Left Ventrical Ejection Fraction

Had a post-Pacemake MRI yesterday--one more attempt to try to figure out why I have a blockage that required a pacemaker. No answers on that front.

But, my left ventrical EF was 45%, less than ideal. During the testing before my ultrasound, they estimated EF to be 60%. I know the ultrasound is less accurate, but anyone have experience with readings from the MRI?

Also curious whether the pacemaker can effect EF. My pacemaker is set to a low of 60, my resting pulse used to be in the low 50s naturally (but dipping lower due to Bradycardia and Sic Sinus Syndrome). They set the pacemaker to 80 for the MRI. 

I don't like the sound of a low EF, especially since I am very active, exercising almost every day. Curious about anyone's experience with EF readings or dealing with EF. . . 




by AgentX86 - 2021-08-24 22:36:27

You say that your LVEF is 45%, then say that ultrasound found it to be 60%.  60% is high but 45% isn't catastrophic.  It's worth watching but not anything to lose sleep over (50-55% is "normal"). A heart rate of 50bpm is the definition of Bradycardia but that's really all it is, a definition. You don't say what your numbers really are so we don't have anything to go on, here. People live very normal lives with a resting heart rate that low or even somewhat lower. I did for years.  If you're having pauses it's another thing entirely.


by justjoe - 2021-08-24 22:49:25

My pulse was dropping into the 20s -- so had Bradycardia, but it was dropping lower due to Sic Sinus Syndrome. So my left ventricle runs on the pacemaker, right one on its own. 

They haven't been able to figure out why it happend, and I'm still trying to work on the right adjustments to the pacemaker. And, trying to understand the underlying medical and health aspects. 

What I am curious about is how the ultrasound could be high and the MRI low, and whether to chalk that up to the ultrasound not being as accurate, or some other factor. 

There's subjectivity in both

by crustyg - 2021-08-25 03:20:17

If you can charm your echo-tech into showing you how the %EF is calculated you quickly see the subjectivity that enters the calculations.  And, if I understand correctly, the same errors can creep into cardiac MRI measurements (unless there's some clever auto-guessing algorithm which will be deemed 'The Truth' and no-one will have the knowledge/confidence to challenge).

All measurements have uncertainty around them - ALL.  The question is how much uncertainty and is there a trend that is greater than the measurement uncertainty.

And to answer your Q can 'the pacemaker affect EF'?, the answer is yes.  There's good evidence that prolonged RV-apical pacing can affect the LV and reduce %LVEF.  But that usually takes months to years.  Simply starting pacing shouldn't have any immediate impact on %LVEF.

Try not to get too focused on the numbers.  What really matters is whether you feel good and can do the activities that you want/need.

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