Sacred

There was post about getting HF and third lead.. 

I'm getting dual chamber pacemaker for complete Heart block...I'm sacred that thos will increase risk of HF..and need of third lead.. 


7 Comments

HIS Bundle Pacing

by Swangirl - 2019-10-27 13:00:03

Ask your surgeon if he is going to place your ventricle lead in the HIS Bundle.  This will help to avoid "pacemaker syndrome" and the risk of lowering Ejection Fraction and ultimately heart failure.  

Trust your doctors

by Benjijohn - 2019-10-27 13:56:48

Surely research your condition to understand what is going on. And ask every possible question to your doctors

But please try not to become a google doctor. We have all been through this road to understand our unfair condition. Why did it happen to me? What did I do wrong? Why me? Etc etc

Trust your doctors and realize that most of the negative things you read on the net, are unique situations

Doctors can also make mistakes. But when we find the right doctor that we trust, then we should stop thinking and live our life as much as we can. Thats my philosophy

good luck

It's okay my friend

by ametcalf86 - 2019-10-27 16:52:19

I have a 3 lead device and it is just like a normal 2 lead. I understand about being scared. I freak out all of the time about the smallest things. Dizziness and my heart rate is what scares me. My heart rate got to 161 this morning and I get shocked at 171! Get a watch with a heart monitor on it and it will show you through the day how it goes. It helps me not worry so much. It will just help pump your heart better so look at it as a blessing. 😊

2 vs 3

by Tracey_E - 2019-10-28 09:34:11

A small number of paced patients end up with heart failure. If that happens, a 3 lead can help. Some people are going to end up with heart failure with or without pacing, it's part of aging. There are a very few doctors out there who start with 3 lead in order to prevent heart failure, however my ep feels there's no evidence that it prevents it, just treats it as it happens, so he doesn't agree with putting them in as a preventative. 

If I was starting new, I would be looking for HIS bundle pacing. It's closer to the heart's natural beat and easier on the heart. 

Yes, there are some risks with pacing. Reading the posts here it seems like half the patients have complications. For every one person who comes here to get answers to a problem, there are hundreds, possibly thousands, out there who heal up and get on with their lives. I've read complications - all of them combined- amount to less than 2% of pacemaker surgeries. So there is a 98% chance you won't have even the smallest complication. The thing we can't forget is, while there are risks to pacing, for us the risks of NOT pacing are enormous. It's not really optional. Without the pacer, I would never have seen my 30th birthday. I celebrated 53 a few weeks ago, and in all the years I've been paced I've never had more than a minor bump in the road. 

I know it's easier said than done, but try not to overthink it. This is going to help you feel better. It's a common and safe surgery and there are a whole lot of us out here who are thriving. 

Pacing induced cardiomyopathy

by Sibber - 2019-10-28 18:55:45

Dual chamber pacing for CHB in a good ventricle is the gold standard and in the majority of cases works perfectly well. Yes there is a small percentage of people who develop a pacing induced cardiomyopathy but the evidence suggests it's in those with already reduces heart function. I would be extremely surprised if any cardiologist implanted a CRT (3 lead) in someone with CHB, narrow QRS and good heart function.

As for HIS pacing whilst I  am of the opinion that it is likely going to become more prevalent in the future, right now there simply is not enough big data to support it. Sure it it theoretically sound and I've seen some good results, but unless an operator is implanting regularly the complication rate is likely much higher. HIS bundle physiology is also different amongst individuals with an eatimated 2/3rds of us having a 'deep' bundle. These 2 factors increase the chances of high thresholds and failure to capture leading to more box changes (and the associated risks) and return of symptoms and further intervention respectively.

two to three

by dwelch - 2019-10-28 22:06:50

I went from a two lead to a three recently 30 years with 2 leads and so far a few with 3.  Aint no thing, allows them to control the ventricles separately.  

HIS Bundle

by Swangirl - 2019-10-29 12:18:20

I had a dual lead PM implanted 4/18 and the ventricle lead was placed in the HIS Bundle.  My cardiologist/surgeon said the research is overwhelming that the pacing that results is superior and helps to prevent complications over time which can necessitate a third lead.

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