Pace and ablate

Hi all

End of November 2020 I had my PM fitted for continued AF,  I have done everything I was told like no raising your arm above your head etc, 7 weeks ,after implant  I had AV-Node Ablation which was done mid January 2021, everything with heart is going well just got to go back end of this month to have lower rate lowered to 60 from 80

Unfortunately I am suffering with a frozen shoulder which I was told could happen plus slight tenderness around the armpit area and top of arm, is this normal, how long does it take to heal, are there any exercises or things I should be avoiding or doing. I will be asking when I go back in a few weeks time just wanted to see what others have experienced 

Thanks in advance

Jackie from England 


Frozen shoulder and sore arm

by Gemita - 2021-03-07 16:41:24


I see you are in the UK.  I am glad your AV Node ablation went well and that you are recovering from the procedure.  Do you still feel your AF or are you completely free from symptoms? 

What to do about your frozen shoulder is the question now and it needs to be treated without delay to avoid further pain and longer healing.  Has your GP sent you for urgent Physio assessment or is Covid interferring with a referral for you?  I expect it is.  I would go back to your GP for advice on a safe exercise programme to get your pacemaker side arm moving again and I wouldn't wait three weeks to see your cardiologist who won't know what to do about it anyway in my experience.

Your GP might be able to arrange a video appointment with your local hospital physio department.  My husband has recently had some online physio appointments which may help.

Jackie I had a sore arm and armpit for months but it slowly healed but frozen shoulder is another matter and needs proper assessment and an effective exercise programme to get it moving again and the earlier this is started the better.  Please go back to your GP.

(I tried gentle circular movements at shoulder level on a wall.  Just try to keep the arm moving until you can be assessed).  Good luck

Pace and Ablate

by Jacjac - 2021-03-07 17:16:16

Gemita  thanks for advice. AF is still there I was told it will never go away but I don't feel it as much and I don't get the side effects either thankfully

I have been doing a few exercises and the shoulder has improved a bit but limiting. Yes COVID has been an issue but I've had my first jab so things are looking up in that respect. I agree I need to get a GP appointment I will look into that tomorrow even though it will be a telephone appointment at the moment

Thanks again stay safe 

AV ablation

by AgentX86 - 2021-03-07 22:29:30

What mode is your PM?  Is it mode switching to block paroxymal AF or is the pacemaker in VVI mode, with no atrial connection? 

I wonder how a tele-doc appointment works with a phycal impairment. Sounds like what they were going to do with my granddaughter (virtual kindergarten!) until cooler heads prevailed.

AV Ablation Agent X86

by Jacjac - 2021-03-08 06:55:57

PM has one wire to replace Av Node they completely ablated  the AV node and the pacemaker has taken its place so solely dependent on PM 

Wasn't a nice feeling when they ablated my AV node heart rate plummeted to 30 then they kicked the PM in at 80 dropped it again to 30 to see if I had a natural backup pacer which thankfully I had they said some people do some don't still felt very lightheaded when they dropped it but not as bad as the first time so now PM set at 80/130 adjusting end of month to 60 

Telephone appointment would be just to discuss problem then go from there as to what to do 

Pace and ablate

by AgentX86 - 2021-03-08 19:26:08

OK, so you're paced VVIR (I assume the 'R').  It's surprising that you only have one lead.  I have a CRT (two leads), which I've read is standard for those with an AV ablation with no AV synchrony. 

I still get the "elevator test" when I go in for an interrogation.  Unfortunately, I fail it - no escape rhythm.  I hit the bottom and, no, it doesn't feel good but as long as I'm warned that it's coming I can deal with it.  When it comes to my heart or PM, I hate surprises. 

Setting the PM to 80 for a month after an AV ablation is the normal procedure.  My EP explained that there was an abnormally high incidence of SCA after an ablation but that raising the heart rate brough the odds back to normal.  In my case, after a month, they reduced my rate to 70bpm, then were to reduce it again to 60bpm after another month.  When they lowered it to 70, I started throwing bigeminal PVCs, which felt awful so they raised it back to 80 during the day.  For some reason, 50 at night is OK with only minor issues.

1 lead vs 2

by atiras - 2021-03-10 08:11:20

"I have a CRT (two leads), which I've read is standard for those with an AV ablation with no AV synchrony. "

I'm paced VVI (single lead) after an AV node ablation -- maybe it's a UK versus US thing?

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