Not sure I need a pacemaker

I have had A-fib twice now that I know of that wouldn't stop. Had to go into the hospital and they did cardioconversion. Might have it other times but 2 times would not stop. I also have a slow heartbeat usually in low 50's. I have Bradycardia with sometimme 2.4, 2.7 sec pauses. Heart rate sometimes goes in 30's when sleeping. Sinus Bradycardia with blocked PAC. Recently went to electrocardiologist and he said also I need a pacemaker. He wouldn't do an abaltion for the A-fib until I had a pacemaker. He also said after pacemaker and going on medications I might not need an ablation as the A-fib might not come back. All this has been going on since I got 1st A-fib in January 2015. I am tired, can't walk as much as I use to etc. Has anyone had A-fib and got a pacemaker for the slow heart rate. I keep putting off this pacemaker idea. It scares me.

7 Comments

pacing

by Tracey_E - 2015-10-26 01:10:06

JMHO, but the thought of not being able to walk much and always being tired is a lot more scary than a pacemaker. It seems scary at first, but it's really not a big deal. Most of us heal and move on.

That said, have you had a second opinion? Your rate is low enough that I can see why they wouldn't want to put you on many meds to treat the afib because the same meds that stop afib also lower the heart rate, and you're borderline now. There are others here who have had a pm put in so they could treat the afib more aggressively with medication and it worked for them. However, there are also many who have had their afib cured with ablation, no pacing needed. And there are some who started getting an ablation but ended up with a pacer. Personally, I'd want to try ablation first and it seems kind of backwards to me to start with the pacer, that should be a last resort. You may still end up with one but I don't understand wanting to do the pacer before ablation. If you have any hesitation, get a second opinion.

If you end up needing the pm, it's nowhere near as scary as it sounds. The important thing is you come out of it feeling good and able to get back to your life.

It is scary

by Theknotguy - 2015-10-26 01:10:23

Your situation sounds very similar to mine. I had afib. Quite a lot. I was in a high stress job and would get a heart flip as much as several times a day. Was going into a full blown afib session as much as once a week.

Doctor didn't want to do an ablation because 1) I wasn't "sick enough". 2) my kind of afib doesn't respond well to ablation (according to my EP). Both my cardiologist and EP were in agreement. They opted for "chemical ablation" which meant i was put on drugs to slow down the heart. Sotalol, Metoprolol, and similar kinds of drugs.

The other side was similar to yours. when I wasn't in afib my heart rate would drop and be real slow.

All of it came to a head when I was out walking the dogs on the pet trail in a remote section of the park. I collapsed on the trail and had to be taken out in an ambulance. Seems the slow down drugs worked too well and my heart decided to stop. Not a good way to go.

There's rhythm control. There's rate control. Rhythm control didn't work for me so they did rate control. Can't talk about rhythm control as I was unconscious at the time.

Rate control is where they give you drugs to slow down the heart so it isn't as likely to go into afib. Then use the PM to bring the heart rate up to speed. It's not a perfect solution, but it's a lot better than what I had. Post PM they can concentrate on the afib side because they don't have to worry about the heart stopping.

For you, two questions to ask are what about rhythm and rate control. What would work best? What, if any, other options are up for consideration?

Since I collapsed on the trail, then woke up six days later, I didn't have to go through the angst of worrying about the pacemaker. It was there when I woke up. So I just had to learn to live with it.

What I can tell you is the pacemaker hasn't been a hindrance. I can do 100% plus of what I did prior to having it. It hasn't restricted my life in any major way. I still work at the wood shop, still do all the yard work at my home, put in a garden this year (something I hadn't done for years). My wife and I were able to take a trip to the UK and another trip to Canada. So travel life hasn't been affected by having a pacemaker either.

Side effects of the drugs.... I wore a jacket for a year after taking the drugs to slow down the heart. They made me feel cold all the time. Some people say those drugs make them feel sluggish - like a zombie.

I have a Medtronic pacemaker. It has a program for afib called APP (Atrial Preference Pacing). I think St. Jude has a similar program. APP has reduced afib sessions for me. Don't know how it has worked for other people but it's another question to ask.

Would I do it again? Yep, sure would. But I'd try to miss the collapsing on the trail, the CPR, broken rib, collapsed lung, cracked ribs, chest tube, pacemaker, and thirteen day hospital stay. Oh, and the six day coma. None of that was any fun. Try to avoid it.

Hope this helps give you a little more insight into your problem and gives you questions to ask about possible solutions.

Hope everything goes well for you.

Similar Symptoms

by Jayp - 2015-10-26 06:10:52

I had many of the same symptoms as you're having, persistent A fib and AV block 2cd degree with HR in the thirties while sleeping. The PM will regulate your heart rate but doesn't solve the Afib problem. Didn't realize that the poor sleep i was experiencing was from a lack of oxygen. Had a PM implanted 3 weeks from today and am sleeping so well i feel like a new person. Hardest part is chomping at the bit to get back on my elliptical trainer and having to hold back. Contrary to previous comment, my EP at CC prefers to employ a PM to regulate the HR and drugs to control the afib before he'll consider ablation.

Get the pacemaker

by Sam148 - 2015-10-27 01:10:50

Hi,
I had a lot of AF prior to having my pacemaker implanted. Sometimes around 300 bpm, and it made me feel awful, and sometimes collapse. I was exhausted all the time, and struggled to get upstairs. My underlying bradycardia was finally picked up when I went for an ECG, I was in complete heart block. Since having the pacemaker, I have only had two episodes of AF and they were both caused by acute emotional stress (both during bad accidents involving my kids). I would strongly recommend getting the pacemaker as soon as you can. My mother has the same issue, and refuses to get one. She's had two strokes already, due to AF, and her quality of life is severely compromised now. It's not worth not the risks of delaying it, in my opinion.

nerves

by Tracey_E - 2015-10-28 01:10:02

I can see why you are nervous about getting a pm, but did they explain stroke risk of untreated afib?? So much more at stake. If it's bad enough that you've had multiple cardioversions, that means it's pretty bad and I take back my comment about trying other stuff first. You've gotta do something that will fix it.

No one wants a pm, however no one wants to lose their quality of life and no one wants to have a stroke, either. Sometimes we have to go with the best of the bad choices and learn to deal with it.

It's ok to be scared. It's ok to be angry and confused and to even mourn. But then we have to try our best to look on the bright side and get on with our lives. Most of us find that the anticipation is much worse than the reality. that we heal and move on. I spent years avoiding it. I avoided it so long I almost died and ended up in emergency surgery. And you know what? The surgery turned out to be a piece of cake, nothing like what I'd built it up to in my head, and afterward I felt better than I ever imagined I could. My situation is different, totally different diagnosis from yours, but the bottom line is the same for both of us, our hearts need help. Listen to Jay and Sam. If you dig through the past posts, there are lots of other similar stories. You can get your life back.

Not sure I need a pacemaker

by DianeJ - 2015-10-28 12:10:12

Had visit with heart doctor again today. Jayp said is what my doc has said. My doctor also said he wants me to have a pacemaker to regulate HR and drugs to control the afib. And then if I have afib he will do an ablation or increase meds. I was taking Flecainide for the A-fib but that has been stopped because it slows the heart down. That A-fib is scary to have. Not fun going to hospital for the cardio inversions. I wish I would feel good about getting one. Right now not on meds so I guess anything can happen. Left office without telling him to go ahead and schedule me in....Guess im just nervous about it.

New afibber

by Ilovebertie1 - 2015-11-02 02:11:23

My husband 59 years old just 3 weeks ago went into AFIB he is healthy, went to cardiologist and electrophysiologist for a TEE and ablation, turned out the ablation was for Aflutter which they thought was the problem but was Afib, he now is on Tambocor 50 mg bid and Metoprolol 12.5mg bid, so far he has been in SR with only a few short runs of afib. hopefully this will do the trick, his anxiety is out the roof tho, If this doesn't work will proceed with ablation for afib. fingers crossed.

You know you're wired when...

You have a maintenance schedule just like your car.

Member Quotes

I am not planning on letting any of this shorten my life. I am planning on living a long happy battery operated life. You never know maybe it will keep me alive longer. I sure know one thing I would have been dead before starting school without it.