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Heart Disease (Expert Forum)
Pacemaker/Stress Echo
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
Pacemaker/Stress Echo
by toby7, Oct 11, 2004 12:00AM
Hi Doc, I'm going to post this last question and stop bothering you for a while!
I just had a stress echo done which showed moderate pulmonary hypertension, moderate tricuspid regurgitation, and mild right ventricular dilation. I also coincidentally had my av node just start to function again. I was in third degree heart block for the last three years from an ablation. The pacemaker pacing full-time and my av node working were giving me really strange symptoms, and since they've turned the pacer down, I'm feeling better.
My question is, do you think that while the pacer was working along with the node that these two things could have caused these echo results?
Also, should the echo show paradoxical motion during exercise and at rest with a pacemaker? This seems to go along with the other symptoms too.
Thanks for your help!
I just had a stress echo done which showed moderate pulmonary hypertension, moderate tricuspid regurgitation, and mild right ventricular dilation. I also coincidentally had my av node just start to function again. I was in third degree heart block for the last three years from an ablation. The pacemaker pacing full-time and my av node working were giving me really strange symptoms, and since they've turned the pacer down, I'm feeling better.
My question is, do you think that while the pacer was working along with the node that these two things could have caused these echo results?
Also, should the echo show paradoxical motion during exercise and at rest with a pacemaker? This seems to go along with the other symptoms too.
Thanks for your help!
Doctor's Answer
by CCF-M.D.-MJM, Oct 11, 2004 12:00AM
Hi Toby,
BKJ answered your last questions. I read his response and agree.
Unfortunately, there is no way to know if the pacemaker caused the echo findings. Right ventricular pacing can cause heart failure, this is true. If this is the case, now that your heart is using its intrinsic conduction system, your right heart function may improve. I don't think the absence or presence of AV node conduction plays a significant role unless it was causing arrhythmias.
Yes, pacemakers cause the septum to move differently than normal. This should improve as well if you are conducting normally again.
I hope this helps answer your questions. Good luck.
BKJ answered your last questions. I read his response and agree.
Unfortunately, there is no way to know if the pacemaker caused the echo findings. Right ventricular pacing can cause heart failure, this is true. If this is the case, now that your heart is using its intrinsic conduction system, your right heart function may improve. I don't think the absence or presence of AV node conduction plays a significant role unless it was causing arrhythmias.
Yes, pacemakers cause the septum to move differently than normal. This should improve as well if you are conducting normally again.
I hope this helps answer your questions. Good luck.
Most here have worked themselves into a real anxiety disorder by obsessing over many items that have been certified as harmless by not only their own physicians/experts but by a physician on this board replying with little if no patient history/information available...Shame on the Clinic doctors for not "pushing" some to move on and stop worrying. I did see a good reply today by the forum doc to a nurse about her worrying too much about her health (I see it too in where I work). I was encouraged...Forum docs should try to keep track of those multiple posters and encourage them to get a psych evaluation...that's not to mention the few who have the obsession of practicing medicine in some manner to alliviate their own anxieties or maybe improve their own self image. Those, and you know who you are...should consider taking your posts to your therapists or consider the need to titrate up their SSRI doses just a tad and move on. You still put some lives in danger...and those who rely on these lay medical opinions, well you have my prayers.
I stop by this page once a month as it's still in my favorites pull down but I see the same people...still asking if they will be alive next week...and guess what, they are!
Stop worrying about Dottie or others and stop worrying about yourselves too.
Sure, MOST of the time ectopics are considered benign, but do not underestimate the possibility of a rare complication.
I have been reading this forum for over 2 years, and I am disappointed in the number of "bashing" comments. Come on guys, give it a rest. Understand that some people need a little more reassurance, and many have problems that most of us couldn't bear. Open your "hearts" and be listeners...You may learn something.
I understand both perspectives here. I don't think anybody is really bashing anyone.
Here is a possible idea to help remember when we are able to post again: put a note on your calendar, planner, computer when your 2 months have elapsed and you are free to post again.
I really have enjoyed the forum since I found it a year and a half ago. I have posted once and am looking forward to posting another question in November.
Sincerely,
Uptown
Have posted a couple times never got any response, but some of you must have great timing for the questions. Have a good one should one have another EP study before each ablation precedure?
I have appt at Duke on this monday for many diff things pvs pacs couplet svts feel really bad everyday. Just finished event monitor for month, shows alot. My cardio doc has referred me to duke by my request. What is your experience with this. Have been reading forum for 5 month or so, since last albation in April. Have any of you had this done more than once.
Thanks L
Glenn
Kristen thanks for the reply. That looks like a possibility. I'll have to look into that. It would be good if that were the case because the other possibility (being pulmonary hypertension) is a lot worse and that gives me a little bit of hope anyway.
I was having over 20,000 (24% of my daily beats) pvcs per day. Thousands of couplets, NSVT, etc. Was on/off beta blockers for about 20 years. Tried tambacor and rhythmol for about 7 months (one at a time) and though they worked pretty well, I didn't like the side effects. I was told that because the pvcs were causing cardiomyopathy, I would have to be on anti-arrythmi- unless I wanted to try an ablation. I was multi-focal, but the strips showed 2 very predominant sites. I was pretty scared, but went ahead with an ablation August 2003. About 6-8 weeks later, holter still showed about 6,000 ectopics/day and doctor wanted the activity reduced further. She asked if I was up for another ablation, and I decided it beat being on the meds for life. Had the second ablation November 2003 and have been nearly pvc-free since. First ablation was to the right side of my heart, and the second was to left side. I do still get occasional pvcs, but I actually have days/weeks go by when I do not feel any extra beats. That took a bit of getting used to after having had so many pvcs for so many years.
Have you had an ablation? Did it help at all?
I've had two ablations and each time an EPS was also performed. I knew ahead of time that I might need more than one ablation. I was multi-focal and the doctor told me she wanted to proceed cautiously. My ablations were for NSVT and tons of pvcs. Fortunately, both procedures were successful. Prior to the first ablation, my ejection had dropped to 40%, but at last check (6 months after the 2nd ablation), I was back at 55%!! Good luck at Duke next week. Please let us know how you make out. I may be moving near Duke in the future and would love to hear if you locate a good (and friendly) EP : )
Connie
tambocor, attenolol, now on Amirodone (sp) still out of rythym.
Has anyone else had this problem?