3rd Lead ?

I haven't posted for a while as I have been having a lot of difficulty. PM DDD implanted November 28th 2008. The windedness and breathlessness has been a real problem upon exertion. After multiple tests and having been referred to an Electrophysiologist (EP) the final diagnosis is "pacemaker syndrome" - lack of synchronicity with atrial and ventricular electrical pulsing. Atrial pacing is about .01% and ventricular pacing is 99% and they just are not syncrhonized. So now the EP is playing with settings with Medtronic - there has been significant improvement but .. still I can not really exert myself. The EP indicated that perhaps a 3rd lead may be helpful if all this tweaking does not improve the situation. Anybody know anything about this? It has been a long long 5 and 1/2 months .

6 Comments

3 Lead PM

by SMITTY - 2009-05-05 07:05:16

Hello PPT,

I'm not familiar with using a 3 lead pacemaker to solve a problem like yours, but I have seen peoples say they are getting one to help with their ejection fraction and almost without exception the reports are good. I will be very, very interested in hearing your results. You see the symptoms you describe are almost identical to what I live with daily, but to date no one has mentioned pacemaker syndrome. About everything else has been suggested, but not that.

The cardiologist did tell me during visit in Jan. that we may want to look at a 3 lead PM to see if that would improve my EF. I'll be seeing him in another month and I'm sure the subject will come up again. By then I will have read all I can find on pacemaker syndrome to see if I need to ask questions about that.

Questions like yours about are what makes this such a valuable site to all of us. In my case I had written off the possibility of ever feeling decent again, but now I have hope that there may be a faint ray of hope still around. Of course I have to accept the fact that lot of years and heart disease for which I started getting treatment 27 years ago also play a major role in my problems and solutions. But this is what keeps me coming back to read what is going on here everyday, because, well you just never know.

Good luck to you,

Smitty

I have a 3 lead

by motherhen - 2009-05-05 07:05:30

I started with a two lead in June of 08 but it gave me so much pain they moved the wires but still had trouble. They tried adjusting it but that did no good. So I saw a new Dr who put in a 3 lead in Aug 08 and after monthsof more adjusting it is finally working well. At 71 I am still working full time at a job I love. I also went thru a knee replacement in Jan. 09 with no problem. It took longer to get over the replacement but now I feel it was worth it.
I love this site as it has helped me undersstand I am not alone with this new pacer and how it works. Good luck.

Diagnosis......

by Pookie - 2009-05-05 08:05:41

Just wondering if you could share with us what tests you had (if any) for your doctor to come up with this Pacemaker Syndrome.

And was it your pacemaker tech, your cardiologist, or your EP who discovered this? As I've been told it's rare.

Good luck & please keep us posted.

Pookie

3rd lead

by dottodot - 2009-05-07 08:05:06

there's a lot of evidence out there on the usefulness of the 3rd lead especially in those individuals who have almost all ventricular pacing. I just think that this technology is really great and people are able to do so much more

Link to Pacemaker Syndrome Article

by ppt - 2009-05-07 10:05:03

Here is the link to the article I mentioned

http://emedicine.medscape.com/article/159706-overview

Answers to questions

by ppt - 2009-05-07 10:05:11

Smitty - There is a great article on www.eMedicine.com - do a search on pacemaker syndrome - My EP wrote it - it fits me to a "tee". It took 5.5 months to diagnose me as "pacemaker syndrome". It really is lack of synchronicity in pulsing. Electric Frank also brought up the idea of an ablation of the AV node. My ejection fraction is 65%.

Pookie - I have had, and passed with flying colors:
1)chest x-ray (to rule out blood clot in lings)
2)cardiac cath (to rule out arterial blockages)
3)Pulmonary Function Test (PFT) (to rule out problems with lung capacity etc)
4)Chest CT Angiogram (to rule out poor blood flow thru lungs)
5)Blood work (to rule out anemia etc)
6)Nuclear Stress Test (passed)
7)Numerous tweakings of PM settings (delay, rate, etc)
8)Been on and off Lopressor, then Enalapril, then Bystolic and I got much much worse - could barely get to Dr office
9) Stress test (not nuclear) while hooked up to EKG, Echo and Medtronic interrogator/programmer -
10) cardiologist is stumped and said "pacemaker syndrome" - rare - took me off all meds - sent me to EP. 11) Since ff the meds am MUCH better and the EP also tweaked some settings

But I a still not right. I can function better than I was - but I am not where I want to be at all. Just took a trip to California (security was GREAT) but I probably should have stayed home - just exhausting.

I too refuse to feel this way for the rest of my life. If th EP can't make me better then I am going to the Cleveland Clinic in Ohio .. There has to be a solution to this malaise !!!!!!!!!!!! And I think before I have a 3rd lead put in I would a 2nd opionion..

Thanks for all the responses :-)

You know you're wired when...

You have a $50,000 chest.

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