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Pacemaker/Stress Echo
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Pacemaker/Stress Echo

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!
Related Discussions
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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.

22 Comments
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I have had an AV Node ablation and am 100% paced now.  The pacemaker actually creates a bundle branch blook which can cause dysnchrony of ventricular contractions.  So, in my case, since I am now in heart failure, their goal is to resynchronize with bi-ventricular pacemaker.  This improves the ejection fraction in about 70% of people.
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Some you you guys are really abusing this board.  Not to be little any ones questions.  However you guys know the rules about posting.  This is like the 4th time in the last month someone hasnt waited the time the forum ask.  Toby your last post was like 3 days ago.  I realize everyone is concerned and just wants some reassurance.  However this isa getting crazy.  These drs are giving us their opinons for free and the least we can do is go by their guidelines.
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Yeah apparently you can tell people like toby and dottycece but they are apparently very selfish people. It never ceases to amaze how some people take advantage and seem to ignore the rules made to benefit everyone who visits the forum. Well I hope a few bad {selfish} apples don't spoil it for all!!!
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Avatar_n_tn
I don't think anyone is selfish.  These are legitimate questions that are quite complex.  It is interesting how many ways the whole PVCs etc are asked over and over and no one comments about that.  The questions you refer to are at least new questions that are very interesting and not easily understood.
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Avatar_n_tn
Some, if not most, are way too preoccupied with your health...just live for crying out loud. Live every day as if it's your last for one day you'll be right.

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.
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21064_tn?1309312333
Hmmmm...Lots of bashing today.  I'll admit I am a frequent visitor and reader of the forum questions and answers.  Like many others, I have a thirst for knowledge and a desire to understand more about my health.  I had pvcs (yes, pvcs...you know, the harmless ectopics that so many have) that led to a cardiomyopathy.  My situation is considered rare, but very REAL!!  Fortunately, the kinds forum doctors communicated with my own physician and today I am nearly pvc-free.  

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.
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I understand some need a little reassurance.  However this is getting to be insane.  The forum its self asked that you limit the number of questions.  Whats so hard to understand about that.  Im not bashing anyone.  I just think out of respect to others and the forum people appreciate and abide by the rules.  Whats so hard to understand about that?  I have posted a question here I think 3 times and I have always waited the time allowed.  To the person going on and on about being preoccupied by their health.  You need to get a life.  Tather it be a pvc or something else to do with the heart.  When your heart is doing funny things it scares you no matter how trivial they seem .  Come on its your heart not that your having a bad hair day or something.  WHen you get a degree in the mental profession why dont you come back and perscribe us all SSRIs.
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Avatar_n_tn
I agree with you completely.  It is very interesting that people get so worked up.
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Avatar_n_tn
I hate to say it...but i told ya' so!
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Avatar_n_tn
Hello all:
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
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Avatar_n_tn
Hi All,

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
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How did you get to the point you are almost pvc free?  I would like to know how to get pvc free without having to have another ablation.

Glenn
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Avatar_n_tn
God!  Ya'll are hilarious!  I haven't read the "rules" of the board.  The 10 commandments weren't written in stone on my computer.  Get a life!  You people must just sit and wait here all day.  

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.
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21064_tn?1309312333
Hi Glenn,

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?
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21064_tn?1309312333
Hi L,

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
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Avatar_n_tn
I have A-Fib and have had 6 cardioversions, 2 ablations, Was on
tambocor, attenolol, now on Amirodone (sp) still out of rythym.
Has anyone else had this problem?
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Hi,  I've had 3 ablations and one ablation was 100% which was my av nodal re-entry tachy (avnrt) - but the vt ablations were not -and the reason I say 100% on the avnrt is because I did NOT need to take any medication after the procedure.  

I've been told that if you still have to take meds after an ablation - then chances are the ablations were probably not a 100%.   I could be wrong..  But it does make sense..  

Best Wishes
Marilyn  (runner)  
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Avatar_n_tn
Thanks for your comment.  Medication is not working cardioversion held once for a year and a half which was done back in 2002.  This year the ablations with the study first, one lasted for 8 days and the last one for 2 months.  Then I was cardioverted again about 2 weeks ago, but it only lasted for about 3 or 4 days.  Now he has changed the meds but can't take full dosage because of side effects.  I am wondering if there is a pacemaker which works for A-Fib.  Holly
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Avatar_n_tn
HI, I'm sorry but my ICD device is for VT's and I'm not familar with having a pacemaker to solve a-fib problems.  I would ask the CCF doctor about this or ask your own doctor.  

I know pacemakers can be a godsend - as without mine I could not walk, talk and breath at the same time.  I can't say enough wonderful things about my quality of life - for without my pacemaker - I would not be able to 'function' well at all..  

I also just thought - you could check out the various pacemaker manufacturer web sites and see what their devices are capable of doing.  They are becoming more high tech every year..  Perhaps they can tell you about A-Fib and what they may offer.  There's two brands that I know of and they are Guidant and Medtronic.  There may be one or two others.  But those two manufactures are well known for manufacturing pacemakers..

I would also check out the American Heart Association - they've always given me some great information.    

Good Luck
Marilyn  (runner)
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Avatar_n_tn
If fault is to be pinned on anybody regarding
excess access by the few to medhelps Cardios,
I believe it should fall on the absence of any
randomization of 'acceptance' of postings by
medhelp.org and its websites software.






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Avatar_n_tn
I am also wondering how much low magnesium has to do as a cause of A-Fib.  I have done some research on other sites which say that low Magnesium can cause a-fib.  Has anyone else heard this said?
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