Pacemakers for hearts that flutter

Dear All, I have had six intrusive operations to replace my knees (2x left 1x right), right hip, spinal and a Melanoma which required an axillary dissection. I was awaiting a metal left hip replacement but my heart began to flutter and it was cancelled. I had to wait five weeks for a Cardioversion during which I have now found and been accepted for a new Superpath hip which is non-intrusive. I have had the Cardioversion which was successful with one 100j zap. Then shortly after it started to flutter again. I am due to see my cardiologist this Wednesday and will ask him about fitting a pacemaker. I believe they are now available with automatic sensors that will shock you when it detects a flutter. Please does anyone have any information on these?  I am just coming up to my 65th Birthday after working for 50years. I have lost my wife to Progressive MS after caring for her for 15 years and keeping my full time employment just over 3 years ago. I am just about to reap the rewards of my pensions and plan on carrying on working for a few more years while I pay off my mortgage. I will be re-marrying and want to travel. I was born in Hong Kong and have relatives and friends all over the world I would like to see again. It would be good to do this with a heart that beats and a new hip. I need the heart first before they will replace the hip. it would also be good to have a heart that will keep up with the new lifestyle I envisage I want to enjoy. I am ordinarily a very happy man with an enormous love for life that I share with other like-minded people. This is also true for my job which I enjoy and have built up with marvellous colleagues over the last 16 years. my forever job that will be my last. please could anyone advise if they know what it would be like with a pacemaker to help me fulfil my dreams. Thank you all. Any message would be greatly appreciated. I can give details for the Superpath hip replacement procedure as well. There are only two surgeons who work out of the Nuffield Hospital in Warwick ( which is actually just on the south side of Kenilworth the town I came back to from Hong Kong in 1966 with my parents who died there in 1977 and 1988)  and their names are Mohammad Faisal and Michael Cronin.

2 Comments

Heart Flutters

by Selwyn - 2018-04-01 12:56:20

There are' flutters' and flutter. Atrial flutter is a definate medical term used to dscribe a circular fast rhythym around the tricuspic valve of your heart. It caused the symptoms of palpitations ( as do other heart arrhythmias) that feel that the heart is 'fluttering'. 

  It sound that you have atrial flutter that has responded to cardioversion. Pacemakers are not indicated for the treatment of atrial flutter. 

The choice is medication for atrial flutter, or ablation surgery. Both have side effects, some serious.  You will need some form of anticoagulation as there is a risk of stroke. 

You would be best reading a little about atrial flutter:

https://www.bhf.org.uk/heart-health/conditions/abnormal-heart-rhythms/atrial-flutter

before your hospital appointment. 

Selwyn

Pacemaker for afib

by Theknotguy - 2018-04-01 23:25:23

Currently the only pacemaker that has programs to control afib/aflutter is Medtronic.  

I have one of the Medtronic pacemakers that has two programs for afib.  First program is APP (Atrial Preference Pacing).  Second is Minerva. (Don't know why they call it that.)  APP works about 10% of the time.  Minerva works about 80% of the time.  The other 10% of the time I'm on my own.  

When APP sees a certain type of afib it will raise my heart rate.  As indicated it works about 10% of the time.  By raising the heart rate it will sometimes stop my afib.  I can tell when it kicks in because I get a hot flash.  I know other heart patients who, when they get afib they'll go for a fast walk, apparently having learned that raising their heart rate by walking will sometimes throw them out of afib.  It doesn't always work but it's a lot better than sitting around just waiting.  

When Minerva sees a certain type of afib it starts to change my pacing.  By changing the pacing it will usually stop my afib.  While Minerva is working I'll get a "stutter step".  I'll expect to get a heartbeat at a specific time but it won't happen.  Minerva will keep changing the pacing until it paces me out of afib or the program times out.  As indicated, Minerva works about 80% of the time.  It usually runs for about two hours then resets.  It isn't very comfortable while it is running but it is a lot better than uncontrolled afib.  

Sometimes APP will kick in and then quit.  Then Minerva kicks in.  At that time I'm usually walking down the hall muttering, "Would you just make up your mind!!!"  But it's a lot better than going into afib and having to wait a day and a half for it to quit.  Also, if the afib gets too bad I have a procedure (approved by my EP) to follow using my current heart regulatory drugs.  So far I haven't needed to go the drug route.  As of my pacemaker reading of a week ago I'm in afib between 15% to 18% of the time.  

Not everyone qualifies for the pacemakers with the afib control.  I had a discussion with my EP about this last Monday.  He indicated that, even though I have afib a lot, I'm still not a good candidate for an ablation.  My EP is the same heart doctor for my wife.  When she went into afib it wouldn't stop.  My EP suggested almost immediately she get an ablation (which she did).  The ablation was successful.  I had suggested she get a pacemaker like mine to help control her afib but my EP said, 1) she wasn't medically qualified, and 2) it wouldn't help her.  Based upon that discussion it seems that not everyone qualifies for an afib controlling pacemaker and not everyone will benefit from such a pacemaker.  Apparently why a heart patient qualifies (or doesn't) is fairly technical.  I still don't have a clear reason why I have one.  I'll be working to get a better answer to that in the future.  

As Selwyn said in the previoius post, pacemakers that control afib don't always work for aflutter.  You can always have a discussion with your EP about getting the Medtronic pacemaker with afib control.  However, he/she may indicate it won't be of benefit to you.  Not because they don't want you to have it, but because it won't do you any good.  So you'll have to talk with your EP to get a clear answer.  

Hope this has been of some help to you.


 

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