pacemaker syndrom

[nuti]

DEAR DOCTOR,           I have undergone 6years ago a mitral valve raplacement and..unsuccessful Maze procedure to cure my Atrial fibrilation.Maybe the left  unlarged atrium,(5,3 )whas the raison for this failling procedure   i don't know...
I took different antyarhitmic drugs and have had some elecrtical cardioversion having only some short atrial fib event...
One day i stoped the amiodarone treatment because thyreotoxicosis; Later Propafenone helped me for a while..and than started my lightdeadness with the 5-6second conversion pause....the last has happen in the hospital and the doctors implant me a pacemaker. It was 9months ago .from then i'm adifferent persone fatigue, breathless and the Afibb became almost permanent...Could anyone help me ,please/?
Anita

[PikaPika88]

Hi Jerry,  if they do ablation or pulmonary vein isolation after the av node ablation, then it is a different result or different case. In this case, they might not require medication if it is the successful PVI.

My doctor turn off my A-Fib suppression.  Sense the Atrial and pace the ventricle if A-Fib or A-Tach occurs.  I don't need to take blood thinner or heart med.  My A-Fib is very short (not full time) one.  It only last for a few seconds.  It then conducts to ventricle through the accessory pathway (wpw).

[Jerry_NJ]

Thanks for the good input/help.  I know there are others on the Community who have extensive knowledge and experience with AV Node Ablation.  Maybe one of more will read and add their inputs.

I was unaware that the Atrial flutter/fibrillation would/could continue after AV Node Ablation, but checking the "web" I see a confirmation of that fact.

[PikaPika88]

So far as I know, av node ablation is just a block the activities in Atrial travel to the ventricle.  If you're in A-Fib or A-tach, you still required medication to control the rates after the av node ablation.  

Pacemaker also can control the fast rate at ventricle by setting the pacemaker mode to VVIR.  The A-Fib remain in Fib at Atrial. Just you don't feel it.  All you feel is ventricle pacing rate.  It also required medication to control the A-Fib otherwise it'll fib to dead.  If it is the long term permanent pacing in right ventricle also can cause heart failure in the future.

The best check with your doctor and double confirm it.  I get those info from the various forums and my cardiologist.  Hope it helps you to make your decision.  Also hope it helps you to raise questions to your cardiologist when you're undergo this topic.  Take care.

[nuti]

Thank you for answering me; sorry i post my Email to the wrong adress. Is the second time that is happened to me( late hour maybe)  and i am grateful getting your comment to my post. I understand you gave up to the "Rhytm control" and choose only Metoprolol for Rate control, if it's enough for you  don't need the  antyarhytmics drugs
    risks and side effects.I used several years Amiodarone beeing in synus rhytm but now this drug induced me thyreotoxicos (thyroid disfunction)  and must remove it;I take like you a betablocker (Bisoprolol) and calcium chanel blocker Verapamil  but my overal bpm is110   -100   in the minimal activity (almost resting) and this  is  not so good... I thing the pacemaker implant wasn't a right decision for me ; it's help me only to take HIGH drugs doses whithout worrying to BRADICARDIA  ,but don't help me with my Atrial fib.  One of EPdoctors proposed me  AV NODE ABLATION;   IS HARD TO DECIDE TO GO ON THIS .People who i know , they    have  undergone  this procedure still, feel some ATRIAL fib. and even some ectopic rhytm rest, they are pacemaker dependant!! What you now about AV NODE ablation? Do you know people they have this procedure?  IF they want to answer me you can  give them my E mail adress:
***@****
best regards
Anita.

[Jerry_NJ]

This is a patient community and normally does not get responses form medical doctors.  There are Forums in the MedHelp group that are supported by doctors, and there is a fee associated with use of those Forums.

To your point, I can share I too have had a mitral valve repair (not replacement) and a mini-maze procedure, the latter to cure my AFib.  I was in sinus rhythm for about 30 days following surgery and then went back into full-time AFib. The surgery was in November 2007, so some time back.  I have undergone one electrocardioversion in August 2008 and was in sinus rhythm for about 7 days, then back into AFib.  I am currently just "managing" AFib with Metoprolol to control my heart rate, to keep it below 100 when at rest.  I go into the 70s to low 80s when fully at rest.

It too have an enlarged left atrial chamber, 5.4 cm best I can recall, and that is at the root of my problem.  The likely cause of the large atrial chamber is the past leaky mitral valve, which no longer leaks. .. but too late to stop the enlargement that took place over many years of a leaky valve.  The leaky valve was not diagosed until after my AFib became active, about 10 years ago.