bi valve pacemaker defibrilator

Hello all; i am very happy to find this site.. i am a 72 year old male . i have a guidant pacemaker tha woks well for the last 6 years I am a symptomatic but I have a low ejection fraction of about 25% My cardiogolisrs office , called me friday and told me he wanted to send my records to st barnabus hospital in livingston new jersey and is recommending that I have a bi valve pacemaker defibrilator implanted in me..I am very hesitant to have this done because of all the recalls of medtronic leads and guidant pacemakers.I have researched this and i can not decide how this will improve my quality of life since Iam with no symptoms . frankly I am un able to decide to go foward with this. i also feel this science is not perfected yet. can anyone relate to me thank you len

4 Comments

BiVent Pacemaker

by SMITTY - 2008-04-07 02:04:36

Hi Len,

You say that your ejection fraction is 25%. As for the upgrade, if you have a 25% EF, I am guessing your doctor is talking about a biventricular pacemaker. This type PM is frequently used when a person has a low EF that is caused by the ventricles not pumping in sync, or the ventricle is getting a weak impulse from the hearts natural pacemakers. If you currently have a two lead, PM one lead goes to the atrium and one goes to one of the ventricle chambers. The bivent PM has a third lead that goes to the other ventricle chamber and helps keep all heart chambers in sync. The reports are that this unit can cause a significant increase in cardiac output and I have seen comments here from people that have a bivent unit singing its praises.

Before going further, let me tell you a little about me. I’m little older than you, (be 79 next month) and I got my dual lead pacemaker in 2000. I have had a love/hate relationship with the thing since the third week. There are days I give it credit for probably keeping me alive, but there are times that I dream of taking my pocket knife and removing the thing. I have a cardiologist pushing me to go to the bivent unit in place of the dual lead unit I currently have. Last week I had a PM checkup and I have an estimated remaining battery life of 2.5 years, so while I have shortness of breath that gets extremely aggravating at times, I am not ready to give the OK for the bivent unit. It is the down side of my experiences with my PM that make me reluctant to agree to a replacement so long as my situation is not life threatening.

Now a little about my experience with EF. In mid-March I had a couple of stents implanted and my ejection was reported to be 45%. One thing I have learned about EF it is that the numbers (for me at least) are seldom consistent. I just looked through some of my records with EF numbers I have been given since 2000. The EF numbers range for a low of 33% to a high of 53%. My first report of the 33% came in 2000 and the 53% was last year. Over these eight years these are some of the EF numbers I have received, 33%, 47%, 39%, 42%, 53%, 37%, and 45%. I think I can relate the changes to the type procedure used to determine my EF. I’ve had them done when I had a chemical stress test, when I was having stents implanted (five times since 2000) and when they preformed an echocardiagram of my heart. I can truthfully say that I'm not sure if my EF is declining or ascending. If I were to plot the numbers they would look about what we would have seen if we plotted the ups and downs of the Wall Street numbers during the last year. All over the board. And yes I have felt very poorly, or good, regardless of whether my EF was reported as being low or high.

Now a purely personal thought. If it were me and I am not having significant symptoms, such as shortness of breath, I would hold off on a bivent PM. But my decision to hold off would not be based on the failures of various brands of PM or PM leads. Pacemakers are like any crap game; we pay our money and hope we win. I know that if I ever get a bivent unit my decision will be based more on how I feel and not on my EF number or failure probability of any of the compnents of the bivent unit. Of course if the battery on mine dies that may change everything. But with an age of 79 and a few other items, I feel reasonably sure the battery will last long enough.

I wish you the best,

Smitty

BI VALVE DEFIB

by peter - 2008-04-07 03:04:00

Yes there are two types, a biventricular pacemaker has 3 lead sockets so 3 leads can be fitted. Bi Ventricular means what it says . It means that the pacemaker will pace both ventricles using 2 separate leads. The ventricles beat together at the same time. The third lead is fitted to the right Atrium. This lead is in some cases not fitted due to complications like Atrial fibrillation as in my case but has the advantage that the pacemaker battery will last about 18 months longer as it is only pacing 2 heart chambers instead of 3. As the pacemaker is ensuring steady pulsing of the ventricles and also ensuring they beat together "in synchrony" the fitting of a bi-ventricular pacemaker is often called "Cardiac Resynchronisation Therapy". The results obtained from this treatment vary from outstanding as in my case to good to no real percieved improvement to even feeling not as good as before but fortunately that is rare but not nice for those who experience it. Generally though the majority of cases find that their state of health is greatly improved. I went from not being able to turn over in bed to being able to climb a mountain 16 weeks after implantation. As I have mentioned I have not had the third lead fitted due to AF. The 2nd type of pacemaker is the BV ICD which does the same but will also shock your heart out of a life threatening rhythym when necessary.All medical proceedures cary a risk but my advice is to take the risk as the risks of not having the treatment are much greater. Cheers Peter

THANK YOU

by rus369 - 2008-04-07 03:04:28

I apreciate the excellent answers recieved it has given me knowledge and a basis to make mt decision . Thank YOU LEN

bi valve

by thomast - 2008-04-07 12:04:34

What is a bi valve defib?

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