Pacemaker nwith One Lead?

Mt Husband has a Boston Scientific Pacemaker w/ 2 Leads. Due to his ongoing A-Fib Issues...His EP wanted to go in surgically and disconnect the One Lead to the upper chambers so he will not feel the A-Fib but will still have it ( Which is still leaving him @ Risk of A-Fib) ...But leaving him w/ just One Lead ...his Heart will be totally dependent on the pacemaker. This scares me to death. Has anyone ever had this done or heard of it? After postponing the Surgical Procedure to Disconnect the One Lead from the Upper Chambers....I learn that Boston Scientific Representative can easy do it by simply touching a program button during a PM Device Check and can Deactivate the One Lead...Just that simple without going through any surgery? She said that she could also re-activate it back that easy also if ever need be. I have not went back to ask the EP about this or if it would be the same as the procedure and the out come as what he wanted to do? So confused...why would a Dr. want someone to go through a surgical procedure if.... it can be done so easy and also have the option of re-connecting it back so easily if needed for any reason??? Please help me if you can? And also what does pacing mean...Or what % of pacing is the pacemaker doing mean? Thank you all so very much...this is all so new to us and a little scary also.

3 Comments

Get a consulatation

by Theknotguy - 2014-12-03 08:12:37

I won't address removal of leads, surgery, and dependency on pacemaker. Your note looks like you received your information second hand. i.e. your husband told you what the doctor said, you didn't get it directly from the doctor. Kinda sounds like what I used to get from my step-mother when she was in the hospital. In any case, I'd schedule a consultation with the doctor.

If your husband isn't in immediate danger of imminent death, I wouldn't do anything until I knew for sure what was being done, why they are doing it that way, and what are your options. Unless your husband is suffering from dementia, that would go for both of you. Don't proceed until you know what is going on.

If his doctor doesn't want to discuss what he's going to do, isn't communicative, is defensive, whatever, get another doctor.

Messing around with the heart is too dangerous and shouldn't be done unless you absolutely know what is going to be done.

About pacing:

The pacemaker goes through a complex set of algorithms to determine what your heart rate should be. Based upon the algorithm the pacemaker will wait to see if your heart initiates a beat. If your heart doesn't start a beat within the calculated time the pacemaker will go ahead and initiate a beat. Then, after another calculated interval it will make sure your ventricle completes the beat (if you have a dual lead).

For example, if the pacemaker determines you need a heartbeat every 1/4 of a second, the pacemaker will watch and see if your heart initiates a beat on time. If the heart doesn't initiate a beat, the pacemaker will step in and start the beat. So if my heart is slow about initiating a beat, the pacemaker will make sure my heart beat occurs on time.

My heart is slow in starting a beat, so my pacemaker steps in about 80% of the time to make sure my heartbeat starts when it should. So I pace about 80% of the time. When I first had the pacemaker it felt strange to have a regular heartbeat.

If my pacemaker would stop working - which it won't - it doesn't mean I'd immediately fall over dead, it just means I'd go back to an irregular heartbeat like I had before having the pacemaker. Probably wouldn't feel too good but I wouldn't immediately die.

You indicate your husband would be 100% dependent upon the pacemaker but I'd want clarification of what the doctor meant. Does it mean his heart can't initiate a beat on its own or does it mean he will be pacing 100% of the time. Once again, a consultation would be helpful to clear up your confusion.

I have afib too. My EP and I have had discussions about my afib, what may come for me in the future, and what will be done. Obviously we don't know for sure what is going to happen, but I have a fairly clear idea of what can be done and my doctor knows what I'm willing to do.

Please don't proceed until you know what is going on.

Ablation?

by Tracey_E - 2014-12-03 08:12:37

It sounds like they're talkng about ablating the av node, not disconnecting a lead.

AV-node ablation

by golden_snitch - 2014-12-04 01:12:48

Already replied to most of your questions before. Let me add one thing:

Of course, the pacemaker rep can change settings, so that the atrial (upper chamber) pacemaker lead is switched off, and only the ventricular lead (lower chamber) works and paces. That is an easy thing to do. However, this does not help at all with Afib as long as the AV-node (the connection between the upper and lower chambers) is still functioning. As long as it's functioning, it will pass on impulses coming from the upper chambers to the lower chambers. So, your husband's Afib will still lead to a very irregular and maybe also fast or slow rhythm in the lower chambers. This can only be prevented when the AV-node is ablated. As I explained to you already, this AV-node ablation is a last resort therapy to help Afib patients. There are other treatment options before thinking of an AV-node ablation. But that's what I already told you in a comment to your last post.

Inga

You know you're wired when...

You have a $50,000 chest.

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Sometimes a device must be tuned a few times before it is right. My cardiologist said it is like fine tuning a car.