For those with a 3rd degree heart block

My CONGENITAL 3rd degree heart block was diagnosed at 3 weeks old. Until the last year (I am almost 32) I have lived a completely normal life with no major symptoms or complications. Over the past year and a half I have started feeling exhausted, have had headaches and an overall, general "icky" feeling every once in a while. I have finally decided to get a pacemaker on 4/25. My Dr. has told me with my condition, I'll only need one lead and those with the same condition PREFER one lead. That being said, people who have my same condition, would you agree?

8 Comments

I have had an AV node ablation

by janetinak - 2014-03-30 11:03:14

due to Afib so as I understand it I have 3rd degree heart block. I have had a single ventricle lead since 2000 & OK with it. No problems for me. Is that what you were asking about?

Janet

disagree!

by Tracey_E - 2014-03-31 01:03:13

There are still a few drs that prefer one lead pm's for CCHB, but most now do two leads. It's the same procedure do both. Theoretically we only need the one but sometimes we end up using the other, and even if it doesn't pace, the atrial lead provides information.

I have CCHB also. Like you, I also did fine through childhood. I got my first pm in 1994 at age 27. I have a secondary problem that was masked by my block so we didn't know about it until after I was paced. I pace 100% ventricle, as expected for CCHB, but I also pace 4% atrial. For me, that's the difference between being able to work out and not. Odds are you won't need the atrial lead and one is fine, but my own choice is if I was doing it all over again would be to get the second lead as insurance policy. Really, there is no right or wrong answer.

My story

by KAG - 2014-03-31 11:03:55

was I started with 2nd deg block and very quickly went to total AV block, within a few weeks.

I received a dual lead PM and I'm currently paced 100% in my ventricle and less than 1% in my atrial. Right now my sinus node works fine it's just my AV node that's failed. So if my sinus node fails or gets faulty, I'll just need a tweak to my PM since I'm already wired.

The decision was made for me since my electrical problems came on so quickly and there was no time for debate. But I'm comfortable with it and having both wires in place.

Kathy

Ask and research until you are comfortable...

by BHayes - 2014-04-01 01:04:04

I am 43 and have also lived a completely normal life with my congenital complete heart block until recently. I am 3 weeks with my new duel lead PM (1 atrial lead; 1 ventricle lead) and I am beginning to rebuild my strength and attempting to return to my normal activities. At my first checkup (10 days after surgery), I was pacing 100% in my ventricle and ~15% in my atrial.

I am also an Electrical Engineer and beyond the comments that donr and KAG have made (which I agree with), I am one who needs as much information as possible to feel confident about my decision. My situation was not an emergency, so I spent a couple of months researching, understanding, and developing the correct questions to ask my EP and Cardio. The gathering of information for me was web-based, Dr supplied information (EP, Cardio & general physician), and this site...but a second opinion would not have been out of the question if I were uncomfortable with any of the information that I had received from my Dr.

I think expressing your concern and question to your Dr. again is not to much. We put our trust that their guidance is best for us and if we are not comfortable with the the decisions, more discussions would be needed to increase my comfort levels.,...but of course these are just my opinions!

Good luck! You still have time to gather information and become more satisfied that you are making the correct decision.

I agree with Donr

by bluebowtye - 2014-04-01 01:04:24

Hi,

I just had a dual lead PM implanted 6 weeks ago so I am no expert by any means. I have 2nd degree heart block which my Dr. told me could rapidly progress to 3rd degree. I did not have a choice in what kind of PM I got because like KAG my need for a PM came about very quickly and was totally unexpected. My first report showed my ventricle pacing at about 4%, atrial at 1% and both together about 9%.

Since you can't feel the lead(s) or it pacing what difference does it make? I would think it would make you happier if you chose to have the dual lead so you could have the peace of mind knowing that you will be prepared should your needs change in the future. If it were me, I would constantly wonder "did I make the right decision by only getting one lead?". With 2 leads you would never have to think about that.

I wish you the best with whatever decision you make.

Take care and good luck!

~Sheila


How the HECK does someone else....

by donr - 2014-04-01 09:04:47

.....know that you will be happier w/ the single lead PM? If they are so great at predicting the future, why are they not filthy rich from playing the horses...or the stock market...or being a political consultant to a presidential candidate?

BTW: I am NOT a CCHB patient, but have experience making decisions for current courses of action that allow for flexibility in the future.

It takes very little greater effort to place a two chamber device than a single chamber. BUT if they guess WRONG, it takes at least twice the effort, plus twice the cost for a NEW PM - the old single lead is not refundable - plus all the hosp costs & surgeon's fees. It also exposes you to a second chance to get an infected pocket, etc. These are NOT trivial issues.

BTW: Have you ever noticed that there are NO warrantees on surgeon's work? They screw up/make a wrong decision, YOU PAY.

PLUS: It is better to have it & not need it, than to NOT have it & need it in the near future.

Buried in your post, written between the lines, is a wicked case of denial of reality & wishful thinking. You have put up w/ symptoms for a year & a half - when you or your parents knew this day would probably come for the last 32 years. You face PM replacement surgeries every 7 - 10 yrs anyway. Why add the potential for an additional one in the nearer future?

I'm going to let you in on an open secret. You have now heard from two Electrical Engineers (KAG & Me). We have lived our professional careers making decisions based on probabilities of future failure of things electrical. Note that she reported that her decision was made for her, due to the near emergency situation she faced. Although she did not say so outright, I'm sure that she would agree w/ me that the BEST course of action is to install the device w/ the greatest flexibility for the future. This is based on the fact that your electrical system has already failed once; the probability that it will fail a second time is not accurately predictable, but is significantly higher than it was, so you want to be prepared.

The best to you in facing this challenge.

Donr

Thank you

by 2219kg - 2014-04-01 12:04:17

For the information. I spoke with the nurse today and they think I will be happier with the one lead. I hope they are right. I appreciate everyone's input. I feel like I have new questions daily. Thanks again.

Thanks again

by 2219kg - 2014-04-02 09:04:06

Everyone's feedback was really helpful. You have really helped me come up with the right questions to ask my cardiologist. For Donr, you couldn't be more right. I am still in denial. I will say much less than before. I love hearing the advise you give everyone on the site and you make me smile.

Everyone has made this experience so much easier. I will keep you posted.

Kelly

You know you're wired when...

Your ICD has a better memory than you.

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