2:1 Heart Block: To PM or not to PM, that is the..

Hi All (especially Pammy),

It's a simple question, unfortunately blessed with countless answers: With a 2:1 exercise induced HB, should I get a PM implanted to fix it?

I know it is a decision only I can make, but I am looking for opinions from people who have already had such decisions to make, as they will be well informed of the pros and cons.

No other problems apart from not being able to raise HR above 140ish BPM without incurring the 2:1 HB.

What PM can best deal with this problem also, as there appears to be numerous functions dependant on make/type?

Happy New Year,

Spin

6 Comments

Happy New Year

by Moner - 2014-01-03 08:01:05

Hi Spin,

Hang tight, I'm sure either TraceyE or DonR will chime in real soon.

They are very reliable and I'm almost certain Tracey has some kind of heartblock, she's a real exercise buff too!

Welcome, this club helps me out a lot.

Moner

>^..^<

OMG!!

by Moner - 2014-01-03 08:01:45

Tracey you must have been working on this, while I was writing this out. LOL

Choosing a pm

by Tracey_E - 2014-01-03 08:01:48

The fine differences between them are usually more important to patients with sinus issues than block. Block Is the easiest problem to fix, any pm will do so don't stress over which one you get. Some hospitals only do one or two brands. Most drs have a preference and don't involve us in the decision, usually because they have a relationship with the rep who will take care of programming it after.

Choosing a PM

by IAN MC - 2014-01-03 09:01:02

Hi Spin I see you are from the UK. Tracey describes the American situation where manufacturers reps do the PM programming after implant. This does not happen in the UK and you will never see a company rep.

Because the programming here is done by cardio physiologists who are trained in every make of PM it is just possible that you have more choice here than in the States but you would have to be a very "informed customer" to talk your Dr out of implanting his favourite brand.

My cardiologist did actually discuss various brands with me and I opted for the Medtronic Avisa in the end because it is OK with MRI scans. As Tracey says, if you have block, there's not much to choose between any of them in my view.

Another thought, Spin

by IAN MC - 2014-01-03 10:01:33

When discussing the merits of various PMs with your cardiologist explore those with Rate Drop Response features as it seems that your HR drops very rapidly during exercise . My understanding is that this feature puts in extra beats depending on the gradient of the fall.

I guess only you know how tolerable your life would be if you were restricted to activities that never take your heart above 140bpm, I hope PAMMY responds to let us know if she would still make the same decision now ; I was one of those who strongly recommended to her to go down the PM route , on the basis that the potential downsides are fairly minimal !

Cheers

Ian

I would say Yes

by PAMMY - 2014-01-04 02:01:16

Hi Spin

I have to say that I was in a dilemma for 12 months trying to decide on what to do, and after 2 months post implant I was still wondering whether I had done the right thing. I felt that I still wasn't getting anywhere with my running (especially when trying to get up any slight gradient) but after a few visits to the pacemaker clinic where they kept 'tweaking' me I can now run uphill (albeit a bit slowly). I think I was a bit impatient wanting to run marathons tomorrow!

The pacemaker clinic have been excellent and told me to keep coming back until I was happy with the pacemaker. I am now just coming up to 3 months post op and ran 6 miles this morning at 10 minute mile pace which is slower than I used to run but I am hoping my fitness will improve with time and effort.

So in answer to whether I am glad I have had it done it is a resounding YES as I feel I can join my fellow runners without having to worry about stopping all the time and can enter races again. In fact I am doing a 10k race next Saturday so will let you know how I get on.

As others on this website advised it is a personal choice but if you are missing exercising I would definitely go for it.

I am grateful to others on this web site for their opinions (especially Tracey and Ian MC) as they helped me reach my final decision.

Good luck with whatever you decide to do and all the best for 2014.

Pam

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