Pregnancy and pacemaker

Hi all,
I am 31 years old and had my PM 3 years ago. I am currently 31 weeks pregnannt and my pregnancy has been going really good with no issues at all. I was wondering if anyone had been pregnant with a PM and did it cause any issues during delivery. My ob and cardiologist dont think I should have any issues, but they wanted me to get a consult with the anesthesia deparment where I am giving birth (I am guessing that's because the epidural lowers bp).

thanks.

7 Comments

You should be fine, but...

by Terry - 2014-03-24 03:03:28

If you have a high ventricular pacing burden you need to monitor what is called your "ventricular ejection fraction" or "end-systolic volume." Google PacemakerPatientAdvocacy.com to learn more.

Terry

what is high venticular pacing burder?

by RTO - 2014-03-24 04:03:40

how do I know if I have high venticular pacing burden? I know i have a dual chamber pacer.

Good Question

by NiceNiecey - 2014-03-24 09:03:47

My guess is that you need to ask your cardio office what percentage you are pacing in the atrium and what percentage in the ventricle. Let us know what you find out.

And, when it comes time to push that baby out, "Think Like A 'J'" Your body is the straight stem of the letter J and the curve is the baby coming toward your chest as you use your vaginal muscles (not rectal!!!) to push him/her out. It works!!! Let me know how you do! BTW, I did not have a PM during my child-bearing years!
Niecey

thank you

by RTO - 2014-03-25 01:03:30

I used to have wolff parkinson white, and during the ablation my naural pacemaker stopped working that's why i got my PM.

with my first baby (prior to PM) I took the epidural and it lowered by BP and they did give me medication for that because they were scared that it will start my arrhythmia, my blood pressure went back to normal really fast and had a very easy labor.

I have been treated normally throughout my pregnancy and no one seems to be concerned that I have a PM, I do trust my doctors but they were never pregnant or had a PM. that's why I wanted an opinion from someone who have had babies and a PM.

do what you want

by Tracey_E - 2014-03-25 03:03:51

As long as your problems are all electrical and are fixed by the pm, then it's a non-event and has no impact on your delivery. If you had an epidural last time and want one this time, go for it. I would definitely have a chat with the anesthesiologist before to make sure he/she is cool with it, if they're not they'll need time to be reassured by the cardio.

Ventricular pacing problems

by Terry - 2014-03-25 07:03:24

Hi RTO, you asked "how do I know if I have high venticular pacing burden?" Niecey responded nicely above. The literature on the Q&A page of PacemakerPatientAdvocacy.com suggests that the answer is ventricular contractions that are due to ventricular pacing 40% of the time, or more is associated with higher rate of heart failure hospitalization and atrial fibrillation. So, if your dual chamber pacemaker paces only in the atrium, for example, and your doctor sets the pacemaker up so that it doesn't pace in the ventricle at all, no problem. Can I lead you to more information in the scientific literature?
Sorry I didn't respond yesterday.

Terry

pacing and delivery

by Tracey_E - 2014-03-25 12:03:32

I had two babies post-pm, nothing to it! Why do you have a pm? I have congenital heart block.

As you are probably learning, pregnant pm patients are few and far between so most of the docs are making it up as they go along. There are two schools of thought on the epidural when we are paced. Some believe it can lower bp and slow down labor so it's best to go without. Others say it relaxes the mother and makes delivery easier so it's best to get it. My opinion is talk to all of your team so you are making an informed decision, then do what you feel comfortable with. I've had allergic reactions to pain meds multiple times and my bp is always very low, so I decided I wasn't taking chances complications while trying to push out a baby, so going without was my choice.

My cardio and ob talked early on when I got pregnant the first time. They decided no special treatment during the pregnancy, cardio insisted the ob could treat me like every other healthy pregnant woman. I was even cleared to work out right up until the end, which I did. They let me deliver in the birthing suites rather than the main hospital. I was on a cardiac monitor during delivery, was told that if there was any sign of my heart getting stressed or things were dragging on too long, then it would be immediate c-section, but everything was fine. Both times :)

Oh! If you are on a monitor, be prepared for a lot of heads to pop in the door. They don't see pacing spikes very often on the ob floor.

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