A-fib

Goodmorning. I have a couple of questions I wonder if you could help with.  I take the following meds. amiodarone, cartia,coumadin,lasix,aldactone,midodrine, and I have a pacemaker. When last I saw my cardiologist he said I had pacemaker syndrome.  On/off, I have head fullness when lying down, trouble breathing, and fast onset edema. I do not have high blood pressure when lying down from midodrine. My doctor changed the mode of the pacer from VVI to DDDR, to see if that would help.  He also reduced my dose of amiodarone. Now I have a-fib much more often, and the same symptoms despite the mode change. I was told that pacemaker syndrome was due to the top and bottom chambers being out of sync.  So my question is...
1. Doesn't afib cause the upper and lower chambers to beat out of sync, and wouldn't this have the same effect as pacemaker syndrome?
2.  Why can some people live with afib and others can't?
Also, my chart says I am NYHA class stage 2.
3. Is this a stage of heart failure, or can it just be functional ability?
Lastly, I have moderate regurg. in my tricuspid valve. I was told due to pacemaker wires.
4. Will this type of regurg. eventually get worse and need to be treated?
Thank you so very much. I hope I am not redundant with my questions.  Have a great day!

[CCF-M.D.-CRC]

Dear cn,
1. Doesn't afib cause the upper and lower chambers to beat out of sync, and wouldn't this have the same effect as pacemaker syndrome?
A: To some degree but not in the true sense of the syndrome where there is a normal atrial contraction against a closed tricuspid valve resulting in backwards expulsion of the blood from the right atrium.
2. Why can some people live with afib and others can't?
Also, my chart says I am NYHA class stage 2.
A: ????
3. Is this a stage of heart failure, or can it just be functional ability?
A: The best way to sort out this question is with a metabolic stress test.  This test can determine if your symptoms are due to heart failure of just being "out of shape".
Lastly, I have moderate regurg. in my tricuspid valve. I was told due to pacemaker wires.
4. Will this type of regurg. eventually get worse and need to be treated?
A: Not necessarily.  It will need to be followed but may never need treated.