What is my PM doing?

Hello Everyone, I am new to this club and have now realised how little I know about my condition and why I have my pacemaker. I was born with congenital hypertrophic cardiomyopathy of the left ventricle. Up until I had my 3rd child I never really experienced any difficulties with my condition until about 20 years ago. I started to get arrythmia and was commenced on Flecainide twice daily which seemed to keep the arrythmia at bay. When this stoppped being effective I had a pacmaker implanted as my cardiologist said that it would help stop the progression of the cardiomyopathy and stop my arrythmia. I have now had 3 devices implanted in the last 11 years and conitnue to take Flecainide 100 mg twice daily and 50 mg daily. I have been told that I am not pacemaker dependent but don't really have clue why I have it. I know that this sounds as if I am very ignorant but nobody has really explained things to me clearly and I just think its a bit late to ask the reasons for the pacemaker.
Any info would be greatly appreciated


Thanks Vai

by shazza40 - 2008-07-23 04:07:41

Many Thanks for all this really helpful information Vai, I am pretty sure that it is atrial fibrillation I suffer from too. I do not have any restrictions on my life, pretty much live life to the full. What about you?

PM doing?

by Vai - 2008-07-23 12:07:22

I share a similar condition - left ventricular hypertrophic cardiomyopathy, suspect its congenital and detected some 15 years ago. You do have a lot of catch-up and this is a good place to learn and share information. This is just sharing some thoughts:
1. Arrythmia is a natural progression of the hcm (abbreviation for hypertrophic cardiomyopathy) condition as the underlying heart disease.
2. Suggest you find out what kind of arrythmia is diagnosed. It could be sick sinus syndrome (SSS), brady-tachy syndrome, ventricular tachycardia, atrial fibrillation, etc
3. For me atrial fibrillation surfaced about 3 years ago.
4. The medication is prescribed to manage your arrythmia. It does not cure it. It is meant to keep the heart beating regularly instead of beating too fast, too slow or too wildly.
5. The PM gives the doctor more room to prescribed heavier dosage of medication. Example if the doctor needs to prescribe a higher dosage in order to regulate your heart by slowing it down. It can slow the heart down too much and you will get fainting spells. Your PM will probably be set at a lower threshold like 60 BPM. The PM will support your heart at this rate and even if it is slowed down by the medication, it will not drop below 60 BPM avoiding the fainting spells.
6. The PM does not stop the arrythmia.
7. Being not PM dependent mean that generally your heart rate can beat on its own within a comfortable range and the PM is only a backup for you.
8. I am not familiar with Flecainide to comment on it.

I hope this helps.

Flecainide Acetate

by richan - 2008-07-24 01:07:25

Hi shazza40,
I also take Flecainide - 50mg twice a day. I'm told that it is a regulatory medication which, as Vai stated, works independently from you PM. Your PM supports you when needed. Dependence on PMs vary from person to person. My top half is 100% dependent and by bottom half is currently 60% dependent.
Vai, thank you for your great information and comments!
OK shazza40, I hope all goes well for you.



by Vai - 2008-07-24 12:07:39

Hi again! Generally speaking there are no restrictions that I cannot live with. However these are some things I am careful about:
- due to PM I gave up all forms of contact sports
- due to my sensitivity to caffeine triggering afib episodes, I avoid caffeinated beverages & chocolates (sigh!)
- I don't smoke
- I consume none or little alcohol as it conflicts with some of my heart medication
- I avoid stress (job or whatever related) - just learn to keep cool
- I exercise regularly (but not as frequently as I ought to)
- I ensure I get enough rest and sleep
- I diligently take my medication on time (essential to manage arrythmia)
Just one of those things I learn and adapt to. Other than that, I travel widely (Singapore, London, Beijing, Hong Kong, Bangkok, Kuala Lumpur, New Delhi) in my job and spent a lot of quality time with my family. On the whole the PM & med treatment has given me a new lease of life and I intend to live it to the full & not worrying about it.

Hope you have fun too.

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My pacemaker is the best thing that every happened to me, had I not got it I would not be here today.