Biological Pacemaker

Hello everyone, im 20 years old and have had my pacemaker for 2 years now from a doctor that ablated my av node from WPW ablation. I want to play sports again and my pacemaker still causes problem such as 2 to 1 atrial tach and also the risk of leads being knocked out. I want to play football again soooo bad! Does anyone know of any clincal studys that may fixed heart block? I want to be able to go without a pacemaker and play sports again!



by dwelch - 2019-10-13 23:15:49

Not sure what your other issues are but got my first pacer at 19, complete heart block, and didnt slow down sports at all.  Not football but bmx and vert skating.  Hitting a wall on a ramp at 20mph or a fall from a dozen feet should equate to a hit in football.  

Who made this restriction and what is the real concern?



reply to dwelch

by RwB15 - 2019-10-13 23:37:14

Im cleared to play anything but my 2 to 1 artrial tach makes me feel awful. I cant sprint without my heart going into it. My top heart rate is set to 180 and my previous heart rate without it would be around 215. My heart cant beat as fast as it wants, and also im just worried about my leads coming out. I just need to get my atrial tach fixed. All in all i just really just really want to play without it. My Doctor has cleared me for everything its just im hesitant still.

Lots to talk about here

by crustyg - 2019-10-14 06:05:29

There's a lot here that doesn't make sense and may reflect a form of verbal shorthand and/or misunderstanding.

With a suitable EP mapping technology it *ought* to have been possible for your EP doc to find the accessory conduction pathway causing your WPW and ablate just that.  But you say that you AV node was damaged and you needed a PM.

1: your leads are well fixed in now, and won't dislodge from vigorous sports.  It's the arm raising that *can* cause leads to dislodge in the first weeks, but by now the growth of fibrous tissue around them will have anchored them.  In any case, having a heart beating fast and hard at 160bpm or more could dislodge them if they were prone to that and they haven't.  Protecting the PM box itself is a different matter, but long-time athletes on the forum can share the need for (if any), and experience of, devices that cover your PM pocket.

2: if you needed a PM but you're talking about 2:1 tachy then you're describing Wenkebach AV conduction (2nd degree heart block) - so if you can't achieve the ventricular rate that your exercising muscles need then your PM needs to be tuned correctly.  Your PM should be capable of driving your ventricles to a sensible rate for you regardless of what your atria are doing, and if it doesn't then it needs to be tuned for *your* requirements.

3: His bundle pacing versus RV pacing.  Make sure that you're followed up by someone who has an interest in myocardial remodelling due to RV pacing.  This *may* become significant for you in the future.

4: IMHO, I'd change EP doc.  It doesn't sound to me as though you have much confidence in your current team and that's an essential ingredient to helping you get your life back to normal.

5: I don't know of any studies that have attempted to revive the AV node, or have tried to find out how often a damaged AV node can heal itself.  The work by Stephen Westaby on myocyte stem cells might one day provide a break-through but I'm not up on the literature.  But hoping for a *magic* cure is probably not the best approach - making what you have now actually work properly for you is much more likely to achieve your goals in a short timescale.  Life is unfair, but anyone who promised you otherwise was reading you a fairy story.

I admire your ambition to aid others - it's a noble road, one I've gone down.

reply to crustyg

by RwB15 - 2019-10-14 13:05:21

Thanks so much! the doctor that ablated my av node was another doctor. I dont have confidence in anyone except people like me and you because we know what its like to have a pacemaker. Thanks for the post, i will see my doctor in 2 weeks and discuss getting another pacemaker becuase my pacemaker wont go over 180, or so they say so. I may get a battery replacement in the next few months that support my higher heart rate. I want to play college football, and have always been hesitant. Thanks so much for the comments, hopefully everything goes good and i can play again. Thanks

upper limits

by Tracey_E - 2019-10-17 22:01:22

Most of them only go to 180, however there are a few on the market that go to 220. I got one of them last time mine was replaced. I regularly maxed out when exercising with the old one. It was frustrating enough that I went on a beta blocker to keep my rate down. Once I got the newer one with the higher limit, I stopped the beta blocker. That said, you may have trouble getting insurance to cover it before the battery needs replaced. 

They may be able to turn off the feature that puts you into an artificial 2:1 block.  It's a safety feature for afib but is like hitting a wall if we are just working out hard. It still doesn't feel good if the atria is going faster than the pacer can pace the ventricles, but it feels better than the pacer shutting us down to half the rate. 

I have never heard of heart block being fixed, sorry. It's an electrical connection that isn't there. 

Full contact sports aren't recommended but there are patients who do it. There are some shirts on the market that protect the pacer, check out the ads here. It's not impossible to damage a lead, but we will bruise up long before the pacer is damaged. Have a chat with your doctor about the best way to get back to doing what you want to do. 

reply to Tracey_E

by RwB15 - 2019-10-18 01:47:36

Ok thanks so much!

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