Pm replacement

I have an echo yearly, one 7/2013. Did not see cardiologist even tho I had an app. Nurse told me to go home, that if anything amiss dr would call. He did not. Near the end of 2013 his asst. called and set up an appt for 1/17/2014 at which time doctor tells me my ef has dropped from 45 to 38. He says I need a new two lead pm vs 1 lead. He sent me for a short echo on 1/2014 in prep for the new pm. Have heard nothing from him. I am feeling insecure with this doc even though he is supposed to be the best in my city, nashville tn. Am I expecting too much or is he negligent?


5 Comments

EF

by golden_snitch - 2014-01-26 02:01:44

Hi!

Since when do you have the pacemaker and how much do you pace in the ventricle?

I'd say that a drop from 45% to 38% is not significant enough to justify immediate upgrade to a bi-ventricular pacemaker. But that's just my opinion. I mean, my EF changes a few percentages depending on who does the echo. It's never exactly the same. So, my feeling is that a drop or gain of around 5% or a little more should not be taken too seriously. If I were you, I'd probably wait another 6 months, and have the echo repeated then. Also, what counts the most is how you are feeling. Are you feeling worse than before, do you show any signs of heart failure?

If you have the chance, you could also go for a second opinion. Unless you are in acute heart failure, you should have enough time to wait a little longer - either for a repeated echo or to get a second opinion.

Best wishes

Inga

Drop in ef from last echo in 2012

by Orba615 - 2014-01-26 06:01:53

My pm is almost 10 years old. I have never had any problems with it. My problem is af. After a bout with lymphoma in 2007 during which had heart failure, my ef went to pot, but after a hospitalization of 5 weeks, remission of the lymphoma, my ef was back to normal, 55.
Now it is 38. The doctor says that he will implant a new pm with two leads one to the atria and one to the ventricle to synchronize the two. I do feel well, none of the symptoms that a low Fe supposedly causes, short of breat, tired, chest pain, swelling in feet, etc. have had no further problems wit lymphoma, did have an infectious tick disease, and took a nasty fall this past year but recovered from both. Guess I am making a mountain. From a molehill, huh? Thanks

Hi

by jeanlancour - 2014-01-27 12:01:37

it is your mountain and you have a right to know what is going on. You also have a right to a second opinion, Golden-snitch has very good advice.

medicine is changing

by RDD - 2014-01-28 12:01:41

I'm a retired MD with a recent pm. Your physician IS negligent and you should look elsewhere. Competence is of no value if you cannot communicate with your provider. Good Luck.

New pm

by Orba615 - 2014-02-06 03:02:17

Surgery coming up Monday, 2/10/14 to implant new pm and add second lead. How long a surgery and will I be put to sleep? Thanks

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