A couple questions . . .

Hi, 
It's been a while since I've been on here. I had my first pacemaker / dual-chamber implanted at age 57 for Bradycardia w/ AV block, Mobitz 1 (Wenckebach). Also, diagnosed w/ HF. Then in 2020 I had it replaced with a CRT pacemaker. So.... my questions are:
1. If you have a CRT, how long have you had it?
2. If you have HF, how long have you had it? 
Thanks,
Damie


6 Comments

A few answers

by Gemita - 2024-05-22 10:53:34

Damie, just wanted to welcome you back and to hope that you are doing okay.  We have a number of members with either CRT and/or heart failure and I hope they will see your post and respond.  Was there any concern in particular, or are you just curious to know how long we can live with heart failure and how long a CRT device lasts?

Average battery life of a CRT device will be different for each one of us, depending on our heart condition, battery use and condition of leads and other factors like lifestyle and medication.  So many variables, but I have seen they can last 6-7 years.

As far as heart failure is concerned, again there are many degrees of heart failure.  Some patients progress, some remain stable for many years and some may even improve their ejection fraction, although their heart failure diagnosis may still remain.

I hope you have no complications and that you are doing well?

Mobitz 1

by AgentX86 - 2024-05-22 14:52:49

Mobitz-I is a second degree heart block.  Second degree type-1, to be precise.  This isn't generally a serious problem and is rarely (I've never heard of it) a reason for a pacemaker.  Type-1 doesn't often progress to a type-2, which will lead to a third degree heart block. Mobitz-II is more of a problem because it will usually progress into a third degree heart block, which can be serious.

Bradycardia is a different thing.  That's precisely what a pacemaker is intended to fix.  The cause of the Bradycardia is another issue (it's not Mobitz-1).

"Average" doesn't mean a lot where pacemakers are concerned because there are many different models of pacemakers, and humans. I don't have three leads, for instance.  I don't have an atrial lead, so there is no energy used pacing the atria. I am paced 100% of the time, so use energy driving both ventricles, every beat,   

I've had my CRT-P for six years. At my last interrogations (I've had six in the last couple of months) it claims to 2.3 years left to go.  It said two years six months ago, so the gas gauge isn't very reliable. The manual says that if I were only paced in one ventricle, it would have a ten to eleven year life. These numbers really don't mean much, other than to marketing.  There are simply too many variables for it to be meaningful. It's not something the EP is concerned with when choosing a pacemaker.  They're looking for features.  They often rely on the manufacturer's representative to choose the best pacemaker for the patient.

Getting a new pacemaker every decade, give or take, isn't all bad.  In addition to getting another decade's use, you pick up all of the technological advances between. Maybe more battery life or a smaller package, as electronics and battery technology advance.

Heart failure comes in many varieties, too. It means that the heart isn't pumping enough blood to satisfy the body's needs. It could be a little, or a lot, not enough.  It may just slow the patient down, or it may so restricted that it can't keep the lungs free of fluid.  Since you have a CRT, I suspect your cardiologist thinks there is a left/right asynchrony problem, which may be fixable.

Thought experiment:  Imagine two water baloons pressed against each other. squeeze one and the other compresses, somewhat, causing some of the water to move out of the other balloon. Now, a second later, squeeze the other.  The same thing happens, but in the opposite direction. But, the second baloon doesn't have as much water in it because the water was driven out by the first balloon pressing on it. This reduces the heart's output.

Now, press both at the same time. Both start full, and are allowed to push their entire contents out. The two baloons actually support each other.

The CRT paces both ventricles with the right timing so the two sides of the heart can pump together, like they should. This increases the heart's output and relieves stress on the heart. 

Since the heart was working too hard, not getting the job done, it can now get back to normal.  Often the CRT will cure the problem completely (but will still be needed to keep it that way).  That's why it's cale "Cardiac Resynchronization Therapy". It is actually therapy, much as physical therapy is to the body's muscles. It is therapy for the heart muscle by resynchronizing the ventricles back to a more normal, relieving stress on it.

I hope this makes a little sense.

A few more answers

by Grateful Heart - 2024-05-22 16:18:20

I'm on my 2nd CRT-D.  The first one lasted 10 years and I am 6 years in on the 2nd one with about 4 years left on this one.  Boy time is really flying.

I was diagnosed in 2008 with HF, SSS, LBBB, enlarged heart and an EF of 24%.  My EF went up to 50% and after a year increased to 55% where it has remained.  

I also changed my diet and starting exercising after about 6 months.  I started with Cardiac Rehab first where your heart is monitored during exercise and you are surrounded by nurses and a crash cart if needed.  My nurses were great!  It was very comforting knowing they were there for you and I highly recommend it to anyone in the beginning.  Eventually I joined a gym and continued on my own.  

I thought I was doomed and I didn't find this site until 2 years after my first implant.    

I hope this helps.

Grateful Heart   

Hi

by Lavender - 2024-05-22 18:58:27

I'm on my third year with a CRT-P. I had LBBB with no symptoms for about 11 years prior.

The estimated left ventricular ejection fraction is 55-60%.

I feel fine but one wire is not optimally placed. When my battery wears down, I will be a candidate for a new pacemaker and lead or lead revision. 

I got my pacemaker due to ventricular standstill. 

CRT

by JaneJ - 2024-05-23 04:13:09

I've had my crt device for almost 7 years.  I'll be due for a replacement in the next 6 months.  I had mine put in after a failed his bundle attempt.  I have complete heart block as well as issues with my sinus node.  So I am paced 92 % in the ventricles and 100 % in the atria.  Interestingly enough I do not have heart failure, mine was put in simply because of high percentages of pacing and concern with developing pacing induced cardiomyopathy at some point in my life.  I am in my mid 40s and had my first pacemaker implanted at 27.  Best of luck to you!

CRT pacemaker

by Aberdeen - 2024-05-24 15:14:23

I have had my CRT pacemaker for 4 years. I had to get it because I had a dual lead pacemaker for bradycardia which caused LVSD after 4 months.

I feel well 🤞and hope to continue feeling well!

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