Single Lead Atrial or Ventricle Paced.

Hello to all,
I've got a question to ask? is there any one that is Atrial Paced for Bradycardia. Reason for this question is that I am Ventricle Paced for Bradycardia ,after three Holter monitor tests they all showed that my heart stops 2/3 times during my sleep for 7-10 sec therefore PM, during the day all is fine .I attended a meeting at my local hospital and manage to catch a few moments with a Professor in Electrophysiology and told him about my condition and showed him my Holter results,he then asked where my lead was implanted I replied Ventricle,his reply if I had come to him he would have put it in the Atria.
Can any one shed some light why my Cardiologist put the lead in the Ventricle and the Professor would put it in the Atria.This has being spinning in my head for a few weeks now.

Well wishes to all.
Francisco.

5 Comments

bradycardia

by Tracey_E - 2008-11-17 04:11:04

Bradycardia is more a symptom than a condition, it just means a slow heart rate. If your hr is low because your atria is slowing down due to Sick Sinus Syndrome or something else affecting the atria, then you need an atrial lead to keep your atrial rate up and your ventricle will keep up with it on its own. If you have a block, this means your atria beats normally but the message doesn't always get through to your ventricle, then you need a ventricular lead to step in and help. That's just two examples, it all depends on your condition. Me, I have a block and primarily pace ventricle, but I have a dual lead and use both.

I wouldn't take a quick diagnosis in a hallway from someone who doesn't know your history over your doctor but it can't hurt to call the doctor and just ask why he put it where he did and what your official diagnosis is aside from bradycardia.

When you get it checked next, you might want to ask for a copy of the report. We have a few around here who can tell you what all the gibberish on it means and help you understand what's going on.

I have both

by Suze - 2008-11-17 04:11:23

I had bradycardia and sinus pauses (during sleep) similar to you. I am paced both in the venticle AND the Atrial. My EP and cardiologist told me they prefer having the patient paced in both.

Anyway, You should feel free to call and ask your dr. why he did it his way. We should get answers to those questions that really bother us. We're entitled!!

Meanwhile, try not to worry...
Suze

I am Atrial paced

by Angelie - 2008-11-17 05:11:54

I agree with the above comments, and feel you should be able to ask your doctor why he chose what chamber to pace.
I am paced in the top chamber because my natural pacemaker is broken and doesn't work right. The top chamber is where the heart's natural pacemaker is (SA node), although sometimes the heart can fire a beat from anywhere. My pacemaker initiates the heartbeat for me and then the signal travels down to my lower chamber and my ventricles beat by themselves without any pacing.
My doctors felt a single lead in the Atria would cause me less problems for now, but I was implanted with a dual chamber in anticipation of adding a ventricular lead at some point in the future, but I hope not.
The more your heart does by itself is best, and that's what my doctors thought would be the best scenario for me. The more complex pacemakers and they're leads the more risk for complications. Right now my doctor is trying to do the less of things for as long as we can. As I get older, (i'm 33) I will most likely progress to both upper and lower chambers being paced.
Works for me. I'll take the little less complicated thing for as long as I possibly can.

Pacemaker

by SMITTY - 2008-11-17 07:11:40


Hello Francisco,

I can't comment why one doctor would do one thing and another something different. I got a two lead pacemaker in 2000 for bradycardia. One lead is in the atria and one in the ventricle. I also have (or had) a problem with the stopping breathing during sleep (the problem is called Sleep Apnea).

I would stop breathing several times each night for periods of 8 to 12 seconds. "Sleep tests" showed that my blood O2 would drop into the low 80% percent range and my doctor said anything below 88% could be a problem. Anyway, after the sleep tests I was given a CPAP (Continuous Positive Airway Pressure) apparatus which solved my problem.

While I am under no illusions that I'm smart enough to tell you what your problem is, there is considerable similarity in the description you give of your problem and mine. You might consider mentioning Sleep Apnea to your doctor.

Google can provide lots of information on Sleep Apnea and CPAP.

I wish you the best,

Smitty

Why single lead?

by ElectricFrank - 2008-11-18 12:11:38

With most of the modern pacemakers having provisions for dual lead, my question is why they only hooked up one lead. With the two lead setup it would only be aminor programming change to include the atrium in the pacing.

Mine is primarily ventricle pacing for AV block, but when I get a run of PVC's it includes atrial pacing for a few beats to coax things back to normal.

One reason for preferring ventricle pacing for brady is that it is more certain to provide a reliable HR than atrial. The heart still provides adequate blood pumping with ventricular beats. There is no assurance that an atrial paced beat will be followed by the ventricles.

frank

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