?? LVF

Hello! havent checked in for quite sometine, just tring to get on with life and forgeting about having a device  

Had a great year last year after more alterations of settings post an AV abaltion 2016....cant belive how the time has passed. However a started feeling less good at the end of the year and after seening new consultant she is sending me for another echo and referal to another electrophysisologist.Getting lots of fluttrts and longer spells of palpatation like feelings ?? atrial in origin. Exercise tolerance starting to drop, really getting into my sea kayaking but now concerned if I will be able to keep it up. PM interegation showed 200 mode switches 

My new consultant was so proactive that i nearly hugged her when we finished, I hardly had to say much. Told me if she was me she would want more aggresive investigation....who was I to argue  ...power to the NHS

Anyone ended up getting a CRT (if thats my problem) 5 yrs post PM. How effective was it and did you return to normal activities. 




by AgentX86 - 2020-03-03 15:57:21

I had an AV node ablation two years ago and had a CRT-P implanted at that time. From reading your post, it appears that your PM still senses atrial activity and keeps AV synchronization unless it detects atrial arrhythmia, then switches to V-only (DDD Tto VVI) pacing? Since, one assumes that you're not in V-only pacing much of the time, VVI pacing into the RA only is determined to be acceptable. Is this essentially where you are?

Since I'm in permanent flutter, there is no point in switching, so am in V-only (VVIR) pacing permanently. Since this causes LV/RV dyssynchrony, as well as AV dyssynchrony, a CRT pacemaker is the norm, right out of the gate.

If your problem is L/R ventricle dyssynchrony, then  a CRT should help. If it's a problem with mode switching, then I don't see how it can. Perhaps it's mode switching so much that they're going to leave it VVIR, stick in a CRT, tell you to live with AV dyssynchrony, then call it a day?

From what you've said, it's hard to make anything other than a wild-ass guess as to what they're thinking.  Ask!


by jsne - 2020-03-04 06:49:04

Thanks AgentX86

I'm 98% V paced and 30% A . Over the years  have been told  I have had AF,inappropriate sinus tach, retrograde feedback and atrial focus tach. As my exercise tolerance has gone off and I have real trouble at night with thumps and flutters etc first check is an echo. The thinking is that will show any abonormality and then hopefully an ep study. There was a thought that my original ablation failed to clear my initial problem. Just feel rather low at the moment, having to once again be at the wait and see treadmill .


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My pacemaker is intact and working great.