I had a helpful pacemaker check today . . .

They were training so there were two technicians present.  I told them about a few near fainting spells I have been having recently as well as some breathlessness and they confirmed non sustained VT episodes had been recorded.

We discussed the possibility of a second lead to the left ventricle, since I only have a single lead to the Right Ventricle at the moment which is now dilated, as are my two upper chambers.  They have requested another echocardiogram and are referring me back to see the cardiologist for follow up.  I haven’t seen a cardiologist since before Covid.  

The technicians were very kind and spent around an hour with me.  They asked me to try out a lower base rate setting (from 60 bpm to 50 bpm) but  when I tried it walking around the hospital, I came over faint and breathless, so they restored my original settings, including Rate Response.  They wanted to see whether I would be more comfortable with my own heart doing more of the work and the ventricles pacing more naturally.

I have got 6+ years battery remaining.  My percentage pacing in the right ventricle over the last 6 months has reduced from 80% to 71%.  I am in persistent/permanent AF, so I get no help from my dilated atria. 

I was happy with my appointment and before taking the train home Gemita and I enjoyed a Costa Cappuccino/Earl Grey tea and a small panettone.  We even had our photo taken in front of the Christmas tree in the entrance of the hospital.  One of the Cardiology doctors took it!  Oh we make ourselves at home wherever we go.

Question, if I am offered a second lead to the left ventricle in the coming months, should I accept it or at 85, should I leave well alone?  Hope you are all doing okay

5 Comments

Second lead

by Penguin - 2023-12-05 17:12:59

Hi Michael, 

I'm pleased that you had a positive appointment and that there's a lot of effort going into making you feel as well as possible.  I'm sorry to hear about the permanent AF.

It's difficult when changes are made in clinic.   I often find that I need a little longer than the time in clinic to realistically assess how any change might affect me.  Nearly fainting doesn't sound very positive though. 

Perhaps it's better to make any further changes after you've had the echo and seen the EP? 

I'm not going to offer an opinion re: another lead and am going to sit on the fence.  Your general health has to be a consideration and the upset that an operation might cause vs how much benefit the EP believes you will receive from this lead.  I'll keep my fingers crossed for a frank and honest discussion which leaves you in a good position to make the best decision.  

I hope that you manage to have a lovely Christmas in spite of these health issues. 

Best Wishes 

 

Hi Mr Gemita🤣

by Lavender - 2023-12-05 21:02:21

Michael,

Your outing sounds quite pleasant! Have Gemita post the Christmas pic in the gallery. 🎄
 

I love panettone and panforte. 😋I bought three panforte and one large panettone already this month-the margherita kind with a communion wafer type coating on the bottom.  I'm not Italian but my guy's dad is first generation Italian-Calabrese- here in the states. We love going to the local Italian specialty store.  
 

Michael-I would ask the pros what they think of adding a lead for you. You can't be their first patient in the 80's needing a lead. I'm of the mind that it may make your heart more efficient. It's a very personal decision, I understand. I'm sure you will make the right one. 😉 Perhaps your upcoming echocardiogram will help with the choice!

Penguin and Lavender

by michael.p - 2023-12-06 04:54:23

Thank you both so much for your support and for your sensible answers.  I know my doctors haven’t always wanted to intervene in the past because of my history of heart disease and strokes, so I don’t know how much this might affect my chances of getting an upgrade in the future, should I need one.  I suspect it might.  I had the same battle on my hands when I needed stents placed in 2017/2018, which had to be done in the end.  They initially tried to offer medication by way of treatment.

When we spoke to the senior technician yesterday, she seemed quite confident that a second lead would be offered, if needed.  

Yes my short challenges Penguin of walking and climbing about 15 steps in the hospital yesterday with the new settings didn’t really provide time to fully trial them, but they were afraid of letting me go home with worsening symptoms.  I gather they were trying to see whether they could reduce total right ventricular pacing time to help with dyssynchrony between the two ventricles, to try to help me to feel better.  

Lavender I would like to try anything that would make my heart more efficient, even if I cannot wind back the clock and undo the damage that has already occurred (due in part I think to untreated high blood pressure over many years) which I have had all my life, even as a young man trying to get into the navy.

I met someone at the hospital yesterday who was enthusiastically telling me about his leadless pacemaker, but then I discovered my wife and you all knew about leadless pacing anyway.  My wife’s hospital has apparently implanted a three chamber leadless pacemaker system and they were the first in the world to do so.

I got the Christmas tree down from the loft a few days ago.  That was hard work and I had to rest afterwards.  We still haven’t decorated it.  Lavender, I will get Gemita to post a pic in the Gallery of me beside the Christmas tree in the hospital yesterday.  Edit:  Cannot do this at present as getting error message "413 - Request Entity too Large" probably due to the site's hosting changes?  We will keep trying.

I hope you both have a wonderful Christmas.

🌟Christmas

by Lavender - 2023-12-06 08:28:08

Thank you for the Christmas greeting! I am allergic to pine, so my tree comes out of a cupboard. 😉 I got it out and will decorate today. I decorate after the first sunday of advent. I used to decorate everything and every room. Over time, I have been giving my decorations to my sons for their homes. I now decorate much less and that makes life easier. 
 

As a child, the tree was a real one and wasn't decorated until Christmas Eve. My parents did it while we slept. It stayed up until January 7. 
 

My motto is to be done shopping/wrapping/decorating by Dec 10. The next two weeks are focused on baking and menu planning for the Christmas Eve gathering here for my sons and grandchildren. 
 

Every year I say this is my last gathering but my sons want to come hang out anyway on Christmas Eve. They're pitching in more with foods and cleanup. They like to come home even though one lives just four doors away. Lol

Michael-a very happy Christmas to you and Gemita as well as your family! May 2024 be a year of renewed health and blessings. 💫♥️💚

okay pics successfully posted to Gallery

by Gemita - 2023-12-08 11:34:19

It seems my new iPhone camera was too powerful and I had to crop or downsize (compress) the photo image sizes to get them to upload to the Gallery.  Anyway, success at last.  

A couple pics also from last night.  We had to go up to London for another hospital appointment (urology) and the hospital is close to Oxford Street.  We walked to see the Christmas lights and then afterwards visited Hamleys Toy Shop.  Michael was in his element with all the children he saw and asked "which shelf did they come off" and "could I get two for the price of one"? 

Anyway thought you might like to see a few more pics.  It was pouring hard but the streets were still full of shoppers

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