Permanent Pacemaker

I have recently had an AV node ablation and permanent pacemaker implanted for uncontrolled atrial fibrillation.  Now I am totally pacemaker dependent and it has a VVIR pacer settings.  What happens if the ventricular lead would fail?  Will there be an intrinsic rhythm to sustain me until the lead is repaired?  or is it true that once one has been pacemaker dependent for a year or more, there would not be an intrinsic rhythm?  I am very thin so my pacer wires are very visible and actually protrude a bit.  I am watching the area for any redness etc which would be a sign or eroding, I am told.

Thanks for answering my questions.

[CCF-M.D.-MJM]

Hello Rick,

If the ventricular lead fell out or failed to capture, you would likely have a slow, underlying heart rhythm that we call an escape rhythm.  It is possible that there would be no underlying rhythm, but very unlikely.  If the lead falls, you will likely become lightheaded, dizzy, and unable to do you normal activity.  If you experience these symptoms, you should either call 911, go to an emergency room or call your doctor, depending on how serious your symptoms are.

Fortunately this seldom happens. After the initial lead placement, if the lead is stable over the first 24-48 hours, it is usually there for good.  When you visit your doctor or when he interrogates your pacemaker over the phone, they receive technical information about how well the leads are working and how good the connection is.

It is a good idea to watch the pacemaker site for redness, but makes sure you don't play with the pacemaker or touch it too much.  There are cases of people who dislodge their own leads because the play with the pacemaker too much.

I hope this helps and thanks for posting.

[bigmick]

Rick,

Just interested to learn how you're doing now having had the procedure as compared to previously. I presume your AF was highly symptomatic and that you are now able to function normally as in pre-AF??

BM

[Rick9897]

My heart rates before the AV node ablation were up to the 190s and persisted around 160 at rest.  So, I did not tolerate activity and it was difficult to carry on with activites of daily living.  Now I am much better but I still have no reserve.  I am taking amiodarone for two months, then I will be cardioverted one more time to see if I can get into sinus rhythm.  If I do, then they will revise my atrial lead and then I will have the atrial kick which may help.  I do truly wish I did not have to have the AV node ablated.  It is a scary thing for me but nothing else worked and there was increasing risk for heart failure secondary to the high rates.  So far, I have no muscle damage.

[bigmick]

Thanks for the answers. Just wondering, however, why you didn't go for PVA or maze for the AF as opposed to going 'straight' for node ablation?

BM

[Guenter]

I had a maze procedure...diddn't work.  Actually, I had it twice in the left atrium and they also did my right atrium for atrial flutter. I have had everything and never wanted an AV node ablation.