Pacemaker Club: CRT-P CRT-D Reaction Time

CRT-P CRT-D Reaction Time

by gaman
2019-08-21 20:43:21
Complications
923 views
3 comments

Had a CRT-P installed for cardiomyopathy on 3/1/19 of this year. EP thinks it was due to RV pacing from my dual chamber pacemaker causing dyssyncrony between RV and LV. I have a very wide QRS > 150 ms and a native LBBB. Recent echocardiogram 5.5 months post install doesn't show any improvment; even a slight drop in EF from 39 to 36%. I also can tell I've picked up a little water weight. I've heard of late responders to this therapy (> 1 year) but also know most see positive results within a few months if they're going to see them at all.

Questions:

1. How long did it take for your CRT to increase EF and improve symptoms?

2. My EP isn't even considering any reprogramming/adjustments of CRT; he's just sending me to a heart failure specialists. Is that normal as I thought there were many ways the devices could be adjusted that might be beneficial?

Alan

3 Comments

ICD

by justice - 2019-08-21 21:06:19

3 months after my pacemaker was replaced with the bi-ventricular ICD my EF went from 22% to 36%

It has now been in for almost 1 year and will have the EF measured again in October

late response

by ROBO Pop - 2019-08-22 13:39:26

The 2 EF numbers you site are well within the tolerance range of echocardiograms. That is to say it's very likely there was no change versus what you perceive as a drop.

In answer

1. It's been 3 years, I'm still waiting and the delay on my QRS is far greater than 150ms. In fact 150 is considered the minimum delay to justify a CRT.

2. Duh, that's what this is all about, heart failure. Be thankful your Cardio isn't arrogant and unwilling to do what's in your best interest. You need to see someone who specializes in your problem so you have the best shot at improving. Thank him

CRT Optimization

by gaman - 2019-08-22 19:03:17

My QRS routinely runs 165-185 ms. Been no lowering of it 5.5 months post CRT. I thought device was supposed to get things in sync. I've had a high QRS for at least 5-6 years so I assume it can lead to the dysfunction I'm currently seeing?

My electrical system got all screwed up due to my tricuspid valve regurgitation not being diagnosed and my right heart dilating too much. Had repair surgery in 11/2014. However, I went into complete heart block in 2015. Got a dual chamber pacemaker and did well for 2-3 yrs and then started seeing a lowering of EF. Finally got a CRT but no change todate.

It's not all just about heart failure.........part of it is ensuring the CRT is optimized to give you the best chance to not stay in heart failure. That will be part of my discussions with the HF Dr.