Echocardiograph pacemaker optimization facilities?

Does anyone have recommendations for facilities that perform Echo-guided BiV pacemaker optimization?  I'm in SC and the two facilities I've gone to don't do it.  Thanks.



by islandgirl - 2019-05-24 15:24:34

 Firstly, I would suggest you speak to your EP.  

Are you talking about synchronization with the pacemaker to your heartbeat? If's my experience.

My EP and an ultrasound/echo tech do it in the radiology dept. at the hospital.  My EP uses his own Medtronic computer and the ultrasound tech does the echo. They call numbers back and forth to eachother.  It takes about an hour.  I've been having it done at least a couple of times a year, but it's specific to my problem.   It's nonivasive and it's just like having an echo. My EP can tell from my EKG when I need to have it done.

I was upgraded 2 1/2 years ago from a pm to an ICD after a sudden cardiac arrest due to electrical problems.    I'm paced 100% in the atrium from SSS, now 100% paced in the right ventricle  since the beginning of the year.  I have something deteriorating my heart/cardiomyopathy and also causing thickening, and the thickened area has now prevented the electrical signal from going to the right ventricle.  


by John@PC - 2019-05-24 20:47:13

Thanks Islandgirl (now I've got that song playing in my head).  Sorry to hear about the issues your having, but it sounds like you're in good hands.

I intend to consult my EP but he's already told me he hasn't seen this before.  This suprises me because from what I've learned it is pretty classic pacemaker syndrome, albiet with pretty drastic drops in blood pressures (up to 40 systolic from sitting to standing when v-paced).  I can tolerate the v-pacing ok when I"m sitting or supine (hate the sensation though).  From I've read about dopler optimization (which I take it is what you had) it's the most effective way to program AV and VV delays and "optimize" your heart and body's hemodynamics. After my last programming changes things are better, right now both my rate response and LV pacing are turned off so I have no benefit from those.  Not complaining, just wanting to find answers.  



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