NYHA Class 1

This has been bothering me for some time and I'm wondering if anyone  here has this included on their transmission reports. My pacemaker is Medtronic, dual lead that I got in 2020 due to 2nd and 3 rd degree Heart block. 
At the top of my report, under History, it says " Normal sinus, frequent 2nd and 3rd AV block, NYHA Class I. 
When I Googled NYHA Class I I found that's the heart failure classification. Class I being no restrictions on activities or symptoms. I asked my doctor first since he's never said I was in heart failure. He said that's a Medtronic thing, not him. So months later when I asked the device rep, she didn't really have an answer. She just said it means I have no restrictions, etc.  What ? Never got a straight answer out of her. 
What I'd like to know, does anybody out there also have this on your reports ? 
It just seems rather arbitrary to me, if everything else is OK.

I realize this sounds like I'm " nit picking"  but it's been 102 degrees here for days, sticking pretty close to the A/C so I thought I'd pose the question.

5 Comments

You are not nit picking !

by Gemita - 2023-08-14 17:24:30

Hello Dixie Chick,

Sorry to hear you cannot get cool over there.  We have had the heating on, on and off throughout July/August.  Really miserable summer over here - well not summer at all.

What is your ejection fraction?  Have you had a recent echocardiogram?  I would get a copy of your last report or get another echocardiogram and then ask your Cardiologist/EP.  I wouldn't read too much into this.  As you know I have a Medtronic dual lead pacemaker for Sick Sinus Syndrome rather than Heart Block but there is nothing about NYHA on my reports.  I wonder whether 3rd degree heart block falls under the classification of NYHA Class 1 but otherwise it is meaningless unless you have symptoms of heart failure and an ejection fraction of less than 35-40%, but you need to know.

 

NYHA Class 1

by AgentX86 - 2023-08-14 17:29:08

All stage-1 means is there is some risk factor but there are no symptoms yet or restrictions.  It's likely that your pacemaker is the risk factor. There is nothing to worry about.

It is amazing that your cardiologist didn't know this.  NYHA is the bible for this stuff.  ...and no, it's not a Medtronic thing.  They aren't doctors.

 

NYHA Class 1

by Dixie Chick 65 - 2023-08-14 18:02:58

Gemita, I'm so jealous of anybody having a " cool" summer !  In December of 2021 my EF was 65 and I am feeling fine. Just the fact that is on the report bugged me. I know, it's not anything to worry about, but I did wonder if other people have the same. Thanks for your response.

Agent I came to the same conclusion.It's nothing to worry about but why is it on there ? Also I agree, it's just the fact I have a pacemaker, I suppose.

 I have no doubt my doctor knows what NYHA is. He just wanted to drop the subject, I think!


I've wanted to ask others about this for months and this afternoon I decided to go for it...Thank you and Gemita easing my mind about it.

 

NYHA

by AgentX86 - 2023-08-14 18:09:09

A doctor just "dropping the subject" isn't right.  You asked the question and deserve an answer.  I'm sure it's just a form thing.  It's a box that has to be checked or is automatically generated based on some other box that's been checked.  It still deserves an answer.

Leaving a question open can increase anxiety, which is exactly what they shouldn't be doing. Hiding information is never good (see: covid). This was a perfect opening for him to reduce anxiety and he blew it.

NYHA Classification

by Gemita - 2023-08-16 10:14:11

Dixie Chick, I have sent you a private message.  I know exactly what you mean and I would be slightly concerned too that they may not be telling me everything about my condition if that NYHA 1 Classification Code appeared on my Medtronic records.  

Looking at the NYHA classification codes in more detail, and going to a few websites, it does appear that Classification Code 1 covers functional heart disease states and just like functional disease of the bowel could mean something like irritable bowel disease, I would suggest functional heart disease could mean something like our Sick Sinus Syndrome or Heart Block?  Perhaps this means that NYHA 1 code for you does not mean the first stage of heart failure at all, but means the first stage of functional heart disease, although the pacemaker effectively treats your condition (Heart Block).  We all know that Sick Sinus Syndrome/Heart Block could progress leading to complicated arrhythmias, cardiomyopathy from an arrhythmia or from RV pacing and things like this.

I would therefore further suggest that AgentX86’s point about NYHA 1 classification possibly relating to our pacemaker being a risk factor for heart failure, might relate more to Heart Block/Sick Sinus Syndrome being a risk factor for heart failure, since both of these conditions are clearly functional heart conditions that could progress and cause heart failure symptoms over time for the reasons I have given above.

Even if I am wrong, perhaps my comments will help you to have that meaningful conversation with your doctors to better understand why the Code NYHA 1 has been placed on your Medtronic records, and the significance of this if different from my interpretation?

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