EJECTION FRACTION

I have had a pacemaker since I was 38, now 69. I have had 3 pacemakers and now 3 ICD, due to a v tach 10 years ago. I had a echo done in May this year, my ef was 43, had one last week 37. Iam now scheduled to have bi-ventricular on installed. Dr. said it was caused by having a pm for a long time, I am dependent. I am worried about all of this, should I be? Anyone else similar problem? What to expect

 

Thank you


6 Comments

worry

by Tracey_E - 2019-02-21 10:34:37

I would take it seriously but not necessarily be worried. 37 isn't great but it's not awful either and the new pacer should help it. 

Long term pacing can cause EF to drop, but so can aging so it may or may not be the pacing. We don't really have much choice in the pacing, especially when we are dependent, so I've always felt that it is what it is. Hope for the best and be proactive if numbers start to change. This can't be fixed but it can be managed.  Your doctor has been keeping a close eye on it and is quick to intervene, so it sounds like you are in good hands. 

pacemaker

by Dave H - 2019-02-21 11:55:20

I'll add this to what Tracy stated:  You mentioned your two echo's and that you'll be getting a new PM soon, correct?  You appear to be the perfect candidate for a pacemaker optimization.  Pacemakers are not "smart" devices - out of the box, they are close, but no cigar.  They can be "tuned" for optimal performance - that requires a Doc. who can really "read" an echo.

--Dave--

What? Me worry?

by AgentX86 - 2019-02-21 15:21:05

First, worrying won't make anything better. Don't do that. It sounds like your EP is on top of things. The biventricular (aka CRT) pacemaker is the fix for pacemaker induced cardiomyopathy.

I had an AV ablation a year ago (leaving me dependent,  also) and they put on a CRT-P pacemaker for the specific purpose of avoiding pacemaker induced cardiomyopathy. They will also reverse cardiomyopathy, in most cases.

CRTs don't work by making the heart work harder, the opposite is true, really. They work by synchronizing the ventricles so they work with each other rather than against each other. If it doesn't seem to help enough out of the box, the pacemaker can be optimized for maximum LVEF. There are more knobs that they can turn to get your life back. There was a thread in this group recently, where someone with a CRT had the optimization done and it changed his life, essentially.

Sure, things can go wrong but that's rare. With these things,  they go right far more often. You have a *lot* to gain and very little chance of making it worse. What's to worry about? Things you can't change?

No Worries

by Scottie - 2019-02-22 10:54:53

I have to back up what AgentX86 said above.  My current pacer (replaced in 2014, my 3rd) is a CRT unit, and they added the third lead at that time.  My understanding, which included a bit of outside research is just that, that the third lead allows for better synchronization to make your heart work more efficiently, not harder.

Just had a stress test last week, and my EF measured out at 65%, and they were pretty happy with that.

I have to believe that your EF will be improved with a CRT pacer.  Please let us know how it works out!

Scott

Ejection fraction

by RON - 2019-02-26 14:36:31

Thanks to all of you for he reassuring commets. I am scheduled to have the CRT put in on March 11th. 

got one

by dwelch - 2019-03-07 22:30:28

My EF dropped over time.  over 30 years with pacers.  Put in a bi-ventrical this time, EF jumped back up, feel better, etc...I do get the belly bumps which are more fun than a problem.  Stand just right hold your breath just right, and the signal that fires the left ventricle will also fire a muscle on the side for a couple of beats.  Cannot make it happen when i want to, might be a nice party trick...

Happy with the settings so no need to adjust that out.  I do feel better now that I have the biventrical...

 

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