Ventricular pacing

Hi All! Happy to have found this awesome page! I am pacing 100% in the ventricles but 0% in the atria, does this mean I'm 100% dependant on the pacemaker? 



by AgentX86 - 2020-09-11 20:12:50

Yes, no, maybe. Define "dependent". 

There is a wide line in the definition of "pacemaker dependency".  Some define it to be merely a high percentage of V-pacing, which certainly includes you.  However, some paced DDD and have a short AV delay programmed.  With the above definition, these people are "pacemaker dependent" but they're not really dependent on their pacemaker because they would have a "normal" heartbeat if their pacemaker stopped. It might not be optimum and maybe not even notice the difference.

Most, if not v-paced, will still have an ectopic heartbeat.  There are several nodes within the heart that will create an impulse to cause a contraction.  The fastest one wins. In a normal heart, the fastest is the Sinus (SI) node.  Next is the AV node (junctional rhythm), then differing ectopics in the ventricles.  Cessation of V-pacing usually causes one of these other "escape rhythyms" to come through.  Sometimes this escape rhythm isn't fast enough to maintain consiousness but is enough to sustain life.

On the other end of the spectrum are those who are paced 100% in the ventricles and who have no escape rhythm at all.  A complete pacemaker failure (fortunately that doesn't happen) would result in asystole.  The patient would be in a world of hurt.

So, what's your definition?  Without an agreed upon definition. it's hard to talk about such things.  That's why I have "no known escape rhythm" on my medic alert dog tag right after "dependent".


by ROBO Pop - 2020-09-12 04:29:25

Simple, ask your Cardiologist. I am 100% paced in both ventricles but not pacemaker dependent. Generally if your heart will continue to beat at a life sustaining rate without your pacemaker, you are not dependent

Exactly Agentx

by PacedNRunning - 2020-09-13 22:14:16

Exactly what AgentX said. I would ask my doctor. 100% pace doesn't mean  dependent.  There are different reason to pace someone 100%.  It really depends on what your underlying rhythm is without the pacemaker.  They check this each time they interrogate your PM.  I'm 100% paced but I had a reliable escape rhythm and will be in 2:1 heart block with it off. Is it sustainable? Yes for me it is. I would feel like crap though but could make it the medical care in time to be ok. The true definition of dependent is no escape rhythm or heart rate less than 30bpm without PM.  

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As for my pacemaker (almost 7 years old) I like to think of it in the terms of the old Timex commercial - takes a licking and keeps on ticking.