My pacemaker story

Hi all, i am fairly new here, i had my pacer implant in 1998.  I had some episodes of AF and when i would go back in NSR my heart rate would drop to almost a flatline for a few seconds, I didn't black out completely but did feel like I might, this was caught in my doctors office, he sent the findings to my EP and was told to go to the hospital immediately for a pacer.  i was told that i had bradycardia, the pacer was for when going back into NSR (the low was set at 50) i would convert without any problems which i did.  i never had that experience again of almost blacking out.

Everything went smoothly until 2012 when i had to have the batteries replaced, since that time my AF episodes did not end the same as before, they did end but my heartrate was fast and took a while to come down to my normal rate, which is in the 60s.  i didn't pay much attention to this as eveything else seemed ok.  Then this last Jan. i was getting more episodes, like every week, which was not my normal routine of AF.  However, the episodes of AF were ending differently, my heart rate was 80 Bpm and lasted for 5 days.  i went to the ER as i thought i had flutter, they said i was pacing and they couldn't see the AF or Flutter.  (if they knew what they were doing, they should have been able to read that EkG).  Anyway, i did get out of that fast rhythm and into my normal rhythm.  This happened again a couple of weeks later, i called my EP and he had me go to the pacer clinic.  My pacing rate had been changed to 80 bpm, i don't know why or exactly when that happened as i do go every 6 months for a pacer checkup.  I had them lower the pacing to 60, since that time i have had no episodes of AF, hardly any palps, and my heart feels calm.  i have a 2 lead pacer, the only reason the pacer was put in so that if my rate dropped below 50, it would kick in.  i don't know why they put in a pacing at 80 bpm, I think when i went for my interrogation for the pacer last Oct., the new tech might have done this because after that i started having more episodes of Af and a higher heart rate getting out of it. 

i have gone for almost 2 and 1/2 months without any AF, i believe that whoever set my pacing at 80 caused my heart to try and keep up when it was pacing.  i am vagal, so i get my AF episodes in the evening at rest, I would wake up with my heart racing after sleeping a couple of hours.  Since the pacing is set at 60 this isn't happening.   Anybody have any thoughts or have similar experiences?  I don't know why they wanted me pacing in the first place, i did not have any problems with low heart rates only when going from AF to NSR, my heart rate is usually in the 60s unless of course i am doing something to raise my heartrate.

liz


1 Comments

Atrial fibrillation

by Selwyn - 2018-07-06 15:25:59

I don't know why your resting PM rate was set to 80. The lower the resting rate the longer the battery is going to last, especially if as you say you still have some vagal activity present affecting your heart. So far I am up to 7 years. 

I found that evenings, especially prior to sleep caused AF.  Excessive exercise caused flutter - along with Flecainide medication for the control of the AF. I could not exercise on beta blockers. 

In order to take Flecainide I opted for a flutter ablation (This is a simpler procedure than for AF, has a high success rate and a low complication rate). All was very well until I was taken off Flecainide having structual heart disease ( a cardiomyopathy, and coronary disease), as the drug is associated with sudden death in these circumstances.

I have now had 2 AF ablations. Excellent results. No flutter, no AF, and I am able to exercise without worry. 

You should know why your pacemaker was indicated. It sounds, like me, that your heart was stopping on changing from AF to normal rhythm.  As Clint Eastwood says in the film 'Dirty Harry, "Are you feeling lucky, punk?"  Sometimes you wake up, and sometimes you are dead.

The indications for PM insertion are clearly known.

Don't foreget that although you don't experience AF you may still be having this ( eg. in your sleep). If anticoagulation is indicated, you should be taking these no matter what you feel,  as there is a risk of embolic stroke. Cheery thought! 

Selwyn 

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