probably getting a pacemaker next week

I am 45 years old and have just been diagnosed with a heart block. It looks like it will require me to get a pacemaker (just awaiting results of blood tests to rule out Lyme disease and thyroid disfunction). Surgery isn't scheduled yet but I'm anticipating it to occur in the next week or so.

I'd like to get some feedback on what to expect and more importantly some advice on what sort of choices I'll need to make with my doctor over the next few days.

Are there different types of pacemakers/features I should be aware of? I'm pretty active as a skier, soccer player, cyclist and want to make sure I can maintain an active lifestyle.

What can I expect from surgery/recovery? Lifestyle changes living with a pacemaker? Things to be careful of, especially in my first few weeks.

Pretty much anything you wish someone told you before you had yours implanted would be appreciated, especially if you were relatively young and active when you first got yours.

6 Comments

have one and its ok

by rwagenblatt - 2012-10-21 04:10:27

You mentioned heart block, what degree? I have third degree and got my PM in may. (Read my post just after yours today), I'm older than you (57) but am active, exercise, referee, racer and was able to get back to normal in short order. Enough about me, we're all in the club for different reasons and while you mentioned heart block, how you do and what you're able to do will depend on your situation. Regardless of that, follow your docs orders and do (or not) what you're told. The hardest thing for me was the emotional issues (I'm not alone on this). Don't be supprised if this happens to you, the people on this site site will be a fantasticsupport tool for you! All the best RW

livng with a pm

by Tracey_E - 2012-10-21 05:10:18

Type of pm- there are several brands out there and most drs have a preference. My dr has an excellent relationship with a St Judes rep so that's mostly what he uses. Medtronic is the largest company. Av block is the simplest thing to fix with a pm so most of the nuances that would make one better than another are irrelevant to you. We don't have a complicated problem to fix. The atria beats normally, the signal doesn't always make it to the ventricles. All the pm does is complete the broken circuit as needed.

There are some smaller companies that make excellent pacemakers like Sorin and Boston Scientific. I'd probably avoid these simply because it's harder to find a rep to take care of it. At home with your own dr it's no big deal but if it turns out your local rep is a dud or you have problems on vacation, it's harder to deal with it. I know someone who had a BS pm and lived in a rural area. She had some complications and ended up traveling 4 hrs every time she got it checked. She ended up switching to Medtronic.

What to expect from surgery- St Judes has a good video that shows how it is implanted.
http://health.sjm.com/arrhythmia-answers/videos-and-animations
Some are fully awake but numbed some get versed so they're awake but don't remember. The less anesthesia you get, the faster you will feel better. Most drs keep us overnight for observation, check the pm and possibly do an xray in the morning to make sure the leads haven't moved, then send us home.

Recovery- drs vary but on average we're told not to lift or raise the left arm (assuming it's on the left) higher than shoulder level for 6 weeks. Other regular arm movement is good, you don't want your shoulder to freeze up. Assuming your dr clears it, light exercise should be ok as soon as you feel up to it. I was walking the neighborhood the day I was released and on a stationary bike a week later.

Lifestyle changes- none! Make sure you get an mri-compatible pm, mri's are the biggest thing most of us have to avoid but they make newer pm's that are compatible. We can't arc weld or visit the junk yards with the giant magnets. We need to keep magnets more than 6" from the device, tho most magnets you'd encounter around the house won't affect it. Once you heal, go back to your sports and don't look back. If you do full contact sports like football or karate, you might want to look into a padded shirt.

Talk to your dr about placement. The easiest and most common placement is just under the skin, just under the collarbone. If you are active, it might be more comfortable subpectoral, a little lower and deeper. It's out of the way so backpack straps won't irritate it and it's less likely to take a direct hit during sports. Healing is a little longer but it's not bad. I got by on Tylenol after the first few days.

I have congenital av block so I was born with what you have. I'm 46, on my 4th pm now. I'm healthy and active, ski or hike most vacations, do crossfit 5 mornings a week. I feel great and can do whatever I want.

PM type

by ChristieD - 2012-10-21 10:10:04

Oh, and I have a Medtronic MRI compatible PM. The rep in my area has been very helpful and has made several adjustments to it already to "tweak" it to fit my level of activity. I've been pleased with it so far.

Agree with above

by ChristieD - 2012-10-21 10:10:46

TracyE gave some great advice above and i agree that for an active person subpectoral placement is really good. I'm 40, run daily, also do crossfit and received my PM for type 2 second degree heart block one month ago. The initial recovery time may be a little longer for the subpectoral placement but I think in the long run its a great choice for younger, more active people.

I was back on the road training for a half marathon within 2 weeks. I also agree with the first poster not to be surprised if you get hit by some emotional issues. I did. The people on this site are very helpful.
Good luck!

Anesthetic

by ElectricFrank - 2012-10-22 12:10:15

You may be given a choice of anesthetic during the procedure and it helps to thing it over ahead of time.

The usual choices are:
1. A general anesthetic where you are completely out
2. A combination of local pain shots around the incision together with a sedative which makes you less anxious
3. Local pain shots only and remain awake.

#1 is pretty much over kill (shouldn't use that word) unless you have some special condition requiring it.

#2 is the most common.

#3 is fine if you aren't the type that freaks out easily. The only pain is the needle stick for the locals. This is the choice I made and it was no problem. It was also nice to bypass the recovery room and go directly back to my hospital bed.

I had my battery replacement done the same way.

If you want more input drop me a PM with any questions.

No matter what way you go the surgery is easy.

frank

Thank you!

by beantownrob - 2012-10-25 02:10:13

Thank you all for taking the time to enlighten me. After speaking to my doctor, he agreed that the Medtronic MRI compatible PM to treat my third degree heart block is a good choice for me. He is however recommending subdermal instead of subpectoral placement. I will be getting a 2nd opinion and then most likely having the surgery early next week.

Rob

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