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Heart Disease (Expert Forum)
Pacemaker problem or is it?
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Pacemaker problem or is it?
by officemanager, Dec 23, 2005 12:00AM
Pacemaker inserted in Sept. for SSS. Difficult insertion. Pneumothorax, etc. From the beginning I could feel "a clicking" and some pulsating pain when the pacemaker came on which was mostly fixed with reprogramming. But I still feel a strong pulsation in my back when I'm pacing, especially at my desk, chair, or in bed. It's very annoying. The EP said that I am pacing 45% in the atrium, none in the ventricle and that the leads are probably not in the optimal spot (maybe heart tissue next to nerve) but OK and working and since the pulsating is not painful or keeping me from sleeping, to just get used to it--basically not worth the risk to move the leads.
Well, OK--I understand that on one level, but it is so annoying. I also understand that she didn't quite know what to make of the pulsing in my back--maybe it's "referred"--I don't know.
Question: Anything else to do at this point? I know exactly when I'm pacing because of this annoying pulsing.
Thanks for taking my question.
Well, OK--I understand that on one level, but it is so annoying. I also understand that she didn't quite know what to make of the pulsing in my back--maybe it's "referred"--I don't know.
Question: Anything else to do at this point? I know exactly when I'm pacing because of this annoying pulsing.
Thanks for taking my question.
Doctor's Answer
by CCF-M.D.-MJM, Dec 23, 2005 12:00AM
Hello,
This is tricky because it is a question of risk / benefit.
The risk is that anytime you open a pocket to work with a pacemaker, you run 1-2% risk of infection. Infections are dangerous. Infections usually require the pacemaker and leads be extracted. For newer devices (implanted less than 6-9 months), this is usually not a big problem because scar tissue hasn't formed yet. For older leads and devices, we sometimes need a laser to extract the leads and there is a about a 2-5% chance of a major complication.
It all depends on how much this is bothering you and whether you want to take this risk.
There are options for programming that may reduce the problem but they should have tried them already:
1. reduce the lower rate limit for atrial pacing so you don't need as much pacing
2. lower the pacing signal amplitude so the stimulus isn't as strong and may not stimulate the muscle or nerve.
I hope this helps and thanks for posting.
This is tricky because it is a question of risk / benefit.
The risk is that anytime you open a pocket to work with a pacemaker, you run 1-2% risk of infection. Infections are dangerous. Infections usually require the pacemaker and leads be extracted. For newer devices (implanted less than 6-9 months), this is usually not a big problem because scar tissue hasn't formed yet. For older leads and devices, we sometimes need a laser to extract the leads and there is a about a 2-5% chance of a major complication.
It all depends on how much this is bothering you and whether you want to take this risk.
There are options for programming that may reduce the problem but they should have tried them already:
1. reduce the lower rate limit for atrial pacing so you don't need as much pacing
2. lower the pacing signal amplitude so the stimulus isn't as strong and may not stimulate the muscle or nerve.
I hope this helps and thanks for posting.
