My upgrade from a dual chamber to a CRT

Finally have my upgrade to a CRT with a new lead (3-lead) on this Tuesday at the Cleveland Clinic Main Campus in Cleveland! Had my pre-op testing yesterday with all my results posted to my Chart within a couple hours. The people there for the testing are wonderful; especially the Pacer Tech. Probably the most knowledgeable and nicest that I've ever had. The way that I judge that is; I felt better (mentally) leaving her office than before I walked-in.

BTW: I am hoping to restore my low EF (due to PM syndrome and RV apical lead pacing for 37 years) with this upgrade. I have read that one of the most significant reasons that restoration of EF (improvement) does not occur in 30% to 40% of patients where that is an issue; is due to incorrect LV lead placement (Anodal Stimulation instead of cathodal capture). It was an old study (2011) so hopefully there is a greater awareness since then. Besides, I do not worry about my treatment at the Clinic. My new LV lead placement should be: left bundle branch (LBB). I will likely come home same-day if I get into surgery early enough. 

I am excited!!!

13 Comments

up grade

by new to pace.... - 2024-03-08 07:38:26

that is so good to hear Good Dog.  let us know how you are doing.

new to pace

🥳

by Lavender - 2024-03-08 08:37:24

Woohoo! Getting an upgrade will be so nice! My CRT-P raised my EF to normal in a short time. I understand though that others have taken longer to improve. I'm sure Cleveland Clinic is going to be the best experience!  Please let us know how it goes. God go with you! 

I am excited too

by Gemita - 2024-03-08 09:40:09

Dave a new chapter, perhaps a new man who will slowly show us what more he can achieve?  And remember the aim of CRT pacing is to pace “more” in complete synchrony, so you don’t need to worry about those pacing percentages anymore - I say the higher the percentage of CRT pacing, the better from now on to improve your ejection fraction.  

We will be following your progress with great interest.  I wish you all the very best Dave for Tuesday and hope that the procedure is a complete success.  Stay safe and please report back promptly.

Edit:  Conduction System Pacing chart (Figure 1) for download which gives all the pacing locations:-

https://www.researchgate.net/figure/Conduction-System-Pacing_fig1_346556769

CRT Upgrade

by benedeni - 2024-03-08 09:44:25

So happy for you Dave.  Having such a caring, thorough, professional team to work with surely gives you a crystal clear mindset.  So very important in these matters of the heart.

Give us a report asap.  (:

awesome!

by Tracey_E - 2024-03-08 10:22:28

You could not be in better hands. Love your attitude. Fingers crossed for a smooth surgery and recovery, and a nice jump in EF over the next months!

Brilliant News

by SeenBetterDays - 2024-03-08 11:04:55

Hi Good Dog

I am so glad your procedure is now imminent.  You have such a positive outlook and a fantastic medical team.which makes for a perfect combination.  I am sure that the next few months will see some really positive changes for you and that your ejection fraction will bounce back up.  I am sending you lots of love and best wishes.  Let us know how everything goes.

Rebecca x

Thankful you have a great Tech!

by USMC-Pacer - 2024-03-08 11:15:58

Lead placement is important as well as a high percentage of therapy (see link). To maintain the high rate of therapy the clinic should be watching for any AF, PVCs, or any other arrhythmia that will adversely affect that percentage and worsen CRT. Pre-implant QRSD is sometimes used as a estimate of how well CRT will work for us. Wide QRSD is a marker for venticular dissychrony and it's improvement (shorter) is a positive marker for effective CRT. 

I also had pacing induced cardiomyopathy with a QRSD of 200ms at implant. My EF at the time was 35-40. One month after implant I was at 45-50 and my QRSD dropped to 136ms!. My one year echo is coming up next month so hoping for some higher numbers.

So many variables to be learned by our clinics but they are coming a long way for our improvement. 

Great article here:

https://journals.lww.com/co-cardiology/Fulltext/2013/01000/The_importance_of_increased_percentage_of.9.aspx

 

Thank you all!

by Good Dog - 2024-03-08 12:03:52

I just want to thank everyone for the kind well wishes! I truly appreciate it. This is such a great group of people! I consider myself very fortunate to have such a great forum here for learning and for support!

I will certainly report back when this is behind me!

Sincerely,

Dave

Great News to Hear!

by Andiek11 - 2024-03-08 13:10:55

As a newbie with CRT-P pending (5-1) , your post was great to read!  I hope that all goes wonderfully for you next week and look forward to you keeping us up to date on your progress.

Pacer Tech

by Flo - 2024-03-08 14:23:11

Good Dog, 


Your Tech sounds good! Wishing you well this Tuesday. 

Andiek11 and Flo

by Good Dog - 2024-03-08 18:30:29

Andiek11  and Flo thank you so much for your kind thoughts and words.

Sincerely,

Dave

CRT and ef

by Aberdeen - 2024-03-09 13:47:10

My short lived dual chamber pacemaker- January 2020 was replaced by a CRT -P pacemaker in May 2020.My low ef around 35-40 (can't remember the exact figure) rose to 55-60.

I hope yours does too. Wishing you well!

Valerie.

Aberdeen

by Good Dog - 2024-03-09 17:12:48

Aberdeen; Thank You!

Sincerely,

Dave

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