Atrial Fibrillation

Hi! 

My mother is probably getting a pacemaker this or next week. She has AFib, with low blood pressure/pulse and an uneven rhythm. 

She was hoping to be able to use a pacemaker instead of drugs, and is deeply disappointed about probably having to continue to take them even with the pacemaker. She's annoyed that scientists have not made a pacemaker that can "do it all." Does anyone have any info for her that can help her feel more confident about getting the pacemaker? 

She gets dizzy spells, rapid heart spells that make her almost or actually faint, and has a bit of an uneven rhythm. After eating is her danger time, when the majority of her episodes occur. She's not a good water drinker. I suspect she's constantly mildly dehydrated.  

I'd love any tips and advice to give over to my sweet Norwegian mom! 

Thanks,

Sarah


2 Comments

Dehydration

by AgentX86 - 2019-12-02 13:59:32

There you have it. She has to get her water intake up and her electrolytes in order or no amount of drugs are going to help. Forget sports drinks.  They're sodium and sugar, things she probably does not need. She probably needs potassium and magnesium but should have her blood tested before going too far. A  banana a day won't hurt for potassium. Magnesium is a little harder but my favorite solution is dark chocolate. ;-). It does take about a half pound a day but what's a calorie or two. ;-).

Added: An Afib ablation is a possibility but only go with the best. The chances of a good outcome are very strongly linked to the skill of the ablationist. He should be doing at least a hundred a year before you consider him.

Pacemakers can only make the heart go faster. The cannot slow it down or fix rhythm problems.  Some have features that try but their efficacy is variable. The solution of last resort is an AV node ablation and pacemaker but that's pretty radical. Since your mother already has a pacemaker,  perhaps it's a possibility (I did it) but she would have to have an otherwise strong heart. You don't say how old she is but that could be a  big factor too.

She has to take care of the dehydration first. That's critical and the easiest step.

Afib and pacemaker

by Theknotguy - 2019-12-02 15:53:32

I'd go with AgentX86's comments.  

I have a Medtronic pacemaker with two programs that work on afib.  I say "work on' afib because pacemaker's aren't a cure for afib.  Only an ablation can do that.  I say "work on" because the programs haven't stopped the afib.  My afib problems continue and the pacemaker programs won't stop the progression. They do, however, reduce the symptoms.  So having a pacemaker with the afib programs isn't a cure all.  Another problem might be that the afib problems your mother has may not be treatable by the pacemaker programs.  You'll have to discuss with her EP. 

You can, of course, ask.  My Medtronic Advisa has two programs for afib.  The first, APP (Atrial Preference Pacing) works about 10% of the time.  The pacemaker watches to see if I'm in afib, determines the type of afib, and then activates the program.  APP raises my heart rate a little bit.  Sometimes that takes me out of afib.  But, like I said, it's only about 10% effective.  

The other program is Minerva.  It is implemented after APP doesn't work.  It watches to see the pattern of my afib, then changes the pacing to pace me out of afib.  Minerva works about 80% of the time.  In the final 10% where nothing works, I'm on my own.  Per my EP's advice, I also take magnesium supplements and they seem to help too.  

I'm taking two drugs to control afib plus having the programs.  Last check up I go into afib about 40% of the time.  The afib can last a few seconds up to and over 24 hours.  Like I said, it isn't a cure all.  But with the programs running I don't feel the afib as badly.  I'm in an on-going discussion with my EP about having an ablation.  

Your EP might be willing to get a pacemaker that can handle the afib programs but he/she might also tell you they won't work in you mother's case.  You'll have to discuss with your EP.  

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