Why dual chamber pm?

Hello. I am still learning the topic. My cardiologist told me he will implant a dual camera pm. I am trying to understand why I can't just have the leads on one side and I am also concerned that having the dual chamber puts me at greater risk. Can anyone address this in simple terms? Thank you.

4 Comments

Dual Chamber PM

by BillH - 2016-05-26 01:05:07

The heart has 4 chambers two small ones that "prime" the heart - the atria's - and two main chambers - the ventricles.

The right side pumps blood to the lungs and the left side pumps blood out to the body

http://www.hrsonline.org/Patient-Resources/The-Normal-Heart/Electrical-System

And click on the heart picture and you will see an animation of the heart and electrical system.

With the dual chamber PM it is not the 2 sides (left/right) that are connected, but rather the atria and ventricle.

In most cases any trigger in one of the atria will also trigger the other one Likewise for the ventricles.

The use of dual chamber helps best replicate the normal sequence of the beating heart.

There are many modes that the PM can be set for, but this is the most complete mode

An atria lead will monitor for the normal trigger from the SA node. If it does not it will fire the atria Then it monitors the ventricle and if it does not fire in the PM will trigger it

I see that you are active and have "athletes" heart Probably have a problem with too low heart rate This also often also leads to a condition where the heart does not speed up during exercise

Ask the doctor about the PM RATE RESPONSE There are several different techniques to do this Some don't work as well for some types of exercise And ask if he has any very active patients with the model that he recommends.

leads

by Tracey_E - 2016-05-26 01:05:59

Most of us have two leads. One goes to the atria, the other goes to the ventricles. Many of us pace primarily just one- atrial if SSS, ventricular if av block. One lead may only pace a little to none, but it senses 100% of the time and sends information. And often we do eventually end up pacing with both at least some of the time. Better to have it and not need it than need it and have another surgery to get it. It's no more risk than getting just one lead.;

No additional risks...

by Xxmikexx - 2016-05-26 02:05:43

Hi there. Well, you are putting a foreign body where your valve opens and closes, so lets not kid ourselves, there is risk of things hhappening. There are really insignificant stats (vitually no addituonal risks) with two vs. One lead. Talk to the doc about it. Depending on your needs, they may go with the newest "leadless"" device where the go up through the leg and permenently install a PM inside the heart ( about the size of a AAA battery). Cool stuff when you think about it. I gotnthe dual lead installed two yeaes ago. Do a little research and talk to the doc about it. Good luck on your journey!

Indication?

by golden_snitch - 2016-05-28 06:05:06

Hi!

It depends a bit on why you need the pacemaker.

If you have sick sinus syndrome, you might be perfectly fine with a single-chamber pacemaker that only paces the right atrium. Research does NOT show that all/many SSS patients will one day develop some kind of heart block, too, and then need ventricular pacing.

If you, on the other hand, have a permanent heart block, I'd rather go for a dual-chamber device. The thing with permanent heart block is that the pacemaker has to track the atrial rhythm and make the ventricles beat in the same rhythm. Without an atrial pacemaker lead the tracking is a little more difficult and you could end up with the atria and ventricles not beating insync which in turn can cause symptoms. But, if you have intermittent heart blocks happening very infrequently (every now and then), a single-chamber pacemaker pacing only the right ventricle might be ok, too. Many of the leadless pacemaker patients have exactly that: an intermittent heart block that only occurs from time to time.

I had a single-chamber atrial pacemaker for nine years. I later needed an upgrade to a dual-chamber device because I had atrial arrhythmias for which I had to go on antiarrhythmic drugs and some of these caused intermittent heart blocks.

If possible, I'd always recommend to put in only what you really need. Leads can cause issues, too, and they do not last forever.

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