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Afib after getting a ICD
A year after getting my icd I have developed severe afib. I'm on Tikosyn and digoxin but still have occasional afib but not as severe. My heart has improved from the cardiomyopathy from 20-25ef to now 50-55 ef. They adjusted my pacemaker from 40-125 to 80-125 and I'm having way less afib. Could my ICD be causing the afib? I never had afib before the icd. I usually get it after I come home from work and set down and relax. I keep getting defibed because the afib makes my heart get up into the 170's. Has anyone else developed afib after receiving a icd?
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ICD & Afib
by golden_snitch - 2015-04-03 02:04:29
Hi Twila!
First of all, heart failure and Afib often go together. When the ventricles get weaker, the atria have to do more work. This in turn causes them to enlarge, and this enlargement/stretching is known to cause Afib. So, if you were in heart failure, it might just be a coincidence that the Afib started after the ICD was put in.
If the pacemaker function of your ICD is activated, and you are being paced (a lot) in the right ventricle, this could be a cause of your Afib, too. Doesn't happen that often, but it's still a well known complication of right ventricular pacing.
Your ICD seems to be programmed old style. After the MADIT-RIT study, ICDs are very rarely programmed to shock at heart rates lower than 200 or 220. Not sure, why you still have the 170 setting. Also, ICDs nowadays are programmed to wait a little longer before delivering anti-tachycardia therapy/shocks. If I were you, I'd ask the cardio why your ICD is set to shock at 170, and ask him why he's not programming according to MADIT-RIT results.
What kind of ICD do you have? A dual-chamber ICD with one lead in the right atrium and another one in the right ventricle should be able to differentiate Afib from a life threatening, ventricular arrhythmia, and not shock you. But in order to do so, it's needs that lead in the right atrium, so that it can "see" properly what's going on in the atria. ICD shocks caused by Afib are a typical problem of single-lead ICDs that only have one lead in the right ventricle.
Hope this helps!