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Question:

Can I reverse my 100% pacemaker dependency?  I'm very fearful of something happening.

I am a 48 year old woman who had my first pacemaker 20 years ago.  Three years ago, I was told that I am 100% dependent and if anything happens to the device or leads, I will die within seconds. My question is there anything I can do to reverse the 100% dependency? I live in fear everyday of something happening as I have had (1) lead breakage before I was 100% dependent and also a lead fracture...I am not living. I am existing.  

submitted by Lisa from Ocala, Florida on 10/31/2012

Answer:

J. Alberto Lopez, MDby Texas Heart Institute cardiologist, J. Alberto Lopez, MD    

Pacemaker dependency is relative. First, it is important to know the reason for the need of a pacemaker 20 years ago. Anybody can have what we call an "escape rhythm".  When the normal human pacemaker fails, a lower quality stimulus will take over prompting a heartbeat.  The question is how long it will take, since the alternate stimulus has been "sleeping" and needs time to wake up [activate]. Nobody dies within seconds unless you crash. What I do to reassure my patients is to reprogram the electronic pacemaker to 30 beats per minute and wait until a natural escape beat starts (30 sec 40 sec),  and show them that even if the pacemaker were to fail, they will still have a heart rhythm (not as good as their usual, but so they can see that they will not die, and may not even faint if failure occurs when they are sitting or lying down.)
 
Because of a particular disease or complication, some patients may have a delayed, slow escape rhythm.  For these patients, I recommend Dual Ventricular pacing. It is more physiologic and in the event one lead fails, the other continues working.  The likelihood that both will fail at the same time is extremely remote.      

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Updated December 2012
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Texas Heart Institute Heart Information Center
Through this community outreach program, staff members of the Texas Heart Institute (THI) provide educational information related to the prevention, diagnosis, and treatment of cardiovascular disease. It is not the intention of THI to provide specific medical advice, but rather to provide users with information to better understand their health and their diagnosed disorders. Specific medical advice will not be provided and THI urges you to visit a qualified physician for diagnosis and for answers to your questions.
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