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Heart Disease (Expert Forum)
AV Node Recovery
Answered by
Cleveland - OH
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve, Pacemaker, PAD, Stenosis, Stress Tests
AV Node Recovery
by toby7, Sep 22, 2004 12:00AM
I had an ablation done 3 years ago for WPW and atrial flutter. I developed complete heart as a result and had a pacemaker implanted. Recently, I’ve been having symptoms of shortness of breath, fatigue, tachycardia, palpitations, and my heart speeding up and slowing down randomly. The doctors haven’t been able to figure it out. The other day the pacemaker people saw that my heart was conducting on it’s own. It has a block only on occasion, so they turned down the pacemaker to let it beat. When Dr. Wyndham here in Dallas did the ablation, he told me that he didn’t know if the av node had problems before or if he ablated it. I can’t find a good doctor here and he has retired unfortunately. He wrote in his notes that “the His bundle was not recordable in the baseline state” and that there was “somewhat depressed av node function in both anterograde and retrograde direction in the baseline state”.
If there was something wrong with the av node to begin with, how could it just come back? If that’s the case, will I go into block again? Have you heard of this happening before and is it bad to have the pacemaker turned up 100% and have my heart beating normally? I was feeling pretty bad. They want to do another ablation for the flutter, but I believe most of my symptoms were due to the pacemaker and my heart competing (for lack of a better word). I’m still tired, but I don’t have all of the weird beats now. Thanks for your help!
If there was something wrong with the av node to begin with, how could it just come back? If that’s the case, will I go into block again? Have you heard of this happening before and is it bad to have the pacemaker turned up 100% and have my heart beating normally? I was feeling pretty bad. They want to do another ablation for the flutter, but I believe most of my symptoms were due to the pacemaker and my heart competing (for lack of a better word). I’m still tired, but I don’t have all of the weird beats now. Thanks for your help!
Doctor's Answer
by Cleveland Clinic, Sep 22, 2004 12:00AM
, Sep 22, 2004 12:00AM
toby,
thanks for the post.
Its possible that your AV node didnt function normally to start. Its also possible that it could have been damaged worse at the time of the procedure, and has slowly recovered. Im not sure if you have had medicines started or stopped, but aside from recovery on its own, which can happen, changing medicines may have allowed it to recover.
Its impossible to tell if you would go into block again, but with a damaged conduction system, the possibility is certainly increased.
A pacemaker can be a wonderous thing. However, some people can have symptoms from the pacer. There are a multitude of ways to pace to get around this, and talking with your EP physician should help get started. Alon, pacing 100% of the time is not necessarily dangerous.
Work with you EP to determine if your symptoms are from your pacer or your flutter before trying another ablation.
good luck
thanks for the post.
Its possible that your AV node didnt function normally to start. Its also possible that it could have been damaged worse at the time of the procedure, and has slowly recovered. Im not sure if you have had medicines started or stopped, but aside from recovery on its own, which can happen, changing medicines may have allowed it to recover.
Its impossible to tell if you would go into block again, but with a damaged conduction system, the possibility is certainly increased.
A pacemaker can be a wonderous thing. However, some people can have symptoms from the pacer. There are a multitude of ways to pace to get around this, and talking with your EP physician should help get started. Alon, pacing 100% of the time is not necessarily dangerous.
Work with you EP to determine if your symptoms are from your pacer or your flutter before trying another ablation.
good luck
I have an ICD for vt's. Previous MI. I went into full heart block after my OHS for MVR - but came out of it for a couple mos. and now I'm back in it intermittently. My meds have not changed - only additional med is 'coumadin' since my surgery.
Today after my pacemaker was programmed 'on' I could feel it kicking in and I had difficulty breathing - everytime it came on. I don't care if it comes 'on' - I just want to walk and breath and I especially want to RUN and breath.. and the pacer gives me a shortness of breath when it comes on.
I had read once that as a runner the "DDD" program worked well. My EP is fantastic - but I don't think he gets many marathon runners with ICD's for vt's and now full heart block walking in and saying - I don't like this program doc - I want a running program?? I know he would give me the best program possible. But I want to go back to him with some 'concrete' evidence that another program 'might' be better suited for me.. This 'rate' response feature on this model isn't all that 'great' if you ask me.. It responds about two minutes after you ask for the beats.. Which by the time it responds - its rather late to do a catch up.. Not that I'm complaining as I know the models today are much more sophisticated than in the past. Guidant already tells me these things were made for marathons.. But MAYBE they can...
Q1. Is it a reasonable question to ask my EP to give me the DDD program even though I have full heart block at times? I was breathing better yesterday without the pacemaker program 'on'. I'm tempted to ask him to shut it off - but from what I''ve been reading - I should have it 'on'.. due to full heart block...
Q2. How do I go about finding out exactly what the "settings" are for the DDD program? I had my ICD inplanted in 2001 - a Guidant 1861 model.. maybe I need a more 'recent' ICD that has 'more' features than this one..
You mentioned there are other programs that are more user friendly without feeling the pacer on.
Q3. What other programs are available for runners with full heart block and I know this is a big question but - what exactly are the settings?
Q4. Can a person who has 'full' heart block safely have the DDD program? I'm a runner and I know after today - this VVI program or whatever it is - my EP said I'm programmed at 'max' on my programming.. I want to walk and run and BREATH.. all at the 'same' time - any suggestions?
I've tried posting several times - but can never get through..
I'm sorry - but do you have any suggestions? I'll try to keep posting these questions for several days.
Sincerely,
Marilyn (runner)
Konopka1955