Mobitz Type II Second Degree Heart Block

Hi all,

I've documented previously on here the problems I encountered post implant but I have a few things I'm throwing out as though I'm starting from scratch;

I was diagnosed with Mobitz Type II Second Degree Heart Block, I'm 57
I was fitted with a Medtronic Ensura PM on 10th Feburary 2020
It is a dual chamber unit but was set initially to single chamber pacing.
My recovery after the procedure was virtually non existent, in fact I felt worse at times than I had done before having the pacemaker. (Documented elsehwere on here). I couldn't walk further than a few steps without becoming breathless, I had a heavy weight across my shoulders and generally felt unwell, unable to 'function' for want of a better word.
I was told that it was 'in my head' and to 'go home and get used to the implant'.

Eventually after much complaining a consultant gave instruction to a PM Tech on how to switch the unit to Dual Chamber pacing and Bingo!!! I feel fine.

It took nearly 6 months of banging on doors trying to get someone to listen to me that all was not well before they acted and switched the pacing mode.

The more I think about this the angrier I become. 

Would there be any reason why I only had single chamber pacing at the beginning given my initial diagnosis and why were they so reluctant to change the pacing mode despite my obvious distress?

Thoughts please...


3 Comments

In my opinion

by doublehorn48 - 2020-08-21 15:59:35

You've had terrible Drs.  I also have Mobitz 2.  And I know just what you mean by breathless after walking a few steps.  When my first dual chamber pm was implanted I walked around and told the cardiologist that I still got breathless if I increased my pace.  He walked the halls with me at a fast pace and I got out of breath.  They found that one of my leads wasn't working.  They went back in and replaced the dead lead.

It wasn't in your head and I am appaled that you would be told that was the problem.  My Dr. believed me and knew that I shouldn't be breathless with a pm.  I can't believe they didn't utilize both leads.  I go back to my first sentance.  You had or have terrible Drs.

It makes me mad when I see posts ,like yours, on this board.  You should not have had this problem.

I read a joke recently.  What do you call the person that went a really bad medical school and graduated last in his/her class?  Doctor.

What a mistake!

by Graham M - 2020-08-21 19:00:10

Hi Paul,

I like to think that we get good medical treatment in the UK (I assume you are an NHS patient), but someone has clearly made a major mistake in your case.

I also have Mobitz type 2 and have no problems at all with my pacemaker.  It was set to DDD from the start, but I couldn't understand why I would need atrial pacing when the block is said to be distal to the Bundle of His.  My first check up showed 3% atrial pacing and 17% ventricular pacing, so I guess that Mobitz type 2 is a bit more complicated than I thought.

I'm glad you're feeling better now, but suggest you make a formal comlaint to your hospital.  Untreated (or incorrectly treated) Mobitz type 2 is potentially fatal, and your cardiologist and electrophysiologist should know this.

Best wishes for the future,

Graham.

My thoughts

by Gemita - 2020-08-21 21:10:29

Hello Paul,

I do recall your several posts and I am so pleased you are at last free from your troublesome symptoms.  

Since my own diagnosis of tachy/brady syndrome, I have come to realise that with electrical problems of the heart, treatment decisions can vary widely from doctor to doctor and everything can be so trial and error until the right treatment for a patient is found.  In saying this, I am certainly not suggesting that implanting a dual lead pacemaker and then not using both leads is a common occurrence and clearly I would be asking the same question as you and wanting to know why the second lead was not utilised from the outset?

I can only make a guess as to why they chose to leave one lead idle apart from someone messing up which I would find difficult to believe.  I recall you had a few problems with high heart rates at one time (I think you mentioned that they found an extra beat or pathway causing this)?  Could it be that they wanted to avoid tracking what was happening in your right atrium to prevent this disturbance from intermittently getting through the AV node to affect your right ventricle?  Perhaps they saw something during implant and decided not to switch on the Right Atrial lead after all.  Alternatively perhaps during implant they found that you needed pacing almost exclusively in the right ventricle and that you would have no real need for atrial pacing?  These really are the sort of questions I would be asking your doctors.

On the positive side, you were fortunate that a dual lead pacemaker system was actually implanted rather than a single lead ventricular pacing system.  My husband wasn’t so lucky with his doctors and has a permanent single lead right ventricular pacing system implant and has been struggling at times to cope with his symptoms.  At implant his doctors decided because he was having a high degree of atrial arrhythmias, they would avoid atrial pacing altogether, hence the single lead to his right ventricle.  In so doing, it has made his situation far worse, I believe, with an increase in his arrhythmias/symptoms.  He was diagnosed with both Left Bundle Branch block and Mobitz Type 2 Block, but he does have ischaemic heart disease.

Hope you continue to do well Paul.  Good to hear a success story

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I'm 44, active and have had my device for two years. I love it as I can run again and enjoy working out without feeling like I'm an old man.