Micra AV Next Week

Cardiologist and EP say I have Sick Sinus Syndrome although I've never fainted. I'm 71 and EP study 6 months ago didn't reveal any problems. I do have a Linq monitor. Recently my heart paused once for 4.7 seconds. It happened at 10AM, I was awake and felt nothing. Cardiologist said that once was too many times and wants me to have a pacemaker (Micra). If I had fainting episodes I'd be onboard. But I don't. Sheduled for surgery in 7 days, reluctantly.


4 Comments

Good luck for next week

by Gemita - 2020-08-06 07:34:27

I also have Sick Sinus (tachy/brady syndrome).  I am also 71 and have had an EP study and long term Reveal Linq monitoring.  I have had fainting episodes and you don't want to wait until this happens before you receive treatment.  Your doctors sound very caring and have your best interests at heart and I would feel very confident in their hands.

I can see you are a reluctant candidate for a pacemaker but your condition is only likely to get worse without treatment so I would bite the bullet so to speak and swallow your Micra AV !!  Sounds tiny enough to me not to cause too traumatic an implant procedure, without the need for any leads.  I expect you have got lots of information on the new Micra AV and what it can and cannot do and who are the best candidates for it.  There are a few folks here with the new Micra AV and I believe they are doing very well.

I attach a link which might be of interest 

https://bjcardio.co.uk/2018/10/leadless-pacing/

Please let us know how your procedure goes.  I would like to learn more about the Micra AV 

when you faint is too late

by Tracey_E - 2020-08-06 10:05:57

The idea is to prevent fainting. You can get seriously hurt that way. 

I thought 6-7 seconds was when they recommended pacing for a pause. Is your rate getting low, or not going up on exertion? Those are other reasons to pace. If you aren't comfortable with the surgery, it's ok to put it off long enough to get a second opinion. But not fainting is not a guideline to go by. You want your rate to go up when you exercise, to not dip under 60 at rest or asleep, to not pause. Other symptoms are fatigue, dizziness. I found after I was paced that I didn't feel as good as I thought I did before. I went downhill so gradually that I had not idea how bad it was until I had a new normal to compare it to. 

I could be wrong but I thought the Micra AV was for ventricular pacing, for av block. SSS would be atrial pacing. Do you have av block also? 

I thought I was missing something.

by AgentX86 - 2020-08-06 21:26:27

I'll ring the bell again... I don't see how a Micra AV can help SSS without causing AV dyssynchrony at the same time.  That just seems silly to me. It's certainly worth another opinion or at least more education.

As Tracy says above, syncope is to be avoided at all costs.  Falls are bad enough but if it happens when you're on stairs or while driving, it could get very bad. 

When a pause happens, you rely on your heart restarting itself.  As the time between when it stops and restarts itself grows, the chance that it won't restart becomes greater.  Sudden cardiac arrest is possible.

A pause of 4.7s isn't the end of the world but it's not good, either.  It won't get better.  It's time to fix it.

How did your pacemaker implant go?

by MaineGrammy - 2021-06-19 21:02:50

I just read your post and realized that it dates back to 2020. You were apprehensive... I'm curious--did you get a pacemaker implanted? If so, was it a Micra or another type? I hope it went very well, and that you now feel wonderful.

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