pacemaker decision coming up

Decision

by Loonylil - 2017-11-10 10:10:22

Hi Don

i don’t play golf, so I am not sure about the correct response. As you are very fit and already exercise I should imagine that the walking part of golf is fine..but you may need to be careful for a while swinging the arm and shoulder.

i expect someone here can help with that! Otherwise if cardiologist advises a pacemaker, I would go for it! Heart problems don’t get better on their own nor will the e.f improve.

the operation is relatively straightforward. Do let us know what you decide and how you get on

best wishes❤️

Ejection Fractions and when to use cardiac resynchronisation therapy using a PM

by Selwyn - 2017-11-10 12:47:53

Actually, your ejection fraction ( EF) is quite good if it is in the 40+ group. Most of the studies show benefit with PM resynchronisation therapy at less than 40, 35 and less being the more common study point. 

I doubt whether you can transfer the study findings to those with a better than the study EFs.

Should your EF fall to 35 or less there is clear benefit in re-synchronisation therapy using a PM >  the median life expectancy of patients enrolled in the Vasodilator in HEart Failure Trial V-HeFT-I trial (study period 1980–85), was just 3.5 years compared with more than 8 years for an age-equivalent population with moderately severe heart failure, treated with pharmacological therapy plus CRT, enrolled in CArdiac REsynchronization in Heart Failure (CARE-HF; study period 2001–2009). An ESC survey found that patients who received a CRT device had a one-year mortality of <10%.

 Outcome is improved in those undertaking regular exercise. Keep playing golf and walking. 

All golf courses should have a readily available defibrillator. 

There are pages and pages of golfing advice under the upper right search facility. 

At 84 years of age, with your quality of life being good, with an EF of over 40, providing there are no other indications for a PM, I doubt whether you will need one. If you do need one, then your golf is likely to improve!

Selwyn

Hi and Welcome

by Bionic Beat - 2017-11-11 19:50:30

You are a very fit person and with a EF in the high 40s, I think you're doctor is correct.

As your EF drops, so does your energy and ability to keep active.  He may be hoping that you keep on keeping on as well as you do.

My EF was in the high 40s for a long time but as it dropped, life became rather difficult.

I got the CRT-D at EF of 42, and had a much better EF in three months.  Am now part way through Cardiac Rehab due to some muscle atrophy that happened rather quickly.  Im on the upswing but its probably better to NOT wait.  Ones muscles, stamina and energy get depleted quickly and dont always bounce right back.

I dont golf but life in general is much better with the CRT and the life span/outcomes are as Selwyn mentioned, much better the sooner you get it.

Wishing you all the best,

Bionic Beat

after almost a year of contemplating PM surgery finally did it!

by donmellon - 2018-10-31 17:03:22

On 10/15/18 I had a bi-ventricuar PM hooked up. At age 40 they discovered a left bundle branch block which until now, (I'm 84 years old) had been managed well with a variety of meds. The docs convinced me that since I was experiencing shortness of breath for the past year or so and my EF was in the low 40's the PM would be a good move. In as much that at least 70% of patients experience better endurance I decided...why not?  The surgery was over in 2 and 1/2 hours, followed by a night in the hospital. Now here's the interesting part. Post-op I really didn't feel that much different, some minor pain at the incision but easily managed with tylenol. The big surprise was the morning pain that I had in my core that I thought was old age... was gone. Also, the pain in my hips after a 2 mile morning walk are gone. Breathing has improved so that exercise activity is enjoyable again. For me the whole process was a remarkable display of kind professional courteous and effecient medical care at it's best..