rushed to the operating room and had the pacemaker implanted. 

Atrial fibrillation due to pacing

by Selwyn - 2018-12-29 11:46:07

There are many reports on this site of the onset of atrial fibrillation (AF) following pacing. Why?

Could this just be due to chance?

Whether having a pacemaker inserted is so stressful that it triggers AF is open to debate as there is no doubt that stress is a trigger?

Exercise also is a trigger for AF. Clearly having a pacemaker enables a lot of us to be fitter, doing more exercise, and therefore more subjected to the onset of AF.

Any surgical operation on the heart may trigger AF. Having wires pushed around the heart could be seen to be one such trigger. Medical studies to date have used  small study groups and therefore are inconclusive.

The asynchronisation of atria with ventricles, should the pacing not be well adjusted, may cause AF.

The longer you have AF the harder it is to get rid of it by medical treatment. My last episode lasted 48 hours and settled with rest ( as it was caused by too much exercise!). I have had one electrocardioversion ( after 3 threats of this for AF), and now am a lot better having had two AF ablations.  AF is not necessarily a sentence for life, though can be difficult to eradicate. 

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