Will 2nd lead stop Junctional rhythm

Hi everyone,
It's been quite awhile since I've been on, but I just found out that I'll need my pacemaker battery changed in the next month or so, and wanted to see what others thought here.

When I went for my checkup and I told the nurse about my Junctional rhythms that my pacmaker can't control, she told me that the reason that is happening is that the lead isn't in the part of the heart that is causing the Junctional rhythm.

I guess I'm just really confused. I just switched doctors, and my old doctor told me that the Juctional rhythm is from other parts of my heart trying to make a heartbeat beacuse I don't have much of a sinus node anymore (My sinus node was burned away because of a high heart rate with very little effort)

But now this nurse, who is with the new doctor is telling me something different, I'm so confused. I feel that since they will be going in anyway, if it will help to get rid of this Junctional rhythm for good, I would have them put in a second lead. I don't want to have any work done that is not necessary, so I'm hoping someone here might have the same issues as me, and can make some sense of this to me.

Also, I was told by my old Doctor back in 2003, when I had my first PM put in, he said that the newer ones would be much smaller, and would put a smaller one in when the battery needed to be changed, that way it won't stick out so much, and won't hurt when I lay on my stomach when I sleep at night.

Thanks to everyone who had read this long post, I just hope that there is someone out there that can help me with this.

Take care, Karri

2 Comments

Hi:)

by Pookie - 2011-11-11 01:11:43

I'm so glad snitch responded cuz she helped me so very much when I was going thru my Junctional Rhythm, she helped me understand exactly what it is:)

While working with my EP - he wanted to eventually do an ablation and I was dead set against that, but with some pure luck, my PM Technician had just returned from a refresher course (Medtronics in Minnesota) and she was really excited to see me this particular day because she thought she had the answer - and she did (for me).......all she did was: she turned the Optimization setting to OFF. Most pacemaker patients, (like 98%) do perfectly fine with it being ON but not everyone - and I was one of "those" - it's part & parcel of the Rate Response.....something to discuss with your doctor???????

I truly got my life back with the adjustment of this ONE little setting:)

I guess it couldn't hurt to discuss it with your doctor or EP or your PM tech or better yet - all 3, eh?

Good luck.
Pookie

My experience...

by golden_snitch - 2011-11-11 03:11:42

Hi Karri!

I have an accelerated junctional or even idioventricular rhythm causing my ventricles to beat faster than my atriums at times. Had an upgrade to a dual chamber pacer - originally I had the same problem as you, multiple sinus node ablations - due to intermittent heart blocks. The second lead did not make any difference with regards to that accelerated junctional rhythm. But they were finally able to put me on more meds to control that rhythm, because before I went into heart blocks when taking meds and with just an atrial lead, that was a problem.

So, an added ventricular lead will according to my experience not help with that rhythm. Have you tried betablockers? Or have them increase the minimum paced heart rate? Mine is set at 70bpm. In some patients it helps to increase this rate to 80, because it then overdrives the junctional rhythm. But depends on how fast your junctional rhythm is.

Best wishes
Inga

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