do I need to be concerned

[valtick]

I had rheumatic heart disease as a child.  I had my aorta valve replaced with a mechanical valve 01/11/05, seven days later they did a biventricular pacemaker.  I am still having lightheadness and blackout(where things go black for a few seconds. (This was the reason for the surgery)I have swelling of the lower legs, ankles and feet and abdomen/I am 53. The doctors say I am still having arrythmias.  Why would I still be having arrythmias after a pacemaker?

[bigmick]

Hi, have you tried for a referral to see Dr. Natale (widely regarded as THE ablation guru for AF in the US) at Cleveland Clinic for a further (and, from current evidence - although without knowing your medical history - likely successful) ablation??

BM

[cryingheart]

You should check your echocardiogram results and look at your ejection fraction. Your symptoms sound like pretty significant heart failure (swelling, blackouts).

[BABlocker]

I am a 48 year old woman with severe atrial arrythmias, including atrial fibrillation/flutter; have undergone 2 PVI ablations, 1 cardiversion, 4 antiarrythmic meds and 3 rate control drugs and all were unsuccessful in controlling the high high rates (over 200) coupled with low heart rates (30s). On 8/10/05, I had a Medtronics Insync III biventricular pacemaker implanted. I do not have cardiomyopath or CHF but the bivent pacer was suggested in order to prevent such occurrences in the future as a result of long term ventricular pacing of only the right ventricle, as would happen with a dual chamber pacemaker.

It was a tradeoff--I was not able to benefit from some of the dual chamber pacemakers that deliver and detect atrial arrythmia therapy.

I continue to have atrial fibillation and flutter, and continue to feel the flutter, although the pacemaker seems to do a fairly good job of pacing me back down when the high heart rates occur, so clinically I am much better. Eventually I am told that I will be in continuous atrial fibrillation. I am glad that I have the pacemaker to keep my heart rates in check and I am able to work, play, exercise strenously and feel pretty well most of the time.

I would be concerned that you continue to have symptoms such as dizziness and feeling like you are going to pass out as well as problems with swelling and edema. Tell your cardiologist immediately and make sure you are in the care of a knowledgable electrophysiologist well versed withe bivent pacemakers; there may be programming that can be done to alleviate your symptoms. Good luck to you!

[CCF-M.D.-MJM]

Hi Valtick,

Sorry to hear about your recent health concerns. Biventricular pacemakers are about 2/3 successful in treating significant heart failure (New York Heart Association class II through IV symptoms).  Unfortunately, it usually does not treat primary arrhythmias like atrial fibrillation, atrial flutter, or ventricular tachycardia.  It does offer more alternative for adding medical therapy like beta blockers, amiodarone, sotalol et al. There is probably more that can be done, although it is tough to say what the options are with out knowing what the arrhythmia is. Be persistent with your doctors and if you don't feel like you are making progress, try a second opinion.

I hope this helps.  Good luck.