Purpose of PM

I had a myectomy/maze open heart surgery done in July 2012 to repair HCM and wishfully to stop afib. From Sept 2012 until 6 weeks ago I was felling better than ever! Gym 5 days a week non stop busy days. Just like I was in my 40's. 6 weeks ago, I began getting fluid in my lungs. I was out of town so I called my Pulmonologist and he prescribed 60 mg of LASIK and 24 meg of potassium Got to feeling better. Thought all was finished. My appt with him the next week showed my lungs to be clear but he kept me on lasiks, lowering my dose over a 4 week period. Then I began afib. More fluid build up and continual afib for 5 straight days before I made a PM transmission proving I was definately in afib. I thought after my surgery last summer these days were behind me. Now the electrical cardiologist is talking about an electrical ablation to do more repair work. What is my PM for if not to keep me from going into afib. Keeping me in rhythm. I'm so sad. I'm right back where I was before my open heart surgery. What does my PM do???? Do I have the wrong PM? Is it wired wrong!!!? Do I need to get another opinion on this PM? Help!

6 Comments

EB is right

by Many Blessings - 2013-04-24 09:04:41

Hi Tech,

EB is right. When I'm taking Lasix, depending on what mg I'm taking, I am also given a prescription med that has both Potassium & Magnesium in it to add back in what is lost. If I'm taking 20 mg, I just take an over the counter supplement. If it's the 40 mg or 80 mg, I take the prescription pill. When I'm in the ER or hospital getting Lasix IV, it's given IV as well.

No matter what, I'm with EB, take a potassium/magnesium supplement along with Lasix or any other diuretic.

Electrolytes

by ebfox - 2013-04-24 09:04:54

Hi Tech,

I agree with the previous comments, one thing to add is get your doctor to check your potassium and magnesium levels. Afib can be caused by low or high Mag and Pot. When you are taking lasiks you can dramatically lower your levels.

I know it is frustrating, get with your doctor and hopefully you can work through this rough patch-

E. B.

What does a PM do?

by donr - 2013-04-24 12:04:01

Good question, Tech. Obviously, no one has ever explained it to you.

The PM corrects ONLY electrical control problems in the two nodes of the heart - the Sinus (SA), controlling the upper (Atrial) chambers & the AV (Ventricular) lower chambers of the heart.

It is an accelerator pedal ONLY. meaning it can only fix things that are about to be late or not to happen at all. It is NOT a brake pedal. Meaning it CANNOT slow down or stop anything that happens early.

A-Fib is an unusually fast functioning of the Atria, meaning the SA node has run amok. The PM cannot slow it down - it just stops functioning & records what happens. If the HR of the Atria is too fast, the Ventricles cannot follow them, so you get an uncoordinated beating of the heart.

A-Fib can only be controlled by meds or ablations near the SA Node. Possibly in the ultimate case, obliterating the SA node, meaning you need a PM to replace it. There are lots of members w/ this situation. If you want some first hand knowledge of this situation, send a Pvt Msg to Janey L in London, UK. She can answer almost any question about SA ablations, as can a woman named snitch in Germany.

UNusually fast rates of Ventricular functioning can only be treated by meds in combination w/ a PM - or an ICD (which you have) It is designed to detect V-tach & V-Fib and give you a jolt when the rates get dangerous.

I do not know which PM you have, but if it is a dual chamber variety, it is probably the correct one. I think you can trust your EP at this point.

I would wait till one of the ablated ones sign aboard. Just wanted to ease your mind a bit about what a PM does.

Don

Thank you Don,

by jeanlancour - 2013-04-24 12:04:16

You were letting him know even as I was haltingly answeing. I am still learning from you pros. Jean

PM

by jeanlancour - 2013-04-24 12:04:19

is doing its job of keeping your heart beating. Its only job is to keep your heart from going to slow, it can not stop afib or aflutter, I, also, thought it would stop all those wierd extra beats, but that is not its job. It sets up there watching and timing the beat if the beat is not completed on time it steps in to make sure its done right. I am on meds to slow the extra stuff thrown in there, I still have aflutter and afib, most of it I try to ignore. It doesn't scare me anymore. Hopefully someone with more experence will step in here and give you a better explanation than mine. keep coming back. Jean

PM & A-fib

by Many Blessings - 2013-04-24 12:04:30

Hi Tech,

Like the others said above, a PM isn't going to stop your A-fib. I've had uncontrolled, high rate chronic A-fib since 1987. I had a CRT-P w/AV Node ablation a year ago to try and slow down my HR to a normal rate and improve the synchronization of the chambers, thus putting me into a controlled A-fib versus uncontrolled. It worked, but, I am still in chronic A-fib, and will always be in chronic A-fib. This was no surprise to any of the cardiologists, EP docs, or surgeons. They knew from the start, this would not cure the A-fib.

I also have CHF and cardiomyopathy which does cause fluid build up at times. Sometimes, worse than others. Lasix is a given during these times, and is probably the best diuretic for CHF (for me anyway).

You really need to meet with your cardio doc, EP doc, surgeons, and whoever else you're seeing, to discuss your concerns. All of us here can give you our opinions and guesses, but your doctors know your situation the best.

You have been given some absolutely awesome information and ideas above, from some very knowledgeable members! Please take everything we've all told you, and do your research to see if anything applies to you. But, PLEASE talk to all of your doctors as well, so you can be sure to have all of the information you need to know about you're particular problems and situation. It is very important you understand what your PM and surgeries cna do or not do.

Lots of luck!



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