Pacemaker settings

Hi I think perhaps someone on here could help me if thats ok,I had a dual pacemaker out in November 2016 for complete hearblock and after a few weeks started to feel unwell again so over two years of going backwards and forwards to different specialists and being told my pacemaker was fine! they decided to do a scan and I was told I had severe lvsd caused by my pacemaker after making me feel like a hyperchondriac all that time,so they put a biventricular pacemaker in to put it right in March 2019, It has brought my ejection fraction up but I have still got weak arms and legs and I wonder if it could be the settings, has anybody got any ideas 

Thanks

Janet

 


3 Comments

It could be, but equally your %LVEF may not have increased much yet

by crustyg - 2020-06-12 10:26:04

Hi Janet: If I understand correctly you've had some years of RV apical pacing as part of your dual-chamber paced approach to cope with acquired CHB.  You say that you now have a 3-lead PM to deliver pacing directly to the LV and, hopefully, improve your %LVEF that has declined due to the remodelling from years of RV apical pacing.

Two things: what were your %LVEF figures, do you know?  And now?

Secondly, it takes a variable time for %LVEF to improve after a third wire has been successfully implanted.  And lastly, sadly, this approach doesn't work for everyone, even after 15months.

Dont' misunderstand me: I want and hope that this therapy *does* work for you, it may take a lot more time (months to year+) to make a significant or big difference, and it may not be the only factor.  Acquired CHB *tends* to be a consquence of underlying heart muscle problems (unlike the congenital CHBs) and often this underlying disease process is progressive.

Are you sure that your HR increases to a sensible level when you move/exercise?  The standard assumption with CHB is that the PM senses the normal SA-node activations and passes them on to the ventricle(s) so bypassing the CHB.  But if your SA node has been affected by an underlying disease process, you may now have an inadequate HR (and hence cardiac output) when you need it.

HTH.

Scan

by PV Gringo - 2020-06-12 22:03:40

When you say you had a scan, what specific kind of scan did you have? I had my pacemaker implant five years ago and have not felt well since. Even though I had begun to experience heart block, my energy and stamina overall were quite high prior to the surgery. Since the surgery they have dropped by at least 25%, if not 50%. I was told I would feel more energetic after the implant, not more lethargic. I too tend to get dismissed as a hypochondriac when I insist something must be amiss.

Hypochondria

by AgentX86 - 2020-06-12 23:51:44

Yeah, that pisses me off too.  It's a good reason to fire your doctor.  Find one who will listen.  It's not like you're coming in with different symptoms each time.

I had (have) an issue where once a month I'd feel light-headed, like I was doing a sommersault and smelled a peculiar smell (kinda like being punched in the nose - had that disease a lot as a kid ;-).  it only happened one day a month but could happen up to two dozen times during that 24hr period.  All my doctors patted me on the head and sent me on my way.  Until one day, I was just turning to my wife to tell her I was feeling it again and collapsed in a complete tonic-clonic seizure.  That got some attention but no answers.  Neurologists aren't my favorite types.  Unless the problem bites them in the ass, they do nothing but pontificate.

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