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What leads to pacemaker dependency?

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Posted on Tue, 27 Oct 2020
Question: How many people are pacemaker dependent? How many people are in A-fib 100% of the time? How many people have a AV node ablation instead of the catheter ablation?
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Answered by Dr. Ilir Sharka (56 minutes later)
Brief Answer:

I would explain as follows:

Detailed Answer:

Hello,

Regarding your concern, I would explain that people who require a pacemaker and become pacemaker dependent all the time are generally with high degree AV block, bradyarrhythmias (AF with low ventricular response), or as in your case have undergone AV node ablation procedure and require continuous pacemaker support for providing adequate ventricles functioning.

As all these patients represent a heterogeneous population it is difficult to arrive on exact numbers.

From the other hand, atrial fibrillation has become an epidemic accounting for more than 3% of individuals greater than 20 years old and increasing with age such as it is calculated that almost one in four individual of middle-age develop AF.

AV node ablation is generally performed when a supraventricular arrhythmia is not properly controlled by means of pharmacologic therapy and also catheter ablation.

In such case, AV node ablation with a permanent pacemaker is recommended.

This strategy is not frequently performed (less than 1-2% 0f cases) as the above-mentioned methods manage in general to control arrhythmia (especially atrial fibrillation).

The downside of this strategy is that left ventricular dyssynchrony happens in around 50% of cases. If this is the case, cardiac resynchronization therapy is the recommended procedure to prevent worsening heart failure symptoms.

In conclusions, I would recommend you to periodically control the pacemaker status and refer all potential clinical symptomatology to your attending cardiologist in order to timely prevent any possible complication.

Hope I have answered your query.

Take care

Regards,
Dr Ilir Sharka, Cardiologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 8492 Questions

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What leads to pacemaker dependency?

Brief Answer: I would explain as follows: Detailed Answer: Hello, Regarding your concern, I would explain that people who require a pacemaker and become pacemaker dependent all the time are generally with high degree AV block, bradyarrhythmias (AF with low ventricular response), or as in your case have undergone AV node ablation procedure and require continuous pacemaker support for providing adequate ventricles functioning. As all these patients represent a heterogeneous population it is difficult to arrive on exact numbers. From the other hand, atrial fibrillation has become an epidemic accounting for more than 3% of individuals greater than 20 years old and increasing with age such as it is calculated that almost one in four individual of middle-age develop AF. AV node ablation is generally performed when a supraventricular arrhythmia is not properly controlled by means of pharmacologic therapy and also catheter ablation. In such case, AV node ablation with a permanent pacemaker is recommended. This strategy is not frequently performed (less than 1-2% 0f cases) as the above-mentioned methods manage in general to control arrhythmia (especially atrial fibrillation). The downside of this strategy is that left ventricular dyssynchrony happens in around 50% of cases. If this is the case, cardiac resynchronization therapy is the recommended procedure to prevent worsening heart failure symptoms. In conclusions, I would recommend you to periodically control the pacemaker status and refer all potential clinical symptomatology to your attending cardiologist in order to timely prevent any possible complication. Hope I have answered your query. Take care Regards, Dr Ilir Sharka, Cardiologist