Need to Know

Hi There,
Pacemakers save lives but your pacemaker may actually be causing your decreased ejection fraction/heart failure.
Our Story...
My father had a slow heartrate (brycardia) and they put in a duel chamber pacemaker into the rightt side of his heart (standard procedure). Over a four year period, his EF went from 50% down to 20% and he ended up hospitalized for congestive heart failure.
After doing some research, and taking dad to a new doctor, the doctor confirmed that there are a percentage of people that the pacemaker will actually cause heartfailure. Because the pacemaker makes your heart pace in an unnatural rhythm, it overworks the left side and causes the left sided heart failure (decreased EF).
My father is getting ready to have his pacemaker replaced with a bi-ventricular pacemaker. By adding a third lead to the left side (ventricle) of his heart, his heart will beat like a natural heart does. The specialist said his EF will improve as well as his quality of life.
Wish I would have known this earlier, as Dad's health has deteriorated drastically over the last couple of years.
What I have learned is to not blindly follow your doctors. You really do need to do research and question. And arrogance in a doctor is a mask for ineptitude. That person is dangerous for your health. Move on to another doctor ASAP!
Hope this experience helps at least one person!
Best Wishes

5 Comments

risks

by Tracey_E - 2013-07-28 01:07:52

Yes, it's true that some of us will end up with heart failure after being paced long term but the benefits far outweigh the risks. In my case, without the ventricular pacing I'd be dead, so really there's no choice and I'll take my chances. If the day comes my EF drops, I'll upgrade to a bi-vent. We can't predict who will end up with problems from pacing, or just additional problems from aging. It doesn't make sense to start everyone with a bi-vent. They are more invasive, don't last as long, and are therefore only used when the EF is too low. It's overkill for bradycardia when the EF is normal.

It's always good to do your homework and be comfortable with your dr, but what would you have had them do differently for your dad? I'm sorry to hear he is having problems and hope the bi-vent brings his EF up, but I'm not seeing anything that was done wrong.

Hi Detradel

by CardiacTechnician - 2013-07-28 02:07:42

It is true that studies have found that pacing the Right Ventricle can lead to heart failure and also AF.
I think the biggest study into comorbidities as a result of Right Ventricular pacing is the PREVENT Study.

However TraceyE is exactly right in what she has said too. I just wanted to try and relax some people that could be concerned by this news!
Firstly understanding has come a long way, now in younger patients that will ultimately have a long time of Right Ventricular Pacing we try and use a Septal Lead position which in theory will minimise the dysynchrony that leads to HF.
Also we now have new Algorithms (pacemaker software) That minimises RV pacing.

I have detailed two of the algorithms on my website one of them is here

http://cardiactechnician.blogspot.co.uk/2013/07/algorithm-of-week-sorin-safer.html

All in all the risk is being reduced through technology and understanding.

I am of course sorry to hear your father isn't doing so well!
Fingers crossed his BiV implant helps with his Ejection Fraction.

www.cardiactechnician.blogspot.co.uk

Kindest Regards

Cardiac Technician

thank you

by Hope - 2013-07-28 03:07:04

Hi! I am sorry your father is having trouble, and I hope the additional lead will be helpful. I am sure you have learned now that a second opinion and personal education on our health issues are vital. Unfortunately, every medical procedure, device and medication comes with risks. Also, I think you are saying that the lack of info some doctors give patients so they can make informed decisions is insulting and unfair whether it be from incompetence or indifference. On the other hand, it our responsi
bility to ourselves to ask questions just like we do when buying a car, etc.. I think you are trying to help others see the need to not be blindly trusting of the medical field, and I am sure you have given more than you know food for thought or a reminder. Please keep us posted about your Dad. Hopeful Heart

You are right..

by Duke999 - 2013-07-28 04:07:09

You are right that we must be active in understanding what the doctor is doing to our body. As in my previous post "We can solve many problems IF.." a couple days ago, I pour out my frustrations somewhat similar to you because the PM tech explained nothing to me. I didn't even know that there's such thing as settings to be adjusted for the PM until I learned about it on this wonderful site. Anyway,
many well wishes go out to your father. Have a great day.

Duke

Thank you for Responses

by Detradel - 2013-07-29 10:07:46

Hi Everyone,
Thank you for your feedback!
The reason I posted our story was not make people afraid about their pacer, just aware. I wish I would have found this site earlier so I could have benefited from the information here.
To TraceyE, I think what I think should have been done differently was that once dad's EF started to decline over the first couple of years, the doctor should have looked at his pacer as a possible contributing factor. I don't think starting him out on a bi-ventricular pacer would have been indicated because his EF at the time was 50-55%.
I never knew that the pacers could cause/contribute to heart failure until I did research. Like Duke, I also never knew they could be adjusted!
We would not have changed the decision to get a pace maker, because he would probably would have died without it also. But that information could have saved my father from further decline and damage to his heart had we known and addressed the pacer issue earlier.
There are many great doctor's out there, but unfortunately, I feel my father's doctor was not one of them. Coincidentally, he retired right after my father's hospitalization.
I hope someone can learn from our experience. Ask questions, do research, and don't let someone tell you that your just over doing it. Listen to your body and question your doctor. They are only human, subject to the same problems, personality flaws and issues that we have. They aren't perfect.
Thank you for the good wishes and I will keep you posted!

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