Electrical / Conduction system Question

Electrical System Question -   If your SA node is completely non-functioning and your AV node is barely functioning, does a pacemaker replace the electrical / conduction system when the hearts natural pacing system is non working?


How it works

by Gotrhythm - 2021-10-05 14:07:13

Yes. The 2-lead pacemaker has one wire or lead which does the work of the SA node. It has another lead doing the work of the AV node.

The pacemaker senses the electrical activity in your heart and is programmed to only fire if your SA or AV nodes don't function on their own.

There is also kind of pacemaker called a His-bundle pacemaker which has one wire which goes into the His bundle. Because of its placement, it does the work of both SA and AV nodes.


by Terry - 2021-10-05 18:59:23

Yes, I agree with Gotrhythm. And, His bundle pacing is the only physiological method of pacing. Google His-pacing.

In fact, various studies find that His bundle pacing is effective in rescuing the 30% of "2-lead pacemaker" patients whom are "non-responders."


His pacing

by AgentX86 - 2021-10-06 14:37:39

His pacing is wonderful for those who it's useful for and with an EP skilled in performing the procedure. It doesn't do anything to answer. ALHEART's question,  however.

His bundle pacing

by ar_vin - 2021-10-07 21:05:19

His pacing has its benefits for the right situation (my ventricular lead is placed at the bundle of His so I understand who it might help). But Agent is 100% right - the OP's question has nothing to do with His pacing.

If all that one has is a hammer in his "toolbox"; everything looks like a nail that needs to be hammered.

Worse yet - the statement "Because of its placement, it does the work of both SA and AV nodes." is 100% wrong! Please do read more about His pacing before posting utter falsehoods. I've said this before in the context of other posts, let's all make an effort to post within our limits of understanding. Doing otherwise only detracts from the purpose of this forum which is to help others gain a better understanding of their condition and their PM.

At first, I refrained from responding on this thread. But Agent's post made me rethink my silence. I don't point these errors to make people look bad but only to further the purpose of helping others gain better understanding.

@Terry give it a rest about His bundle pacing

by ar_vin - 2021-10-09 13:09:29

Yes many of us are aware of the benefits of His bundle pacing; in fact I have a His bundle lead placed in me.

It's appropriate in some individuals and not in others; further many EPs are not trained or experienced in doing His bundle placement.

If you read the papers carefully you'll realize that some patient anatomies preclude His bundle pacing.

It's good that you spread awareness of His pacing but unfortunately most of your posts are out of context and out of place. I for one see your posts as a distraction on most threads; surely not what you'd want if you want to help others.


Bundle of His

by AgentX86 - 2021-10-09 13:33:42

Terry doesn't read the threads he posts to, at all.  He does a web search on "His Bundle" and posts the same thing.  It's a bot.

Feel free to check our website

by Terry - 2021-10-09 15:58:42

I like to suggest His-pacing because, with some browsers, it takes you to the Pacemaker Patient Advocacy website. His and left bundle branch pacing is the new paradigm. It's the go-to method of pacing at placs around the world, in fact, you don't even have to Mayo or Cleveland Clinic to get cardiac conduction system pacing. I feel conscience bound to help prevent what your doctor calls "pacing induced cardiomyopathy."

If this offends you, please disregard. If not, see:


On Twitter: PacemakerPAG



Dual Chamber Pacer

by Stache - 2021-10-19 20:01:02

I had a 3rd-degree complete heart block and now have a dual-chamber pacer (two wires) implanted pacing 100% of the time to beat my heart for me.  I receive micro shocks to beat my heart as my SA node and AV node are both dead.  I was implanted 8-months ago and blue tooth tracked 24/7 by Abbot.

I am a very active 67-year-old and ride a bicycle a lot and my pacer adjusts to my exercise walking or riding.  It’s nice to know my pacer came with a 10-year battery warranty.  So far I have had no issues with my pacer beat at 60 bpm way better they before at 30 bpm.

You know you're wired when...

“Batteries not included” takes on a new meaning.

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