Permanent pacemaker needed after surgery

[Madsometimes]

Hi,
This is my first post. I had my aortic root and valve replaced 3 weeks ago, and my surgeon was delighted with my progress. For the first 2-3 days after surgery my heart was beating independently and only sometimes needing the temporary pacemaker. As time passed I became more reliant on my pacemaker and by day 4 was 100% dependent. A permanent device was implanted on day 7.

Has anyone else experienced needing a pacemaker? I am finding it a bit hard to come to terms with coming out of surgery with a new heart condition. I know that pacemakers are very safe, and mine is set to sinus rhythm, so adapts to my activity. I just need to trust my machine and forget about it. I would love to hear how other members with pacemakers are getting on.

 

[epstns]

Hi, Mad,

I, too, came home from the hospital with a surprise. In addition to my new valve, I received a Boston Scientific pacemaker. In the first few days immediately following valve surgery, we saw my heart rate go from too high to too low, to complete stop. Believe me, it is not a good thing to watch your own monitor go flatline! I was mostly dependent upon the temporary pacemaker, and having a rough time of it. When the electrophysiologist came in and began suggesting a pacemaker, I asked "What are we waiting for?"

My mother had a pacemaker for several years and if she could deal with it, so could I. Mine was implanted on day 5 post surgery, and I haven't looked back. I continue to work out 5 days a week, riding an exercise bike and "power-walking" on a treadmill (would run but my kneew won't take it any more), and lifting light weights. I do what I would do without the device, period.

The pacemaker is going to be a "work in process" for a while - we continue to tweak the many adjustments on it to get the best performance. The only "issue" I have with it is that I had to re-adjust the shoulder harness in the car so it would not rub on the pacemaker. Also, they will give you specific instructions after the implant regarding use of your left arm for the first few weeks. These restrictions will be to allow your body a chance to solidly implant the pacemaker leads so that they do not shift out of place. Not a big deal.

I'd suggest you do a search on pacemakers on this site. We have had several rather detailed discussions of the many benefits and very few issues with pacemakers. I won't write a book here, but my own opinion is that the pacemaker has only improved my life, and in no way detracted from it. Of course, I'm not as handsome without my shirt as I once was. . . I'm a skinny older dude (mid-60's) and the little lump is visible. I just consider it another battle scar. Life is good.

 

[ElectLive]

Welcome to the community and glad to hear your progress is otherwise going well.

There are many members here who have a pacemaker, but it is still a fairly uncommon complication. I suppose I should be a little bummed about mine, but I'm not really at all. Now, if I'd suddenly woken up one morning needing a pacemaker, it probably would feel different, but something about having a valve replaced a few days prior just sort of cushioned the blow. Anyway, in my opinion, there are a lot of other potential complications from valve replacement surgery, and if given the choice, I think I'd probably choose pacemaker 9 times out of 10. They are very easy to forget about. Sure, in 9 years or so, it will be a little annoying to have the batteries finally run out, but who knows, maybe by then the next generation device will also be GPS equipped and able to store my favorite music...

I have mine because I developed complete heart block immediately after surgery, it was put in day 4 after being on a "wait and see" holding pattern. It was supposed to get better. First I was told days, then weeks, then months. Well, it's never improved, I'm 100% paced still. But that is actually pretty rare. A lot of folks have their dependence lessen over time, and the pacemaker becomes more of an emergency backup system. However it turns out for you, you have a medical marvel in your body. Not quite set it and forget it, but all things considered, pretty close.

I have not had near the "tweaking" issue Steve has, but that can happen. I've only had 2 minor adjustments in over a year now. Mine came with a remote receiver of sorts, it transmits info from my pacemaker over a modem connection to the Clinic. They can see everything going on without me having to go in. I'm on a yearly visit schedule now, and changes are done then, if need be.

Now, nothing is perfect of course. So here is my complaint: chest strap heart rate monitors no longer work for me. Some register zero, some register 2 or 3 times my actual rate. This was really annoying at first, but I've gotten over it and finally have found an alternative.

Best wishes in your continued recovery, and before you know it, you'll probably forget about your pacemaker most of the time too...

 

[Greg a]

Welcome to the community and glad to hear your progress is otherwise going well.

There are many members here who have a pacemaker, but it is still a fairly uncommon complication. I suppose I should be a little bummed about mine, but I'm not really at all. Now, if I'd suddenly woken up one morning needing a pacemaker, it probably would feel different, but something about having a valve replaced a few days prior just sort of cushioned the blow. Anyway, in my opinion, there are a lot of other potential complications from valve replacement surgery, and if given the choice, I think I'd probably choose pacemaker 9 times out of 10. They are very easy to forget about. Sure, in 9 years or so, it will be a little annoying to have the batteries finally run out, but who knows, maybe by then the next generation device will also be GPS equipped and able to store my favorite music...

I have mine because I developed complete heart block immediately after surgery, it was put in day 4 after being on a "wait and see" holding pattern. It was supposed to get better. First I was told days, then weeks, then months. Well, it's never improved, I'm 100% paced still. But that is actually pretty rare. A lot of folks have their dependence lessen over time, and the pacemaker becomes more of an emergency backup system. However it turns out for you, you have a medical marvel in your body. Not quite set it and forget it, but all things considered, pretty close.

I have not had near the "tweaking" issue Steve has, but that can happen. I've only had 2 minor adjustments in over a year now. Mine came with a remote receiver of sorts, it transmits info from my pacemaker over a modem connection to the Clinic. They can see everything going on without me having to go in. I'm on a yearly visit schedule now, and changes are done then, if need be.

Now, nothing is perfect of course. So here is my complaint: chest strap heart rate monitors no longer work for me. Some register zero, some register 2 or 3 times my actual rate. This was really annoying at first, but I've gotten over it and finally have found an alternative.

Best wishes in your continued recovery, and before you know it, you'll probably forget about your pacemaker most of the time too...

I too have the "carelink" monitor on my nightstand and in addition to regular unit interogations, it will transmot ANY AND ALL pacing or therapy delivered as soon as i am within range of it

 

[Greg a]

FROM nst2813's thread

FROM nst2813's thread

FROM nst2813's thread http://www.valvereplacement.org/forums/showthread.php?39354-Need-some-HUGE-motivation&p=509975#post509975

My three grand daughters are all the motivation I need in life.

It was my understanding that you have had two OHS's and now were looking at ELECTIVE surgery for a pacemaker or ICD. When my ICD was put in or installed or implanted I had had worse dental work done than that was. I went in at 8am and was on the way home by 1pm I was awake in a twilight or friendly drunken state:biggrin2: and took part in the talk in the OR:thumbup: (niot sure I made a lot of sense:rolleyes2 except when the unit was test fired and was put a little deeper and brought right back out. Since then my ICD has paced me out of trouble once and revived me by delivering therapy (shocked) twice, It really is the angel :angel: on my shoulder.

 

[Madsometimes]

Thanks so much for your replies. It is great to know how many people are getting on with their pacemakers.

My pacemaker scar is fairly neat, and does not show compared to my OHS one. I agree that having the device implanted was not traumatic. My consultant ensured that the best EP in the hospital did the procedure. I asked the EP if the procedure would hurt, and he said yes, then added as much as a trip to the dentist. He was right. The local anaesetic felt v similar to a dental one, and there was no pain after that. The sedation drugs made me not care anyway. They must have quite a street value!

I was initially in shock about being 100% paced but things are getting better. Next task is to build up my fitness and get my INR in range, which is proving to be stubborn. It fell to 1.4 and is now 1.6, even though I am being careful with my diet.

It is great to hear about everyone's marvellous recovery. I will never be lifting weights in the future but would love to go on long walks with my dog and run about with my children. Wish I had trained my dog not to pull on the lead <sigh>!

 

[epstns]

EL - I really don't see my pacemaker tweaking as an issue. From the moment it was implanted, I felt far better than I had for many months. If you look back to my posts immediately post-op, I'm sure I said somewhere that "if this is the best it can be, then it will be just fine with me." We later did some minor adjustments to increase my exercise tolerance (still trying to be a gym rat, in my mid-60's, I guess) and later on, to allow for some of my natural pacing to take control as my heart began to heal a bit. Initially I was 100% paced. It stayed that way for about 6 months, then my natural pacing became strong enough to allow it to control things some of the time. This will extend my battery life, although I don't expect to ever be able to have the pacemaker removed. It will be "the angel on my shoulder" for the rest of my life, and I am really, really thankful for it and for the way it has improved my quality of life.

Also - as for the chest-strap heart rate monitors, I also had lots of problems. I have found that the basic models of the Polar brand work most dependably. I called the manufacturer of my pacemaker (Boston Scientific), and their tech-support folks suggested not only using the basic Polar models, but also to wear the chest strap upside-down. Not sure why they suggested that, but it works almost all the time for me.

 

[John A.]

According to my cardiologist, my pacemaker story is a little unusual. Like a lot of people, I was in heart block for the first couple days after surgery, but gradually got better so that they discharged me without implanting a permanent pacer. I started cardiac rehad about 6 weeks post-surgery and was doing pretty well. Then, with any amount of activity (climbing steps, exercise, etc.), I started to go back into heart block. So, about 10 weeks after my AVR surgery, I had a pacemaker installed. That was late October. I was able to go back to cardiac rehab about a week after the device was implanted and was on a lifting restriction for about 4 weeks. By late November, I was back to lifting light weights, running, and doing a full workout. I've had the pacemaker tweaked once so far, but that was a positive change.

For me, the biggest impact has been when I actually need to rely on the pacemaker. As long as my heart works on its own, I feel pretty great while exercising, but if my pacemaker kicks in, I can still work out at close to the same rate, but it feels more strenuous. Needless to say, this is a vast improvement over not having it at all and going into heart block! The incision area is still a *little* tender to the touch, but my range of motion and ability to use my arm, shoulder and chest muscles is back to where it was prior to the implant.

I have an elliptical machine that came with a chest strap HR monitor that still works fine, but I haven't tried a walk around HR monitor yet. Based on the problems others have had, I think I might try it out before I purchase one.

 

[Julian]

Everyone reacts different to the pacemaker. I was in the hospital for 6 days when they figured my natural pace was never coming back. Since then I'm paced about 14% of the time. In 5 months I've had settings adjusted twice, one to turn rate response off because my heart would race just from walking across the street or on a bumpy road and also to turn off some status check that would happen every day at 4:30pm, Cardio was amazed I could feel it do a check and thought I was joking, the thing is the status check would almost stop me from talking almost like a PVC would feel. Thank God that's over. To be honest I probably got a little more tweaking to do.

 

[ElectLive]

EL - I really don't see my pacemaker tweaking as an issue.

Steve - Sorry, missed this during the holiday week. The wording in my post wasn't quite clear, but did not mean to indicate the tweaks you've done as a problem, just something that is part of the process to varying degress for us all. Case in point, my first tweak wasn't a result of anything I was doing different, just a result of my post-surgery heart rate finally returning to normal.

 

[epstns]

EL - No problem. My pacemaker has been tweaked each time I've been to the electrophysiologist, and always for the better. He is very involved with his patients and I think he actually enjoys having a younger, more active patient (as opposed to the usual crowd of octogenarians in his waiting room) as we discuss options for adjustments and he is challenged to see how "good" we can make things.