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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Will a pace maker be suggested for mild to moderate PAH?

Hi Dr,

My father age is 75, last one week he was complaining discomfort, yesterday we did Echo Cartographic

Ischemic Cardimyopathy
RA/RV MildlyDilated, Mild to Moderate PAH
CAD: RWMA LAD Territory
Sclerosed Martial and Aortic Valve
Severe LV Dysfunction
No LA/LV Clot, Severe MR, Mild TR

my query can we place pacemaker and or else how better we can treat ?

Note: no sugar, or BP
Wed, 30 Sep 2015
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Cardiologist 's  Response
Hello, I am Dr Mody and I will l be addressing your concern.
The basic indication for pacemaker for your father is low LVEF ( when less than 30%-35%) to prevent sudden cardiac death particularly when the ekg too has high risk features . Moderate PAH is not a contraindications for pacemaker. Pacemaker are of many types, and if your ecg particularly has Lbbb pattern and qrs more than 120, and low ef, your doctors may be considering a pacemaker for cardiac resynchronisation to improve LVEF.
However in your father's case I would consider a myocardial perfusion scan for viable myocardium, of present an angiogram and revascularisation of lad territory ( Mitral regurgitation estimation and correction) and pacemaker if particular indication for the same.
Regards Dr Priyank Mody
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