What am I Missing

I have a bi-ventricular/icd pacer,Medtronic Concerto. I have,at times, diaphragm stimulation that is very painful. I had an episode Mon. followed by some muscle twitching on the left side. It was unclear to me if it was muscle or heart, so I asked to Transmit which I did yesterday. Today I talked with pacer tech and she asked me to come in so they could check the lead in the left ventricle. I do not have a left ventricular lead. I have a rt.atrium & ventricle and icd and one lead that has been abandoned for years in the rt ventricle she checked my records and then told me I do have a left lead and they could maybe even turn it off.This tech has been there many years and has checked my pacer several times.I do not want anything turned off I am 100% dependent. I had a consultation regarding epicardial lead placement in June and was considering it this fall.My ejection fraction remains 20%. What is she talking about?Pacer Ck. did not show any did not show any unusual findings

2 Comments

Bivent PM or Not

by SMITTY - 2009-09-16 10:09:36

Hello Brenda,

If you have a bivent pacemaker you have a pacemaker capable of utilizing 3 leads. Like you say, yours may not be using all three leads for some reason. You say you have an EF of 20%. Since I understand one of the primary reason people get the bivent PM is to increase their EF, I have to say based on what you tell us, the evidence indicates yours is not operating as a conventional bivent.
I have to agree with you wholehearted about not wanting the tech to turn off anything. Frankly I have never known of a tech to have the authority to make such major change in a pacemaker without approval from the doctor.

Below is a small excerpt from an article on bivent pacemakers. I am including it just in case it can provide you a little more information on your pacemaker.

Heart Failure: Cardiac Resynchronization Therapy (Biventricular Pacemaker)

In the normal heart, the heart's lower chambers (ventricles) pump at the same time and in sync with the heart's upper chambers (atria).

When a person has heart failure, often the right and left ventricles do not pump together. And when the heart's contractions become out of sync, the left ventricle is not able to pump enough blood to the body.

This eventually leads to an increase in heart failure symptoms, such as shortness of breath, dry cough, swelling in the ankles or legs, weight gain, increased urination, fatigue, or rapid or irregular heartbeat.

Cardiac resynchronization therapy (CRT), also called biventricular pacing, uses a special kind of pacemaker, called a biventricular pacemaker, designed to treat the delay in heart ventricle contractions.

It keeps the right and left ventricles pumping together by sending small electrical impulses through the leads.

This therapy has been shown to improve the symptoms of heart failure and the person's overall quality of life.

What Is a Biventricular Pacemaker?
Leads are implanted through a vein into the right ventricle and into the coronary sinus vein to pace or regulate the left ventricle. Usually (but not always), a lead is also implanted into the right atrium. This helps the heart beat in a more balanced way.

Traditional pacemakers are used to treat slow heart rhythms. Pacemakers regulate the right atrium and right ventricle to maintain a good heart rate and keep the atrium and ventricle working together. This is called AV synchrony. Biventricular pacemakers add a third lead to help the left ventricle contract at the same time as the right ventricle.

Good luck,

Smitty

SHORT ANSWER

by pete - 2009-09-17 02:09:01

Ive had this. All you probably need is some good medical attention in respect of very judicious and skilled fine adjustment of your pacemaker. It worked for me. Cheers Peter

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