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I've had afib for c 18 months now

Had my first PV Ablation in January, with a follow up ablation with

eps in June with my EP, Dr Clague at the Royal Brompton in

London

The procedures have improved things, but I am still dependent on

beta blockers. My sotalol keeps the afib largely under control, but

I use flec if a severe event occurs and am on warfarin

After the second ablation my EP said that he had spent 2 hours

burning and with an enlarged atria, was not confident it would

successfully clear my afib.

Well here we are after 3.5 months and I'm considering a pacemaker.

When we last met a month ago, my ep advised that he uses a St Judes

Affinity or Infinity. Unlike the US this requires hospital visits

for monitoring.

He said it wasn't a guaranteed solution and when pressed gave odds

of 70%

I've seen the ablation questions in the 'files' folder

Has anyone prepared a checklist of questions for the EP prior to a

pacemaker?

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hi

I have met Dr Clague and also hear good things about him.

I do have a pacemaker myself, although its primary aim was not treat

a problem related to AF (I have sick-sinus-syndrome also

called " Tachy-Brady-Syndrome " ).

The main questions I would ask before deciding upon Pacemaker Therapy

are (these would be my questions and concerns and you probably have

others specific to your own situtation):

* What is the goal of having the pacemaker? How much symptom control

can I reasonably expect?

* Is the doctor proposing just the pacemaker implant? or an AV Node

Ablation as well? (this is very important to be clear about)

* Does the pacemaker have " AF Therapies " ? (i.e. does it have special

programming that tries to prevent episodes of AF?)

You will probably have other questions too. From my own experience, I

can tell you that a pacemaker implant usually means 2 - 3 days in

hospital (it takes about an hour to do the implant in the cath lab),

not using the arm much for a few weeks initially (on the side that

the pacemaker was implanted), being careful with mobile phones and

power cables and airport security gates (there are not many 'dont's'

and the Cardiac Tech / Pacemaker Technician will talk with you at

length about it all and give you booklets), Pacing checks ultimately

become Once Per Year, but in the 1st year of implant you are likely

to have a couple of checks, 1 at 6 weeks and then 1 at 6 months.

Pacemakers last on average (and it varies between individuals) about

7 years, then a replacement is needed.

St Jude (SJM) have a website, with detail on the Affinity™

Pacemaker:

http://www.sjm.com/devices/device.aspx?name=Affinity%26%23153%

3B+Pacemaker & location=in & type=2

Some SJM Pacemaker have " AF Suppression Algorithms " (but I am not

sure if the Affinity does or not)

This is what SJM have to say about this : " The AF suppression

algorithm is built into certain pacemakers and was designed to

suppress atrial fibrillation (AF). The implanted pacemaker stimulates

the heart in a way that preempts AF.....The AF Suppression Algorithm

is available in certain pacemakers made by St. Jude Medical " .

I hope some of this has helped a little. I honestly forget my

pacemaker is even there now!

take care,

love Seska x

>

> I've had afib for c 18 months now

> Had my first PV Ablation in January, with a follow up ablation with

> eps in June with my EP, Dr Clague at the Royal Brompton in

> London

>

> The procedures have improved things, but I am still dependent on

> beta blockers. My sotalol keeps the afib largely under control, but

> I use flec if a severe event occurs and am on warfarin

>

> After the second ablation my EP said that he had spent 2 hours

> burning and with an enlarged atria, was not confident it would

> successfully clear my afib.

>

> Well here we are after 3.5 months and I'm considering a pacemaker.

> When we last met a month ago, my ep advised that he uses a St Judes

> Affinity or Infinity. Unlike the US this requires hospital visits

> for monitoring.

> He said it wasn't a guaranteed solution and when pressed gave odds

> of 70%

>

> I've seen the ablation questions in the 'files' folder

> Has anyone prepared a checklist of questions for the EP prior to a

> pacemaker?

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Seska

that is really good of you to reply

the goal for fitting the pacemaker is to control the afib

and it comes with a program/algorithm to do just that

it will not include a PVA

have looked up the website before, but it doesnt seem to say very

much

I'm pleased yours is working for you

and am heartened (pardon the pun!) to hear that you forget it's

there!

How much symptom control > can I reasonably expect?

> You will probably have other questions too. From my own

experience, I

> can tell you that a pacemaker implant usually means 2 - 3 days in

> hospital (it takes about an hour to do the implant in the cath

lab),

> not using the arm much for a few weeks initially (on the side that

> the pacemaker was implanted), being careful with mobile phones and

> power cables and airport security gates (there are not

many 'dont's'

> and the Cardiac Tech / Pacemaker Technician will talk with you at

> length about it all and give you booklets), Pacing checks

ultimately

> become Once Per Year, but in the 1st year of implant you are

likely

> to have a couple of checks, 1 at 6 weeks and then 1 at 6 months.

> Pacemakers last on average (and it varies between individuals)

about

> 7 years, then a replacement is needed.

>

> St Jude (SJM) have a website, with detail on the Affinity™

> Pacemaker:

> http://www.sjm.com/devices/device.aspx?name=Affinity%26%23153%

> 3B+Pacemaker & location=in & type=2

>

> Some SJM Pacemaker have " AF Suppression Algorithms " (but I am not

> sure if the Affinity does or not)

>

> This is what SJM have to say about this : " The AF suppression

> algorithm is built into certain pacemakers and was designed to

> suppress atrial fibrillation (AF). The implanted pacemaker

stimulates

> the heart in a way that preempts AF.....The AF Suppression

Algorithm

> is available in certain pacemakers made by St. Jude Medical " .

>

>

> I hope some of this has helped a little. I honestly forget my

> pacemaker is even there now!

>

>

> take care,

> love Seska x

>

>

>

> >

> > I've had afib for c 18 months now

> > Had my first PV Ablation in January, with a follow up ablation

with

> > eps in June with my EP, Dr Clague at the Royal Brompton

in

> > London

> >

> > The procedures have improved things, but I am still dependent on

> > beta blockers. My sotalol keeps the afib largely under control,

but

> > I use flec if a severe event occurs and am on warfarin

> >

> > After the second ablation my EP said that he had spent 2 hours

> > burning and with an enlarged atria, was not confident it would

> > successfully clear my afib.

> >

> > Well here we are after 3.5 months and I'm considering a

pacemaker.

> > When we last met a month ago, my ep advised that he uses a St

Judes

> > Affinity or Infinity. Unlike the US this requires hospital

visits

> > for monitoring.

> > He said it wasn't a guaranteed solution and when pressed gave

odds

> > of 70%

> >

> > I've seen the ablation questions in the 'files' folder

> > Has anyone prepared a checklist of questions for the EP prior to

a

> > pacemaker?

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