Pace maker damage

Hi, Two years ago I had a complete 3 degree block and received a Sensia DR pacemaker and was told since I didn't have any heart disease this would fix me up. After about 1 and a half years my symptoms returned, exertional chest discomfort, dyspnea, fatigue, palpitations. Of course they said my pacemaker was fine. Had a Stress echo, before I even started the tech. called the Doctor to look at my echo and he said my left side wasn't working and I needed to upgrade to a biventricular and I started Coreg and Prinivil. After cardiac catheterization showed no obstruction I was scheduled. My doctor said I now had chronic systolic heart failure/dilaed cardiomyopathy and CHF due to heart damage caused by the first pacemaker only pacing my right side. Why do they even use a singe side PM? I see so many people having them replace. Now I have heart damage for life. My EF is still only 25%. It cost me 3,500.00 copay for each year that I had my surgery. Is this a common thing and has any one else had damage to their heart caused by their PM. I did apply and received Social Security Disability due to my heart disease now.

8 Comments

First implant

by DMJ - 2013-02-21 01:02:50

I don't remember them telling me what my EF was with my first PM because it was a completed electrical block and they did not do a echo. I just could not do the stress test because I could not raise my heart rate to 65, so they had to use drugs to complete the test. It was not until my last hospital stay with the new bi-ventricular pm with ICD was implanted that it was stated my EF was only 25% and at two months had not improved. I think I will wait at least 6 months to see if the EF has improved, my copays on all these test are killing me. There's nothing to be done anyway, it is what it is. I do get medicare in 2 years and will not have to wait until I'm 65 so that should help if I need to keep having all these test and surgeries.

Right-ventricular pacing and CHF

by golden_snitch - 2013-02-21 04:02:27

Hi!

I agree with Frank that most patients do not experience this complication.

However, obviously there are enough patients suffering from it to raise the cardios' attention. Today, there are quite a few studies out there that indicate that right ventricular pacing can lead to heart failure and onset of atrial fibrillation. Pacemaker manufacturers are developing new modes that reduce ventricular pacing, just because of these studies' results. Seems to be more common in longterm pacing, but sometimes also happens in patients who have just had their pacer for a couple of months or a year or so.

I have heard experts who want to implant bi-ventricular pacemakers in nearly every patient, but the majority of doctors still says, if the EF at the time of implant is perfectly normal, it's safe to just do a dual-chamber pacemaker and monitor the heart's function regularly by echo. Do you know what your EF was at that time? If it was normal, so around 60%, and you now have only 25%, I would also suspect, like Frank, that there might be something else going on. It's just a very significant drop, and I'm really not sure if that can be blamed only on the right-ventricular pacing.

If a cardiomyopathy is caused by asynchroneous beating of the ventricles due to one ventricle being paced and the other not, the bi-ventricular pacemaker will restore the synchrony between the ventricles, and chances are not bad that your EF will increase and stabilize. If you have no other heart disease, and the decline in your EF was really only caused by the right-ventricular pacing, I could even imagine that the cardiomyopathy will degenerate, now that both ventricles are paced. That will surely take some time, though.

A friend of mine had an EF of 28%, and now with bi-ventricular pacing is up to 40%-45% and has been stable since about 10 years. Her cardiomyopathy has improved a lot. In her case the asynchroneous beating of the ventricles wasn't the only cause, she has other heart issues, too, but the CRT device really did a miracle and has helped her a lot.

Best
Inga

Thanks for comments

by DMJ - 2013-02-21 08:02:42

My EF was 25% at the time or surgery and after 2 months had not gone up. I do hope in time it will improve as you have stated. Do most people with PM also take medicine?I'm working on increasing my exercise and need to loose the 15 pounds I've added due do no exercise these past months. I guess like hearing aids, a PM is a aid not a cure.

Dual Lead Pacer also

by TRL28 - 2013-02-21 09:02:18

Hi there! Prior to my pacer, my EF was 60%. 4 months post implant, another echo was done and my EF showed a decrease to 40-45% with left ventricular dysfunction. I just had a MUGA done yesterday to see if this 2nd echo was accurate but my cardiologist is questioning the issues with asyncronized beating. He stated that this can happen to a small percent of people but definately is on his radar with his pacer patients and doesn't like to let it go too long due to possibly causing more permanant issues. Only being 28 I definately don't want that. I recieved my pacer for CHB due to an accidental ablasion of my AV node and do not have any other cardiac issues either and was told the dual pacer should fix all and I should have no issues... definately not the case but the percentage is small and there. We must be the lucky ones to be part of this group... Yay for us! Good luck and I hope all starts looking up for you!

First implant

by golden_snitch - 2013-02-21 09:02:30

I mean, what was your EF at the time of the first imlant, so two years ago? That would be interesting to know, because a drop from a perfectly normal EF of around 60% to just 25% two years later is very significant. Today, patients who already have an EF of 40% or less at the time of their first pacer implant, are more likely to get a bi-ventricular pacemaker right from the beginning, I'd say.

The pacemaker itself, or rather the heart rhythm disorder that led to the pacemaker implant, is usually no reason to take drugs. However, if you also have high blood pressure or cardiomyopathy or some kind of fast arrhythmia, you'll most likely need to take some drugs in addition to getting the pacemaker.

Inga

Doctors story

by ElectricFrank - 2013-02-21 12:02:09

Another fiction writer. While biventricular pacing can assist a failing heart to support you longer, the lack of it isn't likely to have been the cause of such a fast developing failure as yours.

Most of us with 3rd degree block do just fine on the standard 2 lead pacer. I have 9 years of pacing with no problem. There is an advantage of only having 2 leads in our heart to manage, and battery life is likely longer as well.

best wishes,

frank

Biventricular ICD

by Grateful Heart - 2013-02-22 01:02:43

I have a biventricular ICD. I was diagnosed with dilated cardiomyopathy, CHF, LBBB and SSS approx. 4 1/2 years ago. I also had a clean cardiac cath. My EF was 24% at the time. After the implant, my EF is now 50% for the past 3 years and my heart is no longer enlarged. I am on Coreg too (carvedilol, it's generic).

I just wanted you to know the Bi-V may make a huge difference for you when your heart is synchronized and your condition may improve.

Hope this helps,

Grateful Heart

Good to know

by DMJ - 2013-02-22 01:02:49

Thanks for your input everyone. I guess I feel upset because the pacemaker caused more harm. Yet, I may have dropped dead without it. I went at least 1 year with my symptoms because I had decided I had stable angina. Not too worried about the long term yet we all want the best quality life we can have day to day. Just be aware if you have a completed block about the problems with not having synchronized pacing from the start.

It's great to have a place to come and read about others problems and fears and not feel alone.

You know you're wired when...

You have the perfect reason to show off your chest.

Member Quotes

I just had this miracle implanted two weeks ago and I’m feeling better.