Second pacemaker installed

Need help. Spouse is 77 and had the second pacemaker installed because the first went bad. Is struggling with swelling on the feet and very painful and water around the heart. Was doing good but primary dr saw some changes to her kidneys and wanted to reduce some of the meds. This created a tailspin and for the last week has been hardly able to walk due to swollen and painful feet. The heart dr had her put back on the regular meds and she is doing better but it’s been a slow process. She had been attending cardiac rehab exercises and was doing great until the doctors started to change her meds. Is this a normal thing and should we expect things to get better?

4 Comments

Need more information

by LondonAndy - 2019-05-19 16:24:00

Hi there, and sorry to hear of the problems.

What was the diagnosis for needing a pacemaker?  And what does "went bad" mean - battery expired, or infection?

What are the "regular meds"?  Do they include a water tablet (Furosemide or LAssix, for example?).

Second pacemaker

by hosiehose - 2019-05-19 17:33:47

She had a low pulse rate and her body was not sending the electrical signal to her heart to regulate. The first pacemaker only had two lead wires and it looks like she needed an extra lead wire. She takes losartan, carvedilol, bumetanide and potassium cl er. Concerned because she has been having the swellness in her right ankle for over three weeks and it is painful. She started to do better after the heart dr had her get back on her full medicine, but it seems to be taking a toll on her.

Edema

by AgentX86 - 2019-05-19 22:24:03

Yes, edema can cause all sorts of problems, many of which it sounds like your wife is having.  The solution is, or course, a "water pill", which what bumetanide is. The down side is that this class of drugs is hard on the kidneys, so it's often a balancing act.  Too much and the kidneys get stressed, too little and the heart takes the hit because of the load of pumping the additional water around.

The third lead makes perfect sense, too, to hep the heart pump more efficiently. It should help a lot but it may take time to resolve the immediate problems.  I'm surprised they don't use the second ventricle lead more often, particularly if there are any of these sorts of problems in the patient's history.

Good luck to her (and you).  I know how hard this is.  My mother walked the same tightrope for a couple of decades (but didn't have a pacer to complicate things further).

Second pacemaker and swelling

by Selwyn - 2019-05-20 09:31:49

The problem of poor renal function and poor heart function is a medical problem. 

If there is swelling of the ankles to any degree, she needs to have her meds tweeked. 

You can expect things to improve. Cardiac rehabilitation is effective treatment for poor heart function, as is pacing with the third lead.to the left ventricle.

Should you wish to review the British guidelines:

https://www.nice.org.uk/guidance/ng106/resources/chronic-heart-failure-management-visual-summary-pdf-6663137725

 

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