Ventricular Pacing

I had my pacemaker implanted in May 2010 due to tachycardia, afib, and bradychardia issues. Today I had my PM check and found it my ventricular pacing has increased from 45% to 52%. They seem somewhat concerned about this due to the possibility of it causing a-fib issues or even heart failure. After some reading I find this may be called "pacemaker syndrome". Anyone had experience with this? My PM checks never show any episodes, but there are times it doesn't feel like it's beating quite right. I've informed them of these issues on numerous occasions, but since the PM checks are always normal they don't know what to think.

Also, have you all been told to have your heart checked by an electrophysiologist every 1 to 2 years to make sure the ventrical isn't being damaged by the lead? My doc never told me this, but I think it's a great idea.

6 Comments

See The EP

by J.B. - 2011-03-15 01:03:15


Let Frank have his fun with his sarcasm, but I suggest that you make and appointment with an EP but not for the reasons Frank gives, but to get information on you heart and your pacemaker. An EP specializes in diagnosing problems of the heart's electrical system and obviously your's has a problem or you wouldn't have a pacemaker. I see one each year and twice in the 8 years I've had PM and twice the EP had settings changes made and once he changed a medication. So far as I know I needed all of them.

Unlike some people, some of us have problems that change over time and we need some one capable of recognizing them. One thing you need is an answer about the percent increase in pacing and is their a possibility of your PM causing pacemaker syndrome. I doubt it is but the EP is the one that can tell you for certain.

I'll not even guess as to whether a 6% increase is significant or not. Was the 42% the initial number you got for ventricle pacing? What percent pacing are you seeing for the atrial? Just curious.

JB

JB

by DybHen - 2011-03-15 01:03:52

My atrial pacing is 43%, ventrical was 52%. Atrial has remained the same. It has always hovered around 45% in the past in the ventrical, it's the first time it's jumped this much.

If it makes you feel better

by ElectricFrank - 2011-03-15 02:03:53

The difference between 45% and 52% is negligible. More than likely it is just the result of the kind of activity you have been engaged in.

Having your heart checked by an EP every 1-2 yrs has a few advantages:
1. It helps the EP put his kids through college.
2. It treats the fear they instill in you to justify 1.
3. It treats your cardiologist's anxiety.

So like I said, if it makes you feel better and your insurance pays for it you could always have it done. Just be sure you don't get taken in by the next sales pitch which will say "we've detected something we don't quite understand so we are scheduling you for the cath lab". Now you have moved into the realm of procedures that have definite risks,

frank

Pookie

by DybHen - 2011-03-19 10:03:23

Wow, I can't believe you had to go on that long feeling miserable. I too had the same issues as you, however, it only lasted 3 months. Fortunately, I have a wonderful P.A. who took my concerns seriously (even though he too went through a stage where he thought I was just OCD). He finally had me perform a stress test, he had the big wig programmer man from St. Jude come in and he ended up shutting off my Optimization as well as most everything else. The only thing my pacer is doing now is making sure I don't go to low in my heart rhythm. My circumstances are a bit unusual as my doc isn't even a cardiologist, although he was very sought after by the heart center to become one. He's just a small town "cow farmer" who inserts hundreds of pacemakers.

So even though I feel mostly good, there are times when I don't and I want those times to go away. My heart anatomy is different than most so I tend to be a bit nervous at times (ocd I suppsoe) wondering whether everything is in there right in the first place :-)

I forgot to add....

by Pookie - 2011-03-19 12:03:15

After the change was made, I went from 62% pacing to 89% pacing (atrial only - I have always paced less than 1% in the ventricle) but I'd rather take 89% and feel like a human being than be back around 62% and feet like a wet Kleenex.

It will be interesting to see my %s next check-up which is on May 16th.

Pookie

EPs

by Pookie - 2011-03-19 12:03:54

I had my pacemaker put in on November 2 of 2004 and felt like crap until April of 2010 when I FINALLY got referred to an EP. (I even had to quit working) It was then that the EP figured out that I had been in Junctional Rhythm for almost 5 yrs.

Every time I went for my pacemaker check, the PM Tech and the Cardiologist (whichever one happened to be on pacemaker duty that day) could NEVER figure out what to do with me. I felt absolutely miserable for way too long.

Anyways, after my EP had me wear a Holter Monitor for a month he figured it out and the between the EP, the PM Tech and the Medtronics Rep - they figured out the way to fix my Junctional Rhythm: they simply turned OFF the Optimization (which is part of the Rate Response feature).

Now I have my life back. But I still get angry when I think of ALL those years I could have been feeling better if I had only been referred to an EP. And I had to beg to get referred because my Cardiologist thought I was nuts!!!!!! All he saw (in my opinion) was a mid 40s female coming through the door and instantly labeled me as a stressed out blonde female!!!!!!!! Ugh, I still get angry just thinking of it. I lost soooooooo many years because my cardiologist wouldn't take me seriously.

Now, I'm not saying all EPs can figure every problem out, but an EP sure as heck gave me my life back. It's worth a shot in my opinion.

Take care,
Pookie

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