It looks like I’m moving from a dual lead to a hiss bundle pacer , anyone have one ?

Bi-ventricular ...

by Hoser - 2019-06-20 10:21:35

I have a CRT-D, leads in both right and left. 100% paced also with preserved EF (55-60). No issues in 3+ years, doc says my LBB has shown to be intermittent which is a slight improvement.

I have heard good things about HIS bundle pacing, but it is not as popular so less is on record.

Another discussion I look forward to having with my EP

HIS Pacing

by lefty2 - 2019-06-20 11:05:44

Let me know where your procedure will take place. I also heard good things about HIS pacing if it is dome properly. My EP has not done one and is not but I want to consider having it. really pushing it

Bi-ventricle or HIS

by Chapter - 2019-06-20 11:59:27

I am scheduled to go for CRT-P in August.  I got Pacemaker in Nov ‘17, HR was down to 28 when sleeping and 30 when up.  My EF was 55%.  Since receiving Pacemaker I am now 100% paced, EF has dropped to 32%.  Is this what is called Pacemaker Syndrome caused heart failure?  The CRT is going to get my ventricles working on the same team, which I understand might get my EF up a bit and will make me feel better.  I am waiting for call to go for Venogram, which I was told will show the best approach for third lead to left ventricle.  First Pacemaker was an emergency situation so I didn’t have a lot of time to think about it, was done and over before I really started my research.  Now I have had lots of time to think about next step and it is making me smarter, but a lot more worried about my future.  The HIS Bundle Pacer has not been mentioned, I guess not popular here yet.

I hope all goes well for you Zackalope, when will you get new device?

Chapter 🌹

Strictly my opinion

by Gotrhythm - 2019-06-21 16:16:02

I looked into His bundle pacing a couple of years ago when I started having pacing in the ventricle issues. It turned out my new EP was able to reprogram my pacer to take care of the problem.

But I'll say this: if I had to have another pacer, and had a choice between a CRT-P and His-bundle, I'd go with the His bundle. The reason? About a third of CRT-P recipients have no improvement in EF. And HBP produces a more normal heartbeat and the remodeling that has occured due to pacemaker syndrome can be reversed.

The downside of His-bundle pacing is that it is less well known, is harder to do so you need someone who is really well trained. That problem can be overcome by going somewhere that HBP is done routinely.

If my EP thought HBP was a viable option for me, that's the direction I'd go.

My opinion.

His bundle successful

by Zackalope - 2019-06-22 01:57:00

I really appreciate everyone’s comments . Due to your answers , my own research into the available literature and research , and a conversation with my doctors just before the surgery today , I opted to go for the his pacer . They also attempted to remove my previous leads , but that did not get done , or wasn’t feasible . 

Unlike last time , I did not get the complications with the nerve issues on my left side . The pacer implantation was successful so far , (8 hours ago) however I did have a new complication: something got poked the wrong way during the surgery and a stat CT with contrast showed 400 ml of blood in my right pleural space : so blood is around my right lung . It’s not enough to create any shortness of breath , but when I breathe in , it hurts pretty bad . 

So I am being kept on oxygen and on the cardiac telemetry floor for tonight . Other than that , I feel quite well , my vital signs look very good , and I have no palpitations or other symptoms . 

I’ll give another update soon, but thanks again for your input and support , it means a lot .