CRT-P

Hi to all who read this:

I'm new to this site. Have spent the last couple of hours reading posts before deciding to join. Glad to be a member and hope I can contribute at least as much as I take from others.

I had a St. Jude CRT-P (biventricular pacemaker, 3 leads) implanted December 1st 2008 electively after failing antiarrthymic drug trials in hospital to treat highly symptomatic afib, high frequency palpations and nearly constant sinus tachycardia. These drugs put me into V-tac due to my cardiomyopathy.

Two weeks after discharge from hospital I underwent my first PM interragtion. The data showe that I had a heat rate greater than 100 BPM 67% of the time, 0% atrial pacing, and ventricular pacing 97% of the time.

I am scheduled to undergo an ablation of my AV node the 3rd week of Feburary. Once this is done I will then be pacemaker dependent 100% of the time. The purpose of the AV ablation is to block a rapid afib (causing my symptoms) from reaching my ventricals. This treats what for me is highly sympomatic afib; however it does not cure afib. Prior to opting for a CRT-P I was treated medically with a host of medications followed by two ablations. Unfortunately, in time the afib broke through the drugs and my two ablations. It should also be noted that I have a CRT-P to allow my L and R ventricals to contract in sync. An AV ablation is not required for this function of my CRT-P.

My cardiologist wants me to wait until it is absolutely necessary before having my AV node ablated. He wants to work with me to see if he can at least reduce my episodes of afib and the symptoms I experience to a tolerable level with medications. The goal is to preserve my AV node and natural atrial pacing and thus avoid living dependent on a pacemaker.

I would greatly appreciate views, opinions, and insight from members of this support groupl Also, I would love to here from anyone who has a CRT-Pacemaker in general, and from anyone who has a CRT-Pacemaker for reasons similar to mine.

Thanks for taking the time to read this.
Craig1075 (first name Steve)



6 Comments

Thank You

by craig1075 - 2009-01-11 01:01:04

Dear Janet,

Thank you for sharing your story and for your words of encouragement. Glad to hear you are doing better. For the benefit of others I will update as my situation changes. Again, thank you.

Steve

My experience

by janetinak - 2009-01-11 01:01:48

Hi Steve,

I had some of the same issues that you have so I will give you my input. I had very fast Afib with lots of symptoms (SOB, severe fatigue, etc).& tried lots of drugs for two yrs + 3 admissions with about 5 shocks without any help. Was told AV ablation & PM only way I'd feel better. I do not have cardiomyopathy & my PM is a single lead ventricle 100% pacing. I have had 2 ablations (few months apart) & have been living with PM since 2000. My treatment worked as far as I am concerned. I am willing to live with the PM to feel this good. I can be active again given my age (late 60's now) & lots of osteoarthritis. If there was a drug that would have slowed down my Afib & lessened my symptoms I would have been tickled to forgo the ablation & PM but in 2000 there wasn't anything. I hope they can find a drug that will work for you but I wonder how much stress this is putting on your heart if you continue. Being 100% PM dependent for me was a good choice. Lots of luck with your treatment.

Janet

NEXT ABLATION

by pete - 2009-01-11 03:01:58

A biventricular cardiac resynchronisation pacemaker
is usually very effective provided it is combined with an AV node ablation. Your story reads a bit like mine. I had the AV node ablation after having the pacemaker. It was the combination of the two that enabled me to make a remarkable recovery. I had V tach with the pacemaker and no ablation. After ablation I was 100% better and more or less able to lead a normal active life. Most EP Doctors would think the job only half done if you dont also have an AV node ablation. I had mine 21 months ago. Afterwards I went to Australia to see a Koala Bear. Im holding one in the picture gallery on this site !! Also climbed a 2000ft mountain. Please remember that the fast ventricular episodes you are getting along with your AF will weaken your heart and probably give you cardiomyopathy. Go for the AV node ablation but make sure your EP is experienced in this proceedure. I found it painless and it only took 45 minutes from stat to finish. The actual ablation only really took a few shots of a few seconds from the RF catheter. This is a far less complex proceedure than other ablations. I have no residual pacing and I am therefore 100% pacemaker dependant. I have a Guidant Contak TR2 pacemaker. 2 ventrical leads and of course I still have permanent AF. I also had cardiomyopathy and a leaking mitral valve but after the AV node ablation my heart completely remodelled itself and the mitral valve leakage is no longer detectable. Cheers Peter

Peter and Red

by craig1075 - 2009-01-11 06:01:17

Peter and Red,

Thanks for sharing. Peter, I hear what you're saying and know I will have the AV ablation sometime in the future. The big question is when. For the time being I will give my cardiologist an opportunity to suppress my symptoms with drugs, knowing that if this treatment regimen fails I will then be calling my EP to schedule an AV ablation in the event I cancel the one scheduled for the end of Feburary.

Red, I have a CRT-P as opposed to a CRT-D because I currently do not experience spontaneous V-tac for one. Secondly, both medicare and private insurance have strict guidelines governing the implantation of an ICD. Currently I do not meet those guidelines thus my EP doc was unable to give me a CRT-D even though he believes I will likely require one at some point in the future.

Steve

CRT

by Red1958 - 2009-01-11 08:01:10

I have a St-Jude CRT-D due to heart being out of sync.Pacing at 3% and 98%.I was wondering why if your going to get CRT why not get added benefit of a defib if it might be needed one day? Thanks

In Despair & Similar situation...

by bunnykin - 2009-01-11 09:01:45

Hi Steve,
After reading your post I was eager to write back and felt I am not so alone afterall. I've not been posting too much of late cos I've been going thru quite a roller coaster ride since last Oct08. I am in the same boat as you like my EP has mentioned ablation of total AV node if all else fails just Saturd. Have been on most antiarrhythmics one can name so far, in fact just got out of hospital during Christmas week on trial of new a med. to control incessant tachycardia, but in vain.( I've VT and another rarer arrhythmia which is difficult to manage). I know sooner of later I'll have to face another ablation which I'm trying very hard not to cos I've already had 3 ablations so far, all for different arrhythmias but I'm really scared and very tired now....I just can't see myself going thru yet another procedure that may lead me to complications after. I'm 99% ICD/PM dependent now but my tachycardia is still felt often. You're welcomed to send me private message if you want to speak in detail as to your future intention to do the ablation etc. Meanwhile I suppose we just have to pray hard and hang in there.
Best of luck. Bunnykin




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