Upgrade to CRT-P

Same

by USMC-Pacer - 2023-08-26 14:17:53

My EF was as low as 20% at one point. I was implanted with a CRT-D back in March for PICM and probably a little too much alcohol too :) Anyway, between that and an AVR (#2) my EF is now estimated at 45-50% - hoping for more at my next ECHO next May. I had the choice between CRT-P or CRT-D. I chose D because the EP couldn't guarantee an increase in EF and wanted the protection. If my EF continues to improve, the EP will turn off the defibrillator. I could turn it off now, but I want more improvement.

Wishing you all the luck in the world for improvement!

CRT upgrade

by Clover - 2023-08-26 23:40:03

Thank you for your reply! Wishing you the best at your next echo and lots of improvement in EF. 

Thank you for sharing your pacemaker journey with us

by Gemita - 2023-08-27 03:51:25

Hello Clover,

I see you will be upgrading to a CRT-P pacemaker in a few weeks’ time and I sincerely hope it will help improve your ejection fraction (EF) and perhaps even reverse your pacemaker induced  cardiomyopathy from any right ventricular pacing. 

Cardiac Re-synchronization therapy (CRT) can be very effective for some patients, although it may take a few months to see improvements so you may need to be patient.  For some members, a combination of medication and CRT may be needed although the fact that you feel fine and are able to be active is a very good sign that your heart is still coping well.

Your cardiomyopathy and low EF should both improve with synchronised pacing from the CRT-P.   In any event the atria are disconnected from your ventricles, the latter being the main pumping chambers of your heart, so your ventricles should recover nicely Clover even though AF is still present in your atria.  

I see from your previous post that you have had your atrial lead turned off because you are in persistent/permanent AF.  With persistent/permanent AF, it is not unusual to disconnect the upper chambers from the lower chambers, so that the AF will no longer be able to push the ventricles too fast.  I would imagine the atrial lead would stay turned OFF especially while you are healing and until they see the results of CRT pacing.  Perhaps synchronised pacing will improve not only your EF and cardiomyopathy but also your AF too over time and they may be able to re-appraise whether the atrial lead still has a part to play?  It is good to have it in place just in case they might want to use it again one day?  Cardiomyopathy and a poor EF can certainly lead to heart rhythm irregularities, including AF, so it is possible that you will notice many other improvements too with CRT therapy. 

I wish you lots of luck for a successful outcome since I see you have had quite a journey with other health problems also and you deserve the very best care now

Thank you !

by Clover - 2023-08-27 15:57:00

Thank you, Gemita for sharing your knowledge and for the kind words! So glad I found this supportive club, such helpful information!