Single Lead for Intermittent AV Block
Hi again, high-anxiety soon-to-be-implanted pacemaker patient here.
I had a cardiac MRI done last week that confirmed mild LV noncompaction, QRS ~ 140ms. My doctor saw 3 long pauses on my Zio monitor over two weeks: 10s, 8s, and 7s. "High grade AV block". During waking hours I have 1st degree AV block with no pauses, been that way for 5 years. Asymptomatic but he wants to give me a PM to reduce my risk...
I talked with this doctor yesterday, and he recommended a single lead (VVI) pacemaker for these nighttime pauses. This seems counterintuitive considering the EKG shows symptoms of AV block. But, he wants to give me "the simplest system possible" so it can be useful for the longest amount of time.
He also said I could get a leadless pacemaker (he didn't mention if he meant the AV Micra or VR Micra) but he would rather fit me with a single-chamber in the RV.
I did not expect him to even suggest leadless given the cardiomyopathy and AV block, and was shocked that he said he wanted to "start with one lead and see if we need more". I am kind of scared of the stability of a 1-lead PM even if I'm only being paced like 5% of time time.
I need another opinion, I don't know what to do. I desperately am seeking a second opinion from another EP, but don't have one yet (Kaiser Insurance).