Increase in Atrial Pacing

i have had a biventricular pacemaker for the past 10 years. For many years, pacemaker interrogation showed AS at 99%/VP 100% (had AVN abation in 2005) During the last 3 pacer checks, my atrial pacing has increased from sensing my intrinsic beat 99% of the time to 80% during today's pacer check. I was a fib free after a successful ablation in 2008, until 3 months ago, when I began paroxysmal a fib in short bursts, as well as occasional atrial tachycardia. My question...what would cause the increase in atrial pacing (not due to programming). My cardio says I could be developing bradycardia, or SA node disease...I am 58, BTW. Comments? I take Ranexa, which suppresses PACs, and Verapamil for BP control and arrhythmia control, but have been on these meds for years. This increased Atrial pacing is a new development. The increase in Atrial pacing has been increasing a bit each check every 3 months...last check it was 14% pacing and 20% today. Thanks for any comments...

3 Comments

numbers

by Tracey_E - 2015-04-28 08:04:48

Don't get too caught up in the numbers. Our hearts change as we age, how we react to meds can change over time also. In our case it doesn't much matter our rate drops off some because the pm is already in place to fix it. How much we pace isn't really a big deal, what matters is if you feel good. If you feel good, then 20% is a good number for now.

Healthy Perspective

by BABlocker - 2015-04-28 11:04:25

TraceyE, thanks for your comment. I was looking at the increase in pacing as a clinical indication that the SA node was deteriorating...philosophically, you are right. I have the pacemaker in place to handle any new rhythm issues, so the goal is to just live. I am a retired nurse as well, so I always want to understand the whys of my situation. Another question...do you think the decade of pacing has made my SA Node lazy, so it is now firing less or at a slower rate?

nah

by Tracey_E - 2015-04-28 11:04:55

The only long term studies I've seen that the heart becomes less responsive from pacing is the right ventricle, not sinus node. However, who knows?? There aren't enough of us who have been living long lives paced to really know. I'm no medical professional, just a lifetime cardiac patient who reads a lot and asks questions, but it seems like electrical problems go hand in hand, and one problem makes us more likely to develop others, whether we're paced or not. I started with av block, after 15 years of pacing I developed SVT also. Would I have it whether I was paced or not? Who knows. The fact is I probably wouldn't have lived long enough to develop it without it so I don't lose any sleep over it.

I don't like that they'd call it disease. Our hearts are not diseased. Often they're structurally perfectly healthy but with faulty wiring, and we're monitored more closely than the average population so any little thing is likely to be caught more quickly. Your sinus node has been zapped and you're on meds to suppress it, it doesn't really surprise me that pacing would increase eventually. However, lazy is better than hyperactive, it's easier to fix ;)

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