Heart Failure

Your report on pace makers causing heart failure was very interesting but I dont see how any of us who had no choice could do anything about it,This is a discouraging report in that for all of us it is after the fact. I for one have enough trouble getting used to having this thing much less reading what it can cause when I can do nothing about it.DD


6 Comments

Heart Failure not inevitable

by Robin Branda - 2008-04-01 04:04:53

Hello DD:

i apologize for making you feel uneasy but i wanted to air a concern of mine and get some feedback since for me it "after the fact" also.

However, reading the abstract of the study it just noted that people with pms were more likely to get HF. But the numbers still didn't look too bad (81 people out of 11,000). And, as you can read, there are many many people out there who have been paced for longer than you and i who are doing very well. They are sources of great optimism and i thank them.

Good Luck

Robin

Avoiding cardiomyopathy

by BABlocker - 2008-04-01 05:04:01

When I had my PM implanted, the implanting EP provided me with the choice of having a Biventricular (1 lead in right atrium, and 1 lead each in each ventricle to synchronize the ventricles) for just the purpose of preventing right pacing cardiomyopathy from occurring, as I have complete heart block and therefore am being paced 100% in the ventricles..

I am glad that I had this done, but most folks have dual chambered pacemakers and live their lives without ever developing cardiomyopathy.

I have asked my cardiologist to monitor this annually by doing an echo which will let them know if my EF drops, and intervention is needed, even though I have a 3 lead pacemaker. He concurred and readily and happily agreed to this plan.

So, simply, as advocates for our own health outcomes, we can ask our cardiologists to monitor for this closely and we can report symptoms early to prevent this from occuring.

Being proactive and working with your physician as a partner will go a long way in preventing this concern from ever coming to pass.

Of course I am speaking to those who have structurally normal hearts without coronary artery disease or damage to the heart muscle.

Those who have had an MI or had other damage to the heart muscle itself may want to discuss whether a biventricular pacemaker is indicated when it comes time to replace the pacemaker, as they are more prone to developing ventricular arrythmias as a result of their compromised heart muscle.
Good luck to all!

Can't find the mentioned study in journal.

by dward - 2008-04-01 08:04:12

I posted this on the other article, but wanted to be sure evrybody sees it...

The American Journal of Cardiology is published twice per month.

In the March 1 2008 edition, this is the only article in the journal relating to Pacemakers:

Utility of Isoproterenol in Unmasking Latent Escape Rhythm in Pacemaker Dependent Patients Undergoing Pacemaker Replacement 631
by
Stephen M. Chihrin, Uwais Mohamed, Raymond Yee, Lorne J. Gula, George J. Klein, Allan C. Skanes, and Andrew D. Krahn

The March 15th Edition has no articles relating to PMs

Oh, and the Robert Wood Johnson Medical School is in New Jersey not New Brunswick.

Just so you know.

Risks That Go With A Pacemaker

by Nim Rod - 2008-04-01 08:04:28

From where I sit this getting a pacemaker with the risks that go with one falls under the category of "choose your posion" or "d----- if you do and d---- if you don't." I haven't yet seen anyone say their getting a pacemaker was elective surgery for them.

I Agree

by kimm102576 - 2008-04-01 10:04:40

I have to Agree with DD...I have had a Pacer for 31 years and if i worried about what could, might, happen I could not live the wonderful life I was given...if its your time its your time and pacer is NOT going to help you over come it...Live life and dont worrie you good old pacemaket friend that sits next to you for however long you need it!

HF for some, but not the end

by Sig27 - 2020-07-28 22:03:54

So, I was not told about the possibility of developing heart failure from the PM when I first got it in 2005. This February, they told me a lead is malfunctioning, I have borderline systolic HF (low EF) and the battery was wearing out early, because they keep having to turn it up (due to the bad lead). So, I was a bit shocked and upset, but now I've educated myself on all that and here is the long and short of it. 

Some people with a PM or ICD, especially those who pace at a high percentage (which those with Heart Block tend to do), get heart failure over time, because the constant prodding and artificial impulsing by the PM weakens the heart in it's own rhythm and contractions strength and the artificial beat of dual chamber PMs is not synchronized enough. Sometime it interferes with the valve, which can also lead to HF.

My HF is only borderline, so not that bad yet, but I did have symptoms, which they sort of ignored. (Like when I mentioned severed edema on flights in 2016, should have rung a bell with them in my opinion). Here's the deal, some people will just get HF after many years of pacing (I'm at 15) so, the younger you got your PM, the more chance you have over time to develop HF. I'm really pretty healthy otherwise, eat healthy, exercise. Stress doesn't help. For some it's just what happens and unavoidable.

There are many things they can do to minimize and stabilize HF (though they can't reverse it). I am taking extremely low dose ß-blocker, to help the heart chill out and take a break, basically. Eventually, I may need CRT (Cardiac Resynchronization Therapy, aka a third lead to the right ventricle that re-synchronizes my heart beat more fully, than my dual chamber pacer is doing) and it should be under control. If that doesn't work, they can up the meds, try other meds (not that I'm a med fan, but if it's between that and not living, I'll take it, I guess). And, let's not forget, they are making constant advances in the science of hearth rhythm treatments, there are already leadless pacers being implanted in Europe, gene-technology in dogs being done in the US, where they regrow the sinus nodes etc and you don't need any pacemaker.

Those of us who are younger and have that higher chance of HF, we also have more time for these advances to kick in and one day, maybe none of us will need another PM or lead implanted or replaced. Just live as healthily as you can and make every day count!! 

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