2:1 Heart Block, 3.3% Pacing – Did I need my Pacemaker?
I just had my semi-annual pacemaker checkup. I was told that my Medtronic pacemaker is pacing me just 3.3% of the time. I feel well, am running 5 to 6 miles every other day and also cycle regularly. My question is did I really need a pacemaker if it’s only used very infrequently? Could my underlying condition have improved since implantation? I was diagnosed with AV block Mobitz type 2 in January this year. No plumbing problems, heart rate increases normally with exercise. I had pauses up to 7 seconds at night (based on 24 hour holter monitor). Current settings are min rate 60 (50 at night), max 150. Rate response off.
Firstly, thank you for your question, its a good question and I am sure many other people are in the same boat!
As a pacemaker technician and not a Doctor I would be unable to answer whether or not your underlying condition could have improved, though it is not something I have personally come across in my working career to date. I am also unable to give you any medical advice or indeed speculate whether your pacemaker implant was appropriate or not..
I do know that our doctors at my practice consider every option before pacemaker implantation especially in the younger generation where they will then require multiple devices in their lifetime.
Pacemakers work as much or as little as they are required to…
A bit about intermittent conditions such as intermittent 2:1 HB.
In intermittent conditions (ones that come and go) it is not uncommon for pacemakers to have to kick in only briefly however the importance of the brief intervention is often paramount. If a pacemaker has just paced 3.3% of the time over 6 months it may seem almost negligible However if you look at those figures slightly differently then it can sound a lot more substantial. If we we consider there is 730 hours in the month then 3.3% of this is 24 hours (almost conveniently) so over every month the pacemaker is required to work for an entire day (cumulative).
Alternatively you could think of it as an average of 48 minutes each day.
Depending on how symptomatic a patient is, just a few beats of 2:1 Heart Block or other intermittent heart blocks, could cause dizziness or fainting… which could lead to injury to themselves or others.
Without seeing your file I could not say anything without any certainty but doctors are trained and will make the best decision based on the information they have. The ideal scenario is a patient who lives a totally normal life and who uses the pacemaker as little as possible.
When a patient feels so well that they question whether they even needed the pacemaker in the first place, I see that as a credit to their cardiology team and pacemaker staff.
If you do have any concerns over the reasoning/rationale behind your pacemaker and indeed how often it is working then I suggest you contact your Cardiologist and your pacemaker team, they will be able to answer your questions directly.
A complete explanation of these topics and more is available in the book Pacemakers Made Easy by Carl Robinson.
Thanks for reading,
Time for Football Training!
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