AV delay & optimisation question

Hi all
Further to my post 2 days ago, I have a result!

Many thanks to Idebaugh who helped me with this. Yesterday I e-mailed the Head of Pacing (who has been trying to sort my problem out with my EP) & asked her if my problem of neck pressure & breathlessness etc could be due to the AV delay on my PM. I had an AV node ablation in October & have been 100% ventricle paced since then......& I've had these symptoms since then. Previously I was only 100% atrial paced (due to sinus node damage from ablations).

The Head of Pacing replied to say that before reading my e-mail, she had actually just e-mailed my EP to suggest exactly the same thing, AV delay! She suggested to him optimisation & he agreed.

So on Monday I'm going to the hospital for optimisation. Has anyone had this done? What does it involve? I know it is to try & sort out whether the AV delay is causing my symptoms but I don't know much else about it. I've had a look on the internet but just wondered if anyone has personal experience of this or can anyone tell me more about it please.

I'm hopeful this might sort my symptoms out.

Many thanks
Janey

7 Comments

Best of luck Janey

by IAN MC - 2013-02-15 03:02:52

Hope you finally get all the symptoms sorted

Ian

Many thanks

by Janey L - 2013-02-15 06:02:21

Thanks Don & Ian, your kind words are much appreciated. I'll let you know how I get on.
Best wishes
Janey

Congratulations

by donr - 2013-02-15 09:02:29

That says it all!

Hope it gets successfully optimized & solves all your symptoms problems.

Don

Optimizing Echo

by ldebaugh - 2013-02-15 11:02:45

Hi Janey L.
Thanks for the compliment!

I live near Baltimore and you can go on the Hopkins Hospital website and read about a Dr. Abraham who does Optimizing Echos for people with Pacemakers. Also the St. Jude Medical technician said that they also do an optimizing procedure with their computers. So your doctors could be referring to either one. Both are completely non-invasive, I'm sure you've had an Echo before, well it's no more a big deal than that.

So glad at least there's a direction to pursue, if this doesn't work, bring up the 2 to 1 ratio and ask them to raise those numbers.

Actually the optimizing Echo didn't work for me. Today, in fact, my EP put the settings back to where they were before the Optimizing Echo because he said my ECG looked better before and he didn't like the way it looked afterward. Interesting. This is definitely not an exact science!

All the best,
M'Liz (ldebaugh)

Keep us informed

by judy13 - 2013-02-16 08:02:25

Hi Janey,

I hope they resolve this for you. An AV node ablation has been mentioned for me and the accelerated junctional rhythm also, so am particularly interested in your results.

Interesting that the Echo did not work well. Definitely setting these things is an art. Unfortunately, too many people believe they are perfect little black boxes.

Judy

optimization

by sam78 - 2013-02-16 10:02:17

I had an optimization done since I had an AV node ablation. I did not have good luck with it. I kept having what they called "fused" beats so on the echo the way the settings were set looked good. But I felt terrible with it. I had missed beats. Also a couple weeks later I had failure to capture essentially from it, they had my delay so set long that it caused it to not pace me correctly. Be sure to tell them how you feel afterwards as it may make a difference.

Thank you

by Janey L - 2013-02-17 03:02:35

Thank you so much for all your helpful replies. I found a really good article online last night by St Jude's technicians which explained (in simple terms I could understand) why & how they do the AV optimisation. I have a Medtronics Surescan PM so not sure but I guess the methods must be similar.

The Head of Pacing, who has been dealing with my case since last August, will be involved in the optimisation tomorrow (not sure if my EP will be there).
So I feel confident I am in good hands.

I will let you know how I get on. Here's hoping it all goes well & the awful pressure in my neck symptoms finally go away!

Thanks again to you all, your help is much appreciated.

Best wishes
Janey

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