New to this situation!

Me too!

by AgentX86 - 2018-08-06 22:52:33

I'm not an athlete and I wasn't in AFib as long as you were (11 years) but I've been through it all, with the addition of a Maze procedure.  Last summer, before the second ablation (of three), my EP was suggesting either a pacemaker with even more antiarrhythmics or a pacemaker with AV ablation, instead of the drugs.  Two more ablations failed, then in February I was starting to have serious pauses (8-seconds) so I ended up with the AV ablation and pacemaker. 

My surgery went very smoothly and I felt better immediately (felt almost high, I felt so good).  That lasted a couple of months, then I slipped back for a while with dizzy spells.  All has been good for a couple of months now.  I wouldn't go back.  Highly recommended for those who have exhausted all other options (and only after all other options have failed).

I don’t know what to do ?

I can't tell you what to do but from the above, you can guess what I'd do in your situation.

how good are the pacemakers ?

Very good, though like everything made by man, they aren't perfect. There are a lot of problems discussed on this forum but remember, people don't talk a lot about things that work right.  It's when something goes wrong that they start looking for answers.

can I return to hard cycling and physical tasks? 

No guarantees.  As you said above, your atria aren't doing you much good.  With Afib as the reason for the pacemaker, you'll likely get a VVIR mode pacemaker so you won't have AV synchrony.  Your heart's efficiency won't be 100% but it may not be worse than it is now.

Whats the long term issues with pacemakers?

There are several issues with them but one is pacemaker induced cardiomyopathy.  There is a lot of evidence that this can be avoided with a CRT pacemaker.  Since your heart is in reasonable shape (you don't mention any cardiomyopathy) you probably don't need a cardioverter, so it would be a CRT-P pacemaker.  I'm in the same situation.

Which pacemaker do I choose ?

Id say a CRT-P or CRT-D (if you do need the defibrillator).  I'd be asking your EP, though. Make sure he'll justify his choices. 

I just went through your situation

by Charlied20 - 2018-08-20 22:41:29

I had a pacemaker put in 3 weeks ago today. I have been in and out of afib for almost 20 years. They tried every mediation that I could tolerate and performed 6 ablations. Still no luck. My EP suggested a pacemaker and AV node ablation. My cardiologist suggested the pacemaker without the ablation as you can always do it later if needed. 

I was put on amiodarone about 2 months ago as it was the only last drug that helped but which I am not a fan of due to side effects. Since my install my cardiologist reduced by half my amiodarone dose and increased my metoprolol and I have had great results. 

Today I went for my 3 week check and my device has recorded me being in afib less than 5% of the time since install. I used to be in afib all the time. The plan is to get me off amiodarone soon. 

Check with your cardiologist and see if the approach they used on me may be right for you. He also said he could do another cardiac ablation after the pacemaker install but before the AV ablation. Good luck!