Stroke due to pacemaker

I recently had a major stroke four months after a pacer implant. Tests after stroke revealed that I have a hole in my heart between right and left chambers (a patent foramen ovale - PFO). I've had the PFO since birth many, many years ago.
No strokes in my history and I rate way low on risks for stroke.

Has anyone heard of a stroke in a person with a pacer and a PFO?
The hole allowed a blood clot to move from right side of heart into the left and then be pumped to my brain.

There's some research that indicates that a PFO in people with transvenous leads for a pacemaker more than triples the long-term risk of stroke (DeSimone, CV et al. 2013. Stroke or transient ischemic attack in patients with transvenous pacemaker ... and echocardiography detected patent foramen ovale. in Circulation).

The pacemaker leads are a site for blood clot formation in the heart.

If you have any experience to share re: what you did to reduce the likelihood of a second stroke I'd appreciate hearing about it (what you did, how it's working out, etc.).

Thanks for your help!

3 Comments

PFO

by golden_snitch - 2015-04-16 01:04:14

I know a pacemaker patient who had a mini-stroke, and was diagnosed with PFO. The PFO was closed via catheter procedure, no more issues afterwards.

https://my.clevelandclinic.org/health/treatments_and_procedures/hic_Endovascular_Patent_Foramen_Ovale_PFO_Closure/hic_how_is_a_patient_foramen_ovale_pfo_closed_using_catheter_based_procedure

They never specifically adressed the pacemaker as being the cause of the clot. Stroke and TIA are well known complications of PFO, even in patients without any device leads in the heart. So, it's hard to tell whether the lead really was the cause or not.

Best wishes!

PFO

by Pacemum - 2015-04-16 02:04:58

Your right in that research has shown that anyone with a PFO will have a higher risk of stroke. There are higher risks associated with some other congenital heart defects also. Congenital means present at birth for those not familiar with the lingo.

Have a pacemaker.....

by aussieray - 2015-04-18 03:04:15

But I had a stroke before I had my pacemaker fitted. I have a hole also between my right and left chambers and because of an atrial fibrillation episode I had early one morning whilst asleep a clot formed, travelled between the two chambers and caused me to have a stroke. The solution in my cardiologists opinion at the time was to immediately start warfarin. I have since switched over to Xarelto and so far so good, I have had no more in the past 3 years. Apart from atrial fibrillation, I have bradycardia (a slow heart rate) and whilst in hospital for a hernia repair and whilst on a monitor in hospital, they noticed my heart rate while asleep would drop into the low 30's, so a pacemaker was ordered. I think in your case, it's probably just a bad coincidence that you had a stroke and I certainly wouldn't be blaming your pacemaker or procedure for that. All the best and hope everything goes ok.

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