Anyone have a valve replacement AND a pacemaker?

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Enigmalady777

Member
Joined
Mar 27, 2018
Messages
9
Location
Santa Clarita, CA
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

VR.org Supporter
Joined
Aug 1, 2015
Messages
289
Location
London, UK
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

Member
Joined
Dec 22, 2014
Messages
6
Location
Erie, PA
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 .
 
Last edited:

vitdoc

Member
Joined
Apr 16, 2017
Messages
17
Location
Southern Ca.
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

Well-known member
Joined
Nov 17, 2012
Messages
164
Location
Moose Jaw, SK, Canada
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.
 
Last edited:

bobr33543

New member
Joined
Jun 26, 2015
Messages
3
Location
Tampa, FL
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

Member
Joined
Sep 25, 2016
Messages
22
Location
Andover, Hampshire. UK
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

Member
Joined
May 16, 2019
Messages
6
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

Well-known member
Joined
May 6, 2015
Messages
92
Location
Temecula, CA , USA
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.
 

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