Replacement PM and new 3rd wire

Last year I started getting fluid buildup but was focused on issues my Mom was having so pretty much ignored my symptoms, shortness of breath.  Anyway Mom died in Jan and I finally got my symptoms looked at.  Turns out by then I was in heart failure, left EF down to 10%.  

I've had my current 2 wire Medtronic PM since 2013, due to total AV block.  Also got arrhythmia about a year ago.  

My Dr put me on Entresto and a couple of other heart meds, did an angiogram (no blockages), PET scan with nuclear stress test.  After a couple of months on the new meds my EF was up to 25% and I'm feeling pretty good, comparitively.  Dr feels that I need a 3rd wire installed and a new PM, my current one's battery life is getting down to about 6 months.  My old 2 wires have been good so far.  

So I'm wondering if anyone has any suggestions or things I should be concerned about.  Any info would be appreciated.



by AgentX86 - 2020-05-31 17:55:45

Sure.  Listen to your doctors.  There is no guarantee that a third lead (CRT or Cardiac Resynchronization Therapy) pacemaker will improve your LVEF but the chances are quite good.  That's exactly the purpose of the third lead (the "resynchronization" part), to coordinate the left and right ventricles so they don't push on each other at the wrong time.  Since you need a new PM anyway, there is no reason to put it off. With an LVEF that low they'll probably want to implant an ICD (in the pacemaker-speak, a CRT-D - 'D' for defibrillator) to be on the cautious side.

(Edited to correct brain-fart)

What AgentX said

by Grateful Heart - 2020-05-31 19:38:32

There is a good chance you will see improvement.  My EF improved with meds a little but not enough.

I have an ICD since 2008...3 leads.  My EF went from 24% to 55%.  

Your doctor sounds like he is on top of it.  Hopefully you will see improvement. Good luck.

Grateful Heart 

Replacement PM and new 3rd wire

by KAG - 2020-05-31 21:48:32

Thanks for the comments, good to hear from people who have had EF improvement.  I guess the big question now is CRT-P or CRT-D.  Hadn't thought about a defibulator.  I do have Afib but never had ventricular tachycardia.  Would this make a difference in the type of device I should get?

CRT D or P

by AgentX86 - 2020-05-31 22:45:15

It's my understanding that with a low CHF/LVEF there is a higher risk of SCA, hence the defibrillator.  Atrial arrhythmias aren't the issue (or I'd be wearing a Double-D ;-).


by SheilaG57 - 2020-06-09 00:12:41

I have a dual chamber icd Boston scientific it's always been the kind I had. 
I think icd does more than a pacer. 

It can defibrillate you. Though I've never been shocked. It's there in case I need it. 

2006 was my first I'm paced 91% in Atrium. 

You know you're wired when...

Like the Energizer Bunny, you keep going.

Member Quotes

My pacemaker is the best thing that every happened to me, had I not got it I would not be here today.