long term effects of having a pacemaker

Hi okgemini,

by Gellia2 - 2008-03-15 03:03:51

It seems that now there are a lot more people the doctors have been able to follow over an extended period of time. They are finding that long term pacing of the right ventricle "may" lead to congestive heart failure. I say "may" because I have right paced for 33 years now and still show none to very little symptoms of CHF. I also have third degree block and pace 100% of the time. I think it's an individual thing and something your cardiologist or EP will certainly watch. I wouldn't worry about it, though. If you do have concern, check the symptoms of CHF and if you have any, please make your doctor aware of them. When I see my cardio., that's the first thing he asks about. So far, so good!
Hope this helps.
Best to you,
Gellia

Hi Okgemini

by bini - 2008-03-15 04:03:00

I would suggest talking to your Dr. about all your concerns. I am not a Dr, but I was nervous about my duel chamber PM as well. What he told me was that if your Ventricle is being paced 50% of the time or more...this can cause you heart to expand. He told me that they can check to see if this is happening by doing an ultrasound of the heart. If your heart looks expanded then they would try to turn the PM to a lower setting and then things should get back to normal.

Again, I am not a Dr. so i would contact ASAP to make sure all your questions and concerns are answered.

Good lick with everything,
Christine

Medical evidence

by admin - 2008-03-16 10:03:10

Hi! I've been paced since 1978 and have heard stories that long-term pacing can reduce ones heart efficiency, but I have not found any medical research evidence to support it. Most of the stories are from patients, not doctors. I'm told my pacer has not negatively impacted my heart, but I plan to dicuss this topic again with my doctors at my next appointment.

I suggest you do they same.

Blake

long term effects of pacemaker

by fox30 - 2019-03-19 17:02:11

Yes,there is sufficient medical evidence that right ventricular apical pacemaking can in some patients over time lead to heart failure(Hf).The left ventricular contraction sequence is abnormal similar to the abnormality in left bunde branch block (LBBB) which is some cases can over time cause cardiac remodeling and HF.

One study from Cleveland Clinic provides some light on that topic.See here.https://consultqd.clevelandclinic.org/pacing-induced-cardiomyopathy-patients-heart-block-normal-ef-know/

In Cleveland Clinic's experience about1/8 ( I have also read 1/10 )patients with right ventricular apical pacing will develop HF after a variable period of time.Some  articles have said the risk exists if you are paced 40% of the time or longer but another article said over 20% of the time would be enough to increase HF risk.

The Cleveland Clinic article emphases that if HF should develop CRT can be very helpful.CRT has typically been done with bi-v pacing with a lead paced in the coronary sinus to stimulate the LV and often reveses or nearly reverses the HF

More recenty a number of EP docs are doing Bundle of His pacing in cases of pacing induced HFt(aka pacing induced cardiomypathy or 

dyssynchronopahty  rather than BI-V pacing and reports indicates the results are as good as BIV pacing and certainty seems more physiologic as it uses the normal conduction system (ie,the bunde branch and the purkinje fiber branches) 

 I believe a Randomized clinical trial is now underway to compare BI-V with HBP in patents with pacing induced HF.

EP docs are recommending that someone pacing more than20% be regularly monitored (probably with Echo) to detect this problem that occur in some but not in all patients with RV pacing