Surgery is Monday

Anxiety

by AgentX86 - 2021-06-25 15:43:22

Hi Rocks.  Don't worry, you're not going to die. Pacemaker surgery isn't any worse than a tooth extraction and for some, far less.

You haven't said why you need a pacemaker so we can't get into specifics but you'll bo alright. For the vast majority of us, a pacemaker has given us our lives back.

You're certainly not alone feeling PVCs. Most don't feel a single PVC, or most likely notice but ignore it because they think they imagined it.  String these puppies together and I don't see how they COULD be ignored. Much worse than Afib.

Anyway,  keep us informed about your progress. We can likely help you through this. Nothing to worry about. Take your wife to dinner this weekend and celebrate your new you.

To Knock - PM

by Ram - 2021-06-25 15:46:20

I'm sure you will be fine with the pacemaker as I've spoken to many of my friends who wished they had done it earlier and no complications.  One person I've known forever and just told me she's had a pm since 1998 and she is extremely active.  I also took it very bad after losing both my parents in 6 months.  For a whole year I started having heart pains and thought it was due to heartache.  Apparently there is such a thing but not in my case.  During covid and the political state of the country I came down with anxiety and they checked my heart again and found AV heart block 3 and I need to get a pm soon.  Still deciding on which kind and dreading it but after reading some other posts on this site and talking to medical people & friends it appears to be one of the least problematic surgerys.  Condolences about your parents.  Death sucks and grief is the worst thing I've ever experienced even though most everyone I know has been through it.  It will become more bearable after a few years.  Think positive and good luck.

Reason for pacemaker

by KRock75 - 2021-06-25 15:54:35

They can't give me meds to suppress the PVCs because my heart rate is already too low. They are telling me that the pacemaker will override the PVCs and relieve the symptoms plus it will help me feel better because of the bradycardia. Usually, ablation is the option but Dr is afraid because of overall health that keeping me under for 5 hours to map my heart would be too hard on me. So the pacemaker is the less stressful option on my body. 

I'm hoping it's as easy as a tooth extraction. Just had one of those in Feb. 😁

I know I sound like a big baby. Just had a lot hit me in a short amount of time. I tell myself to quit feeling sorry for myself but sometimes it's easier said than done. 

Thank you for responding. God bless you! 

Thank you Ram

by KRock75 - 2021-06-25 15:57:25

Thanks for the awesome words and sorry about your folks too. I'm gonna get through this...

Bradycardia

by AgentX86 - 2021-06-25 19:51:04

A pacemaker will easily fix the Bradycardia (slow heart rate) and maybe tame the PVCs.  A pacemaker, alone, can't keep your heart in rhythm but just a higher heart rate may chase them away.

Essentially, every nervous cell in the heart has the potential to be a pacemaker.  Normally the Sinus (SI) node has this responsibity because it's the fastest (fastest to the next beat wins).  This beat, as you know, is typically 60-90bpm.Sometimes another nerve cell in the atrium decides to be the pacemaker so the two are fighting, and you have Afib.  Afib usually causes tachycardia (>100bpm) and the heart to beat irregularly as the two fight.

If the SI node doesn't do its work, the next lever down is the A/V node.  A pace from the A/V node is called a "nodal rhythm".  This often screws with the SI node so causes another sort of arrhythmia.  It's usually silent because the SI node outpaces it.  The A/V node usually has a normal rate of 30-40bpm.

The next level down are the ventricles themselves.  If there is no signal from the A/V node, the ventricles will create a beat, though often as low as 20-30bpm.  This doesn't sustain consiousness but will keep one alive. 

A PVC is when this latter pulse goes whacky and inserts a pulse even if something else has already issued its orders.  This causes the heart to beat before the ventricle completely fills with blood so it's often felt as a "skipped" beat.  Since the ventricle isn't filling properly, the heart pumps less blood.  String a bunch of these togther and you are going to feel it.

Now, all a pacemaker can do is make you heart go faster.  If there is still one of these errant natural pacemakers doing its thing, a pacemaker won't help at all.  However, if the problem is that the SI node isn't firing fast enough such that these other alternate pacemakers bleed through, a pacemaker will solve the problem.  If it doesn't, at least it'll keep the heart rate from falling below some floor, so drugs that have a side-effect of slowing the heart can work safely.

My EP was going to give me a PM for this exact reason.  I had A-flutter (where the SI node creates a pulse, which races around the heart and retriggers ths SI node before its time and the atrial pulse rate can get into the 300s) but also Bradycardia.  So he was going to do exactly what your doctor is doing.  However, just before we got that far, I started having asystoles (instaineous flat-lining of the heart), so it moved up the plans to "tomorrow"). 

I also had the A/v node destroyed so the Aflutter couldn't get to my ventricles and the pacemaker took over everything (but the atria, which were now useless).  At that point, I got bigeminal PVCs (one every other beat - Gemini, the twins).  Setting the PM to a higher rate chased the PVCs away.  I rarely have a PVC now.

So, your doctor is on the right track, IMO, and you should be fine.  You aren't the first one to be where you are and won't be the last.  If you have to have a health problem, this isn't by any stretch of the imagination one of the worst. It's actually not so bad and most of us have gotten our lives back.

A far as your anxiety goes, I think the best way to beat it is to learn as much as you can about your condition and the possible solutions available.  Read.  Ask questions here.  ...and above all else, ask questions from your doctors.  Be sure you have an electrophysiologist (EP) working with you.  You're beyond a cardiologist.  The bottom line is to keep your head in front of your heart.  Understand what's happening to you.  Be an active participant.  The more you're in control, the less anxious you'll become.

Your not the only southerner in the club!

by asully - 2021-07-01 22:49:49

You will see plenty of y'all's out of me!  I wasn't born or raised in the south but I hail from Georgia and my other half is a true Texan.  Welcome to the club! Pacemaker surgery while scary for many is literally a cakewalk!  I would say having my tonsils out, having my wisdom teeth pulled, and breaking my knee a long time ago outranked pacemaker implant 1, 2, 3, and 4.