Pacemaker issues?

Hi all, I am new to the PM club.  I just had my PM put in on July 17th.  The reason that I had to have one is very different from most people. I got diagnosed with inappropiate sinus tachycardia about 2 years ago after getting heart rates reaching almost 200. I had an ablation in February 2012 and another in April 2012. The ablations should have worked, my heart made new electrical pathways deeper into the heart so my EP doctor sent me to a doctor in Chicago where he did an aggressive ablation for almost 8 hours then my heart rate was in the 40’s and unsteady so they put a single chamber PM in.

I was doing really well until a couple of days ago, when I started having bouts of tachycardia off and on with horrible pounding my in chest. I called the doctor and he said they may have to tweek some of the settings. The thing that worries me the most is he said that this can all come back which then they would have to burn more nerves that surround the outside of the heart. He called me one of his most difficult patients ever.  

Has anyone else had this kind of a problem?  I’m getting along pretty good with the PM now if the pounding of my heart would quit. I would really appreciate any comments or ideas from anyone.  Thanks ... by the way, I am only 36 :(

5 Comments

That can be a problem

by ElectricFrank - 2012-08-01 01:08:16

Kind of like weeds in the yard. Get rid of them and they come back.

It's hard to know what to to do with situation like that. The problem is that the hearts nerve system isn't a simple thing. I'm wondering if the heart doesn't grow new pathways as a survival method. It doesn't realize that you have a pacemaker taking care of things.

frank

Been there, done that

by golden_snitch - 2012-08-01 03:08:30

Hi!

Been there, done that. I'm very sorry, but what I can tell you is not very encouraging:

Have had seven ablations so far, four of them for permanent sinus-node reentry-tachycardia. After those I also developed AV-nodal reentrant-tachycardia, ectopic atrial tachycardias, atrial flutter, junctional tachycardia, and accelerated idioventricular rhythm. Oh, and I have just been told that my sinus node is acting up again - after three modifications and one complete sinus node ablation with more than 120 radiofrequency applications.

All the sinus tachycardia patients I know who underwent ablations have come down with more arrhythmias and with recurrent sinus tachycardia. They all had several ablations, all needed a pacer. Three of us have had a very serious complication called "vena cava superior syndrome" due to an excessive amount of scar tissue from the sinus node ablations; the scar tissue blocked the vein. We needed open-heart surgery.

So, what I would like to say is, be careful with more ablations in that sinus node area, and don't expect too much, if you decide to have more ablations done. We sinus tachycardia patients seem to be tricky and tend to come up with more arrhythmias. My right atrium is now so full of arrhythmias that my EP wants to do an AV-node ablation. That's the last resort. For the past four years I have tried every anti-arrhythmic drug on the market in order to avoid AV-node ablation, but since they all failed, I'm opting for the last resort now. If you haven't tried several drugs, yet, I'd suggest that you do that before you go for another ablation.

Sorry again for this discouraging story, but I think it's better to be honest.

Best
Inga

rotor ablation

by ldebaugh - 2012-08-01 09:08:07

Read this article, print it out and ask your doctor if he could do this for you. i think this is the wave of the future because it's a much more effective ablation method.


http://www.medpagetoday.com/MeetingCoverage/HRS/26336

the ablation process

by daisy0388 - 2012-08-01 11:08:28

In my last surgery that lasted 8 hrs the agressive ablation was very agressvie, they went in on both sides of my groin, my juglar vein, 2 incisions below my ribs so they could go in epicardial way and get to the outside of the heart as well so I think all and all I don't think there is much else he could of done other than doing an av abltion which they don't want to do cause they want my heart to try to beat on its own!

Snitch...thankyou so much for your comment it does shed a little light and things and its nice to know that I'm not the only one dealing with an issue that is so complicated, my EP dr in chicago was at Loyola and he is one of the best in the country so I feel good at what he has done but I'm still afraid of things coming back in full force..I'm sorry you have also had to edure so much I know how fustrating it can be. The drs told me that when your dealing with this kind of isssue its very hard to fix and understand and that they are still continuing to learn about it themselves. Please let me know if you have anymore advice! Thanks so much

Idebaugh

by daisy0388 - 2012-08-06 08:08:18

I looked at the article but don't know if it would work for my because I don't have Afib its sinus tachycardia..btw feeling horrible today hr keeps jumping off and on to 115 with me just sitting on the couch...gets old

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