Pacemaker induced cardiomyopathy
- by Rizzo#1Dog
- 2018-08-21 18:17:55
- Complications
- 1358 views
- 4 comments
I am a 63 year old white male with occasional low heart rate. A pacemaker was recommended and implanted to correct this issue. My ejection fraction was 50% to 55% prior to the procedure. My post procedure symptoms were worse and I was unable to return to work. A complete blood and physical work up was done, but no cause for my fatigue was determined. An echo was ordered two months after implantation indicating the following results, ejection fraction 25% to 30%. I had lost 50% of my heart function. My cardiologist said it was pacemaker induced cardiomyopathy. I started Entresto a month ago, but still have not seen any improvement. What are my future options?
4 Comments
CRT
by AgentX86 - 2018-08-21 21:26:17
Yes, TracyE is right. The "solution" for this is a CRT (Cardiac Resynchronization Therapy) pacemaker.
Think of your heart as a water baloon. If you squeeze one side, it bulges out the other. Then squeeze that side and it sloshes back to the first side. A single ventricle lead causes sorta the same thing. When the ventricle lead fires, that ventricle contracts but there is a delay in the signal getting to the other side of the heart. By the time it gets there, the first side is relaxing. CRT adds another lead to the second ventricle, so they can be paced together. Now, both sides contract together and they "support" each other.
hmm
by ROBO Pop - 2018-08-22 13:31:12
While you don't specify a timeline, it sounds from what you said as if this all transpired in a very short time frame after your device implant...if that's the case then it isn't likely it's pacemaker induced Cardiomyopathy.
Additionally you stated that you had periodic low heart rate so your device should have been probgrammed for on demand pacing, meaning it would only kick in when your heart rate dropped below a set rate. Again that implies that Cardiomyopathy is not likely. Frankly it sounds like the leads were mislocated and/or the settings were all wrong for you. Still I'm not a doctor and can only go based on the information you provided.
Entresto takes some time to be effective in many cases, that's why you go through a stepped phase in of doages. Still in spite of how highly that drug is touted, their own study showed it was only effective in 25% of the patients...not that great a number for the other 75% is it? I immediately developed Angio Edema and couldn't take it, and a CRT-D didn't work either.
Pacemaker induced cardiomyopathy
by Rizzo#1Dog - 2018-08-22 16:34:50
I had a cardiomyopathy 7 years ago that was beleive to have been caused by virus. I recovered and to a normal heart function, 50% to 55% ejection fraction. I have been monitored by a cardiologist since with an echo each year. Over the past year I experienced several episodes of low heart rate, less than 40 b/m, and my cardiologist recomended the pacemaker. Another cardiologist implanted rhe device June 8, 2018. I was working fulltime and expected to off 1 to 2 weeks. I have been unable to return to work, my employer wants my ejection fraction to be higher. Since I had the pacemaker implanted my life has been turned upside down. Have gone from a relatively active individual to who spends about 50% of my days in bed. The other days I am up, but very fatigue. This is very different from the experience other people I know have had with a pacemaker.
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the future
by Tracey_E - 2018-08-21 20:47:05
I'm so sorry you are dealing with this. The first thing I would do is seek a second opinion with an unrelated board certified electrophysiologist to see if the drop in function is at all related to pacemaker settings or placement of the leads. Then I would pursue cardiac rehab, get in as good a shape as you can, done with medical supervision. Medication can help take the stress off the heart. They can also upgrade you to a CRT, which is a 3-lead pacer. It paces both ventricles and forces them to stay in sync. It can't make the heart beat harder, but sometimes forcing the ventricles to stay in sync will increase function. Keep a positive, fighting attitude and learn as much as you can. Good luck to you.