Cardiac Electrophysiology

Muriel met the latest addition to her Cardiac team on Friday.  Dr. Shetty met with us for over an hour and explained in great detail how the pacemaker works, what is it intended to do, and what we might expect maintenance-wise.  We got to see the device that will be implanted in Muriel's abdomen, just below her breastbone.  Its about the size of mini Altoid's tin, is hermetically sealed, and contains all the electronic goodness plus battery.

Muriel's condition, Heart Block, concerns signals passing from the upper (atrial) chambers to the lower (ventricle) chambers.  Her atrial rhythm is fine, and normal, if I understand correctly.  Somewhere around 110bpm.  Up until six months ago more than half of those beats were signaled to her one remaining ventricle, which would then beat as it should.  The others were simply lost, and her measured heart rate was low - typically in the 70-90bpm range.

The Holter Monitors that she has worn for her past two cardiologist appointments showed the average dropping, as well as the range.  Three months back her average was in the mid sixties, with a max reading in the nineties and minimum in the fifties.  That was concerning.  The last Holter, about a month ago, showed an average in the low fifties, with a max of only 64, and minimums in the forties.  That is what has prompted all this activity a few months earlier than expected.  Without the pacemaker she is at risk for total heart failure.

We still have a catheter lab scheduled for next Tuesday, which should let us know if it is too soon for her final plumbing operation (that would be very unfortunate).  In the meantime, and until the pacemaker surgery, we have been asked to outfit Muriel with an "Event Monitor", a cellular phone equipped device that will automatically send alerts to ECG monitoring technicians if her heart rate drops below a certain rate, or if we manually press a button to alert them.  Its kind of bulky and we are having challenges concealing it in her clothes without it falling out and dragging behind her!

Dr. Shetty is very nice and extremely knowledgeable, and we feel very comfortable in her care.  Fingers crossed we get the green light to do both operations at once, so this will be the last time we have to open her chest...