New to the Club

Great site.  I had a Medtronic PM W1DR01 installed on 4/21 due to low heart beat and Atrial Flutter. Prior to the PM I had ended up in the Hospital for 3 days after I noticed my heartbeat was in the 40's.  My bpm one night got down to 35, got the nurse running around on that one. Heart tests showed the heart was strong and healthy, just my sinus node was diseased.  I had a Cardioversion the 3rd day in the hospital to stop the flutter. 

Prior to the PM, did a sleep apnea test which was negative.  Wore a ECG event monitor (sticks to your chest) for 7 days.  Showed heart block/Bradycardia and that my heart had stopped for 7 seconds when I was asleep one night.   I just turned 71 in May.

Main pacer is in the lower chamber and upper atrium lead is mainly to try and offset any flutter that may occur. My 1st diagnostic check 3 mo's. later & unbeknowst to me, showed that I was in flutter and the upper artrium lead had dislodged from the heart.  I have no symptoms when I am in flutter (high bpm range). Had the lead reattached successfully in 9/21, which also meant I had to go through another "frozen shoulder" recovery, which is just now almost normal.  Went in for my diagnostic check, PM was all good, but I was in flutter.  My doctor tried getting me out of flutter by manipulatin my PM pace, but got me into Afib, then back into flutter.  Was worth a try I guess, but had to have Caridoversion a few weeks later.

I was put on Solotal to see if meds might control any future flutter episodes, but that stuff was nasty. Started getting tired and soon barely could walk from fatigue, quit taking it!  We decided to do ablation. Had the surgery/procedure done 5/22 successfully.  I was under for 5-6 hr. while he mapped and did a Cyroballoon ablation for the Afib, and a radio frequency burn for the flutter.  He found scarring on my right atrium wall, possibly due to an unknown infection which posed an issue.  Recovery so far has been okay, just hope it works to prevent any future flutter episodes. 

I would like to get a portable ECG unit to check myself on occassion for any reoccurance of flutter.  Would probably be cheaper long term than going in for an ECG office visit.  Did a lot of research, and settled on a Heal Force Prince 180B.  Has 3 external leads, or you can use the palms, downloads to a PC also.  Question is.....what is the deal with using these and having a pacemaker??  It obviously doesn't interfere with the pacemaker as far as I know.  I understand the PM will affect the readout of the ECG, but the idea is to be able to read the ECG and know where the pacer is.  Quite fascinating studying ECG readings, and seeing flutter on a readout is rather easy.  Actually, everything about the heart is amazing, esp. the electrial aspects!  Any help on this?  Thank you 



by AgentX86 - 2022-06-02 20:03:39

Yeah, you have stuff going on.  Welcome to the club (take any or all ways you want. Most of us have been there.

Your first paragraph is pretty typical except that none of that would have excited any of the nurses in the hospital I use (a large metropolitan teaching hospital) that I go to.  They've seen it all and unless the beepers start going off, they're not going to get excited at all. My cardioloogist and EP didn't think it was worth hopspitalization and went like that for months. It's good to take care of it but don't get too worked up over it.  It's all taken care of now.  No worries.

If you're asymptomatic, there is no need to control flutter.  Anticoagulation and rate control is enough and a pacemaker is going to do absolutely nothing. It can only go faster.  It's a car with no brakes.

Sotolol is a good antiarrhythmic but it is also a beta blocker, which can have exactly the side-effects you descibe. There are others and, in fact, Sotalol is pretty high up on the chain.  They usually start with the less effective, though safer, drugs and work up from there.

The cryo and RF are usually done for the opposite (cryo for flutter and RF for fib).  Cryo is simpler but RF is more flexible. Flutter is usually confined to the pulmonary vein, though it's possible elsewhere. AF can be pretty much anywhere so the RF soldering iron (that's what it feels like) is used.

You have a bit of a misconception about your two-chamber pacemaker.  You're right that the lower (ventricle) lead is doing the pacing but the upper lead isn't doing anything for your AFL.  It can't.  It's there to sense the atrial contraction so yuor pacemaker can relay that information to the second lead in the ventricle. It's basically a hot-wire around your heart (AV) block.

I hope the ablation works for you too.  Don't be surprised or disheartened if you get some AF or AFL over the next couple of months.  It takes a while for the scar tissue to form. The cardioversion was a good idea, unil they could do the ablation.  It rarely lasts long, though I didn't have a problem for seven years.  Then all hell broke loose,

A personal EKG, at this point, is pretty useless.  It's an interessting toy but it's not going to tell you much.  Your pacing will invalidate any dignostics that it can do.  It may be interesting to learn how to read an EKG but other than that, it's not all that interesting.  I gave mine to my son, who was recently diagnosed with AF.  The thing you really want to watch out for is getting obsessed with the thing.  It's not going to tell you much that's interesting but it can drive you litterally crazy if you get obsessed over your heart.  Treat it as a toy, learn how to read EKGs, and put it away.  They're great for paroxysmal or persistent AF and used in conjunction with the "pill in the pocket" strategy of treatment.  For persistent AF, they may use it to schedule a cardioversion but that's about it.

You have a pacemaker now.  It can detect AF and if there is anything that needs to be done, it'll give your doctors the information needed. If you have symptoms (this goes for anything) press the button on your monitor and call your EP's office to be on the lookout for the transmission.


RE: Stuff

by Secrent - 2022-06-03 18:19:36

Thank you so much for the reply, good info and updates on certain things I wasn't completely on track about.  About the nurse, I think she was more upset that I had gotten out of bed without "ringing" her and consequently setting off the nighttime out of bed alarm,  than the heart alarm.  I haven't been in the hospital for awhile, and I didn't know they set an alarm on your bed at night, which is a good thing if you fall out of bed.

What would be nice is if Medtronic would allow me to also have access to the My Care Heart Mobile App that sends a nightly WiFi transmission from the PM that goes to my Doctor's office.  Not sure what "flags" are on the program that would post an alert to the staff at the Doctors office should a person have something going on that might be of importance. During my Diagnostic visits they bring up the history & review the transmissions that had been sent in. 

I am sure there is a PC program associated with it, would be nice to have it and be able to check it once in awhile.  Keep trying to get Medtronic on the phone for that particular division, but it is always busy and they never call back.  

So, guess we should all be thankful for modern technology that gives us a life extension so to speak.  

Take care, and thank you again.


Bed alarm

by AgentX86 - 2022-06-03 20:13:52

That's funny.  When I've been in the hospital, nurses never left me alone.  Every time I drifted off to sleep, there were right there taking my BP, blood, or who knows what.  If you need to rest, never go to a hospital. 

I've never had an alarm on the bed, I don't think.  I've only been in the cardiac wing (IIRC) so the telemetry would see if I was going anwhere.  Any changes and they're right there.  They did miss a 5-second pause because they thought I was just sleeping on the leads.  Again, they woke me up.

Why can't you get the phone app?  I have it and think it's great.  It's a whole lot better than the <explitive deleted> bedside box. Forget getting through to Medtronic.  It's not going to happen.



by new to pace.... - 2022-06-04 07:52:39

I got through to Medtronic just this week with a question i had.

new to pace

Catheter incision

by Secrent - 2022-06-13 15:55:43

For my abalation, they went up both sides of my groin for the Catheters.  Everything went well, I took it easy for a week, then found the incision for the catheter on the right side had opened up.  They glue the incision together after the ablation.  Well, what I had after it opened up was a wound or "hole" about the size of a nickle that just would not heal.  Went to my physician as the office of my Cardiac electrophysiologist who did the ablation just said to watch it and it will heal up.  My physician swabbed it for culture and prescribed anitbiotics and said it needs to heal from the inside out and to watch it, if it didn't get better he would send me to a wound center.  Culture came back with Light growth Streptococcus anginosus group.  The antibiotics are working and the wound is showing signs of healing up slowly.  Such a bad area for an open wound, right in the crease of your groin.  Lucky I went when I did to my pyhsician, otherwise the infection would have gotten worse.

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