CRT.. when did you get it

Hey everyone, been a little while since I have been on here. Just had lots of things going on. I am curious at what point people were switched to biventricular pacing due to lower EF. I got my pacer in 2009. At that point my EF was 60-65% Since then my EF has steadily declined. In sept of last year I reached the 45-50% mark. We talked about adding the third lead, but decided to wait until the next echo. In december I had an echo which surprisenly was read at 55-60% I felt aweful in january but since EP decided to go for another ablation he wanted to wait on the echo. Major ablation was done on Feb 1st and my echo the next day was 40% Doc is still not wanting to put the third lead in just yet. His plan is to wait 3 more months and retest it and then if continues to be low he will add the third lead in. I have been for getting this third lead for some time, hoping it would make me feel better, PLUS my pacemaker is a POS (piece of shit!) Any change my EP has wanted to make has not been possible with my pacemaker. The list just keeps adding up of what it DOESNT do. Right now my EP is holding off because I am young, 34, and he knows I will have a lot of pacemaker changes in the future and he wants to minimize the times they enter the pacer site. I totally get that. But at what point do you draw the line? When was the decision made for you? I have to say, it really sucks to think that with just 3 years of pacing, my function has dropped so much, however I was warned my heart would fail sooner or later due to the amount of tachycardia I have. Just curious when they changed it for you.

4 Comments

Maybe an insurance thing?

by golden_snitch - 2013-02-14 03:02:10

Hi Sam!

I have heard that at least some insurances in the U.S. won't pay for a biventricular pacemaker, unless your EF drops below a certain percentage. I think that this is 40%. However, there are people who feel awful with 40%, and there are some who still run around happily with just 20%-30%. So, it makes no sense to me to have this criteria of a certain percentage. But, again, this is what I have read somewhere, and I hope that other members can shed more light on this.

My EP said that he would put the third lead in as soon as the EF starts to drop. Maybe not after the first echo that shows a drop, and maybe not if it's only a 5% drop, but I guess if it's 10% or even more in one year, he'd not hesitate. The good thing though about my case is that I'm paced on the left side. I have epicardial leads on the left atrium and ventricle. And so the right-ventricular pacing that leads to heart failure problem does not to apply to me.

Are you still having tachycardia? I thought you had an AV-node ablation (among other ablations).

Best wishes
Inga

Ef factor

by terrythetech - 2013-02-14 03:02:37

I was at 10% while in hospital, increased and stopped at 30-35% they said I needed PM as it was not coming up past 30-35

Terry

Hi

by Many Blessings - 2013-02-14 10:02:22

Hi Sam,

It may be different for different doctors/patients, but for me, my EP doc and cardiologists would not do my CRT-P (with AV Node ablation) until I was at the high level of cardiomyopathy and heart failure, they had tried every medication out there (that didn't work), an EF under 30, and less than a year to live (one said less than 3 months). It was either doing this or a transplant.

I'm not sure what your history is, but mine problems were caused from a lifetime of heart problems, heart surgeries, chronic, uncontrolled high rate A-fib, stroke history,etc. All at a very young age. The symptoms from all of the above were also making trying to live a normal life impossible at that point, and I'm very active. That's when they said "we have to do it or else". They really didn't want to do this procedure unless it was absolutely necessary. It may be the same for you. I'm with Inga above, I don't get the EF % criteria either, as I was doing pretty well with a lower EF until it started dropping a lot every 3 months. That was worrying the docs.

I think their worry was doing the AV Node ablation and making me 100% dependent. Will you be having that done as well? Or, did you already have that done? Are you already 100% paced/dependent?

I'm going to private message you as well because I want to ask you a few things.

Good luck, and I hope others have more answers for you as well. The more the better!

thanks for the feedback

by sam78 - 2013-02-16 10:02:37

Many Blessings, I will private message you back.

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