New Pacemaker/AV Block Yesterday- Surprisingly Easy Surgery

I received a dual chamber pacemaker yesterday and was surprised that the surgery to implant the pacemaker and the AV node block was pretty easy.   I was a little anxious ahead of time since the idea of being awake while someone mucked about my heart wasn't something I wanted to think about.  It also took me a few months to get my mind in the right place and reconcile being dependent on the pacemaker for the rest of my life -  I'm 69.  I was able to talk and even joke with nurses and doctor during surgery.  Amazing!  There was no pain at all.  They had to go in twice - once before the pacemaker implant and once afterwards to burn out the AV node since they were still getting some activity after the first AV block.  They used Fentanyl and Versed which was a winning combination.  There was no pain and honestly I didn't care with the drug combo.

I am home now and  having very little discomfort from the pacemaker incision today which is also surprising to me.  Just a twinge now and then and a little itchy..  It looks a little bruised with a slender two inch incision.covered by a thin piece of gauze.  I've been sleepy today and indulged myself in naps

I don't know what to expect next.  I really hope this helps.   I can't tell any difference right now.  I still get out of breath when I'm moving around but my heart has a rock solid beat of 80 (temporarily set a little higher)  when sitting and goes up normally when I'm moving around and down to 65 when sleeping like a normal person.  I've not been normal for a very long time.

I was reading that the pacemaker they used had some recalls in 2017.  I sure hope they have fixed those issues.  It's not like recalling a car!!!

I feel good but don't tell my husband.  He has made a couple of terrific meals for me today and served them in my lounge chair on a tray. I even got fresh squeezed juice.   I might milk this for a couple of days if I can get by with it.  He is a great cook but loves having me cook for us which I normally really enjoy doing.





You have done well

by Gemita - 2021-02-03 02:09:26

Dear Anna,

Well done you!  You seem to have sailed through that part.  Yes I was told an AV node ablation was a fairly simple procedure, taking just a short time compared to a regular pulmonary vein isolation ablation.  I cannot seem to find anything in your medical history about the reason for your AV node ablation, although presume this was for an atrial tachy-arrhythmia like AFib or Flutter?  I suffer from these and other arrhythmias too but am managing on a beta blocker and my dual chamber pacemaker for the moment.

I would encourage your husband to continue cooking for a few days.  When well, my husband also likes to do things around the home so I am very lucky and in my case if I try to stop him he is not happy !

Yes of course I understand your real concern about being pacemaker dependent but pacemakers are really very safe today and rarely fail.  In any event we have escape rhythms I believe which would keep us alive long enough to get help.  But let us not dwell on negative possibilities.  Let us think about the positive aspects of having a pacemaker and there are many.  

Once you get over the healing period any symptoms should ease.  Any high heart rates will be prevented from getting through your AV node to affect your ventricles and you should no longer feel the arrhythmia in your atria, although the arrhythmia will still continue to fibrillate, flutter or whatever it does in your upper chambers but your lower chambers will be steadily beating and controlled by your pacemaker.  Slowly you should be able to stop some or many of your rate control/anti arrhythmic meds.  Wonderful.  Of course I do not know what other heart conditions you might have, but your AV node ablation should help to give you a better quality of life.

Hopefully your breathlessness will ease over time especially if high heart rates were causing this.  

Great news

by Persephone - 2021-02-03 21:05:07

Thanks for sharing your story of your positive experience, Anna.  I'm envious of the royal treatment you've been getting as you mend!

I hope you continue to feel better with each day.


by AgentX86 - 2021-02-03 22:01:10

I had pretty much the same surgery and same outcome as you did.  I was fully awake and lucid when I had my surgery - only locals.  I had one EP at one end of me, doing the implant and another at the other, doing the AV ablation.  I was joking with the EP doing my implant.  At one point it sounded like he had some sort of plastic ratchet, like a child's toy.  I asked if he was winding up my pacemaker.

I was in the hospital overnight because of the AV ablation (and was then dependent).  They gave me pain meds that night and gave me a prescription for vicodin to take home.  I never took any.  I didn't have much pain at all.  Like you, it itched but that didn't go away for some time.

It's normal to set the PM higher after an AV ablation. I was told that there was an elevated risk of SCD after an AV ablation but raising the heart rate after reduces this risk into the noise. They'd planned to leave mine at 80 for a month, then at 70 for a month, then to 60bpm.  They tried reducing it to 70bpm but I was throwing PVCs and felt awful so my EP set it back to 80 and it's stayed there since.

Milk it as long as you can.  I still try (after three years).  ;-)

Thank you for the support

by AnnaFerris - 2021-02-05 02:14:01

Thank you so much for taking a minute to encourage me.  I tend to be upbeat about things but it really helps to have support from those who have walked the walk.  I was in persistent AFib with RVR from the time I was diagnosed in 2018.  Also have a minor mitral valve leak that hasn't really caused me problems.   Who knows when it first started!  I was diagnosed by accident after hustling to a doctor's appointment and collapsing on his floor.  I just gradually got weaker and weaker over the last two years to the point I struggled just to go to the grocery store.    I tried a couple of cardioversions and all the rate and rhythm drugs with no luck.  It may be my imagination but I already feel much more mentally focused and clear-headed and I'm breathing a lot easier.  Also, the pain in my lower legs and swelling is greatly decreased.  I have a long way to go to build back my strength and I hope I will be able to do it without complications.

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