Anyone have a valve replacement AND a pacemaker?

[Enigmalady777]

I had mitral valve replacement (mechanical valve) last year in March. Now it is looking like I will be needing a pacemaker for my aFib/high heart rate in the next couple of months.

I had the aFib prior to needing the heart valve replacement, but never this bad. Since the surgery, (exactly a year after the surgery) I have been experiencing a high resting heart rate and all the symptoms of CHF that landed me in the ER twice in the past 6 weeks.Seems like the CHF is even worse than it was before my valve surgery. My edema was so bad last month, that when my cardiologist prescribed an additional diuretic along with my usual Lasix, I lost 18 lbs of fluid within five days. According to my cardiologist, now that the heart has healed from the surgery, there are new electrical pathways in my heart and they are miss firing. Nice.

Now I'm looking for whatever info I can find about having a pacemaker as well as anyone's experience with needing both a valve replacement and a pacemaker.

I feel like I'm going to turn into the bionic woman soon.

 

[LondonAndy]

Yes, I had my aortic valve replaced in 2014, and they accidentally damaged my heart's electrics so I ended up with a pacemaker a week later. It was about 4 months later that I actually started to think what do I need to know about pacemakers - no biggie in themselves. There is support site, www.pacemakerclub.com with more info, and you may well find someone with a similar situation.

 

[JonML]

Yep. Aortic valve replaced with a lilihi-castor(?) valve in 1979 (apparently St. Jude was just coming out)then replaced in 1990 then a mitral valve in 2000 which at the time they had trouble and corrected it because they needed another drain tube as the blood had pooled around my heart (both are St. Judes). Got a defibrilator/pacemaker at that time. Battery life approx. 7 years but mine went after 5. 2nd lasted 7 years and 3rd 7 years. Just had the 4th put in last Monday due to low battery life. I keep popping into and out of a-fib. so they put me on Tikosyn (which requires a 3 day hospital stay to make sure things are okay) and it helped alot. Was in a-fib. for about 9 months and they did a cardioversion but it only lasted a bit...story of my life lol. For me the obliqution(?) wasn't something they felt would work at any time. So the pacing basically you don't feel. The defibrilator makes the unit larger and being thinner it is noticable but again a reg. pacemaker isn't that bad both being noticed when it paces (mine paces when the heart rate gets below 60 bpm) or if you don't weigh 130# like me, very noticable .

 

[vitdoc]

The need and use of a pacemaker in your situation can be a bit complicated. You could need a pacer possibly because at times your heart rate goes very slowly and needs to be boosted. Or you could need one if the A. Fib goes too fast and the AV node that connects your upper heart electrically is purposely ablated to prevent the rapid A. Fib beats from reaching your lower heart. Then the pacer provides the electrical impulses to make the ventricles contract. This basically is making you have third degree heart block on purpose. Finally if you have the AV node ablated then you have to choose whether you have a lead in just the right ventricle or both the right and left ventricle to motivate contracture of the ventricles. The most common is just a lead to the right ventricle but it is more physiological to have leads to both. In patients in heart failure (which you sound like) a pacer to both ventricles would be better.
Having the pacer is no big deal and generally is rarely noticed. I had third degree block develop after my third open heart which was a repeat #3 aortic valve plus an aortic aneurysm. That was in 2006.
I have just had a replacement of my bi ventricular pacer due to battery issues. My pacer follows my normal heart beat and sends the signal to both the ventricles. I have been in A. Fib but not now. When in A. Fib the pacer recognizes the rhythm ignores it and paces at the rhythm it selects. But now it just follows my natural normal sinus rhythm since I went out of A. Fib.. Ask your physician why the specific need for a pacer , what is the strategy , and whether you will have just a right lead or a right and left leads to your ventricles.

 

[gerrychuck]

Another yes. I had a mechanical mitral valve installed in emergent circumstances in late 2012. On metoprolol since to deal with afib that was paroxysmal to start but is now pretty much constant. A loop monitor a year and a half ago revealed that my heart was taking 1 or 2 beat breaks at rest (up to 3.4 sec), and if I was taken off the beta blocker this improved somewhat, but then I was prone to tachycardia, so I was becoming somewhat brady-tachy. End result was a right ventricular pacer. Aside from the bump on my chest I would never notice it, and I am only paced at about 50% (mainly at rest/sleeping). As another poster noted you may be a good candidate for biventricular pacing, which resyncs the ventricals and results in much better ejection fraction. A disadvantage of right ventricle pacers is they cause a slight delay between contraction of the right and left chambers, which lowers the efficiency of the pump and reduces your left ef. Mine seems to have dropped from around 50 into the low to mid 40's. I was told recently that an lvef below 30 usually means they will go with biventricular and probably a defibrillator as well. Good luck! The pacer is absolutely not a big deal in itself.

 

[Enigmalady777]

Thank you for the responses. I feel better knowing that it's something that can be corrected and not at all that unusual.

 

[bobr33543]

I had mitral valve replacement (mechanical valve) last year in March. Now it is looking like I will be needing a pacemaker for my aFib/high heart rate in the next couple of months.

I had the aFib prior to needing the heart valve replacement, but never this bad. Since the surgery, (exactly a year after the surgery) I have been experiencing a high resting heart rate and all the symptoms of CHF that landed me in the ER twice in the past 6 weeks.Seems like the CHF is even worse than it was before my valve surgery. My edema was so bad last month, that when my cardiologist prescribed an additional diuretic along with my usual Lasix, I lost 18 lbs of fluid within five days. According to my cardiologist, now that the heart has healed from the surgery, there are new electrical pathways in my heart and they are miss firing. Nice.

Now I'm looking for whatever info I can find about having a pacemaker as well as anyone's experience with needing both a valve replacement and a pacemaker.

I feel like I'm going to turn into the bionic woman soon.

Aortic valve replaced in 12/2011 but surgery was botched so replaced again in 01/2012. After the second surgery the pulses were not reaching the ventricles so a St. Jude pacer was installed about 4 days following the second surgery. As everyone else has said, no big deal at all. In fact the pacer monitors most of your heart's electrical activity and will notify your cardiologist of any problems, probably before you even notice them. The pacer gets 'interrogated' on a set schedule (usually 90 days or 6 months) and will automatically send info if certain conditions are detected (low battery, malfunction, A-Fib, etc.).

I just had a bit of a pacer scare I would like to share. I have been having some back issues and I purchased an Icy Hot brand TENS machine at Walmart yesterday to see if it would help. This device is adhered to any area of the body that is having muscle aches. It generates very weak electrical pulses to stimulate the affected muscle(s) which helps to relieve pain and heal the muscle. After 10 minutes or so on the TENS I started to feel weak and started having tightness in my chest. I Immediately removed the TENS and checked on line to see if it was safe to use with a pacemaker. I did not get a definitive answer but there was enough evidence against using a TENS with a pacemaker to expect there to be a warning on the packaging. Nothing on the packaging or in the user guide! On the advice of my cardiologist, I am having the pacemaker interrogated tomorrow to see if it needs to be re-adjusted. I know I should have been smarter, but maybe by posting my experience will help someone else avoid a possible problem.

 

[DougWyndham]

I had mitral valve replacement (mechanical valve) last year in March. Now it is looking like I will be needing a pacemaker for my aFib/high heart rate in the next couple of months.

I had the aFib prior to needing the heart valve replacement, but never this bad. Since the surgery, (exactly a year after the surgery) I have been experiencing a high resting heart rate and all the symptoms of CHF that landed me in the ER twice in the past 6 weeks.Seems like the CHF is even worse than it was before my valve surgery. My edema was so bad last month, that when my cardiologist prescribed an additional diuretic along with my usual Lasix, I lost 18 lbs of fluid within five days. According to my cardiologist, now that the heart has healed from the surgery, there are new electrical pathways in my heart and they are miss firing. Nice.

Now I'm looking for whatever info I can find about having a pacemaker as well as anyone's experience with needing both a valve replacement and a pacemaker.

I feel like I'm going to turn into the bionic woman soon.

I had an aortic valve replacement (St Judes mechanical valve) 6 years ago. I've also had a pacemaker (Abbots St Judes) inserted January this year as the two chambers were not communicating with each other and I had an extremely low pulse. Siince then no more dizzy spells and all good so far

 

[Asystole]

I have a St. Jude mechanical aortic valve composite ascending aortic graft and a Boston Scientific dual chamber pacemaker. The pacemaker is for symptomatic bradycardia (resting HR was in the 30s). I had a-fib as well, but two catheter ablations are currently keeping my heart in NSR.

My valve and pacemaker get along well together. OP, you should have no worries having them both. Good luck.

 

[Dodger Fan]

Wow! I thought there were only a couple of us. I acquired 3rd degree heart block during AVR in 2016. I had pacemaker installed before going home. It was mostly a psychological blow to me. I had mentally prepared for AVR for 17 years. I didn't prepare for a pacemaker at all. I agree with everyone else, it's no big deal. They are amazing machines! I am about to have my 3rd MRI with a pacemaker.

 

[Enigmalady777]

Thanks to everyone who shared their stories. I am scheduled to have an ICD (which I understand is a pacemaker/Defibrillator) installed on June 20. A month after that I will have a catheter ablation to “zap” my heart’s faulty electrical system. Now I’m more concerned about the Defibrillator shocking me, since I read that it can seriously knock you out. What if I’m driving when it happens? I’m hopeful it won’t have to shock me ever, once the ablation is done. Like one of my friends told me “it beats the alternative - be thankful you’re alive and it’s amazing what medical advances we have today”.

 

[Asystole]

Thanks to everyone who shared their stories. I am scheduled to have an ICD (which I understand is a pacemaker/Defibrillator) installed on June 20. A month after that I will have a catheter ablation to “zap” my heart’s faulty electrical system. Now I’m more concerned about the Defibrillator shocking me, since I read that it can seriously knock you out. What if I’m driving when it happens? I’m hopeful it won’t have to shock me ever, once the ablation is done. Like one of my friends told me “it beats the alternative - be thankful you’re alive and it’s amazing what medical advances we have today”.

https://www.cardiosmart.org/News-an...-with-Implantable-Cardioverter-Defibrillators

An implantable cardioverter defibrillator (ICD) is a small device placed in the chest or abdomen of patients with an irregular heartbeat or history of sudden cardiac arrest. These devices send electrical pulses or shocks to the heart when they sense any abnormalities in heartbeat. For example, if a patient with an ICD has an irregular heartbeat or goes into sudden cardiac arrest, the device will send a shock to the heart to restore normal heart rhythm. ICDs can be life-saving, as cardiac arrest can cause death within minutes if not treated.
However, with an increase in ICD implants over the years, doctors worry about the risk these devices may impose on patients while driving a vehicle. When an ICD sends an electrical pulse to the heart, it can cause sudden pain and incapacitate patients. If this shock were to happen while a patient was operating a vehicle, it could cause serious harm to the driver and others around him. So should patients with ICDs be permitted to drive at all?
A recent study helped quantify the risk associated with ICD patients driving, in order to help provide concrete guidelines surrounding this issue. Researchers found that directly after implantation of an ICD, patients with private driving habits are at low-risk for shock and should therefore be permitted to drive. This also holds true for patients with an ICD following an inappropriate shock, which occurs when an ICD mistakenly shocks the heart. However, risk of harm while driving increases in patients with a recent appropriate shock, when the electrical shock was necessary to restore the heart’s rhythm. Following an appropriate shock, patients should be restricted from driving for 2 months, and those with a history of sudden cardiac arrest should not drive for 4 months.
It is important to note that these guidelines apply only to patients that drive for personal use, rather than professional use. Those with professional driving habits, such as truck drivers, should not be allowed to drive for this purpose after receiving an ICD implant, as risk is substantially higher than those with private driving habits.

 

[tom in MO]

Aortic valve replaced in 12/2011 but surgery was botched so replaced again in 01/2012. After the second surgery the pulses were not reaching the ventricles so a St. Jude pacer was installed about 4 days following the second surgery. As everyone else has said, no big deal at all. In fact the pacer monitors most of your heart's electrical activity and will notify your cardiologist of any problems, probably before you even notice them. The pacer gets 'interrogated' on a set schedule (usually 90 days or 6 months) and will automatically send info if certain conditions are detected (low battery, malfunction, A-Fib, etc.).

I just had a bit of a pacer scare I would like to share. I have been having some back issues and I purchased an Icy Hot brand TENS machine at Walmart yesterday to see if it would help. This device is adhered to any area of the body that is having muscle aches. It generates very weak electrical pulses to stimulate the affected muscle(s) which helps to relieve pain and heal the muscle. After 10 minutes or so on the TENS I started to feel weak and started having tightness in my chest. I Immediately removed the TENS and checked on line to see if it was safe to use with a pacemaker. I did not get a definitive answer but there was enough evidence against using a TENS with a pacemaker to expect there to be a warning on the packaging. Nothing on the packaging or in the user guide! On the advice of my cardiologist, I am having the pacemaker interrogated tomorrow to see if it needs to be re-adjusted. I know I should have been smarter, but maybe by posting my experience will help someone else avoid a possible problem.

If the Icy Hot TENS machine did effect your pacemaker, make sure it was reported to the FDA as an adverse event for a medical device. If the TENS machine is not classified as a medical device, I believe it can be reported to the Consumer Products Safety Commission. Reporting it is the best way to make sure a warning gets put on the package and to support someone's lawsuit if the manufacturer doesn't do it quick enough.

 

[Enigmalady777]

Thanks to everyone who shared their stories. I am scheduled to have an ICD (which I understand is a pacemaker/Defibrillator) installed on June 20. A month after that I will have a catheter ablation to “zap” my heart’s faulty electrical system. Now I’m more concerned about the Defibrillator shocking me, since I read that it can seriously knock you out. What if I’m driving when it happens? I’m hopeful it won’t have to shock me ever, once the ablation is done. Like one of my friends told me “it beats the alternative - be thankful you’re alive and it’s amazing what medical advances we have today”.

Ok, so I’m here in the hospital today. Had the ICD implant done, but only one lead - it took six hours and two top surgeons (three in total) to TRY to get the second lead in (the one to resynchronize my heart rhythm), but my anatomy is “unique” along with a lot of scar tissue from my MVR surgery last year. Talk about being bummed out when they told me this.

The doctors are changing up my meds, upping my dosage of coreg (wish me luck - beta blockers wipe me out and I had to go on and off them twice). The doctor wants to try to get the second lead in via the right side of my chest through the ribs. That will be a second surgery. We are trying the meds now in the meantime to see if I can get any improvement from them. My oxygen levels are too low so I’m on oxygen now but they don’t want to send me home with oxygen and they also want to see how I tolerate the higher dose of coreg here at the hospital before they send me home. The plan is/was to go home today, so we shall see. Like I said it’s endless.

 

[tom in MO]

Ok, so I’m here in the hospital today. Had the ICD implant done, but only one lead - it took six hours and two top surgeons (three in total) to TRY to get the second lead in (the one to resynchronize my heart rhythm), but my anatomy is “unique” along with a lot of scar tissue from my MVR surgery last year. Talk about being bummed out when they told me this.

The doctors are changing up my meds, upping my dosage of coreg (wish me luck - beta blockers wipe me out and I had to go on and off them twice). The doctor wants to try to get the second lead in via the right side of my chest through the ribs. That will be a second surgery. We are trying the meds now in the meantime to see if I can get any improvement from them. My oxygen levels are too low so I’m on oxygen now but they don’t want to send me home with oxygen and they also want to see how I tolerate the higher dose of coreg here at the hospital before they send me home. The plan is/was to go home today, so we shall see. Like I said it’s endless.

Good luck. Sorry to hear that things didn't work out as planned, but glad to hear you've come through the first hurdle "still ticking." It may seem endless, but take heart, things always change even if they seem to be staying still. Your body is trying to heal and come to a new equilibrium, even if you don't notice it at first.

 

[Enigmalady777]

So now I’m STILL at the hospital. The plan to discharge late yesterday (I was so close to escaping, lol) when the nurse noticed my heart rate in the 130s and it wasn’t budging for hours! Another med switch (added two) and I’m still racing around 120 - 130. Dr can’t promise I will even go home today until this heart rate garbage is at least somewhat stabilized.

This was supposed to be a “slam dunk” quickie surgery but has been anything but. But I digress, it really IS endless.