EF lower than 6 yrs ago

Hello!  It's me again.  Please indulge me as y'all might have answered this previously but I am perseverating about the results of my most recent echo.here's what is happening:

1.  I see a new to me cardiologist tomorrow .  I need to know what questions to ask.

2.  I got my 3rd battery Medtronic dual chamber 2 weeks ago.  Echo was 16 days ago.

3.  Last week I visited a friend.  We played pickle ball, went biking and kayaking.  I felt SO MUCH better since getting the new battery.  It had gone into safe mode and I felt like crap.

4.  2016 echo 55-60%EF.  2023 echo 45% EF.

5.  I thought the drop was due to the safe mode setting.  The surgeon said probably not and made the appointment for me with the cardiologist.  ( I thought that was very nice of him).

Im not up on a lot of the acronyms used here so if you would please identify .  Thanks.  My bio is up to date.  I got my first device 1998.  I was 44 and had a failed ablation after an STV.  I have a family history of heart attacks - dad and sister - and my cholesterol is 230 ir more.  Not on steroids.  
 

Thanks for your help!
 

4 Comments

So you had the echo before the new device?

by PacedNRunning - 2023-09-21 20:27:41

You had an echo before your battery change? Did they add a lead?  With an EF of 45%, my doctor would have implanted a CRT.  I have yearly echo's and this was discussed when my EF dropped to 53%.  He said I do not have to wait to be below 40% to upgrade to CRT. I would definetly ask about that. If you did receive a CRT, it should improve in a few months.  There are good results with CRT's when the EF is low from pacing.  Sorry you had to experience safe mode.  Insurances need  to fix this. 

Reply to PacedNRunning

by Lulu2468 - 2023-09-21 21:32:29

Hi Paced. Tks for your reply. So....what's a CRT?  Told you I was bad at acronyms 😁.  Yes, lab work and echo required before surgery "in case there have been any changes".  I was hoping the safe  mode status was the reason?  Also forgot to mention that one of the leads - original from 1998- had lost its protective coating where it crossed the other so they repaired that.  I guess none of this might affect how my blood moves around but that is one of my questions for the doc.  I must stop googling about this as it freaks me out. Heart failure and such. Also it sounds like that pesky EF number can change and vary and perhaps I can do things to improve it?  The reason I had that echo ( and a stress echo) 6 years ago was my concern about SOB.  I thought either there was a problem or I'm just out of shape.  Hiking uphill is killer for me.  Stopping to catch my breath.  Thanks again. Does that CRT mean a 3rd lead as well?

CRT

by Tracey_E - 2023-09-22 10:30:30

CRT- cardiac resynchronization therapy- is when they add a third lead so that both ventricles are paced. If forces them to stay in sync and can therefore help with EF. 

45 is a little low but probably not low enough to add the third lead yet. Over 50 is "normal" range. I put that in quotes because the number is an estimate and two techs can get two different numbers so when it's a little off they don't get too stressed over it. 

Hiking uphill is a killer for lots of us. I can do a half marathon and daily crossfit but put me on a steep hill and I'm stopping every few minutes to huff and puff. Frustrating. I'm doing a tour next month that has 700+ stairs. That's gonna be fun lol. 

Safe mode absolutely feels like crap! Sorry you had to deal with that. Did they let it get that low on purpose? If yes, have a chat with them about not letting it happen next time! I'm on my 5th and they bump up how often they check it at the end so we've always been able to get it done before the mode switch. 

Reply to Tracey_E

by Lulu2468 - 2023-09-22 22:56:12

Thanks so much for your comment, Tracey.  My new cardiologist is awesome!  He feels the drop in EF had a lot to do with the LV pacing at 65.  We will do another echo in 6 weeks to give my heart time to adjust again and go from there.  He has seen it come back after the new device so that's encouraging!  
Then I had the new device checked.  It's been 2 weeks and I'm completely healed.  Surgeon did a beautiful job.  I was told with the new device I won't go past the device switching modes near EOL as it's checked daily via my iPhone Medtronic app.  Yay.  
Good luck on your 700 stair tour next month.  I'm panting just thinking about it!

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