AFib after pacemaker

I'm sorry to see you have this development. Why did you have a pacemaker installed? It should control heart rate, but not cause AF. It seems to me you have had another development, or one revealed when the pacemaker was put in place, which sometimes happens. You might still need, and profit from, a catheter ablation.

Are you seeing an electrophysiologist? I would assume so because you have the pacemaker. Let that person know ASAP.

Had high heart rate. Had Afib once in a while. Never had it nonstop. Dr meds haven’t helped

But heart rate and blood pressure are very good.

I had paroxysmal Afib. My cardiologist put me on Amiodarone. That did stop the Afib but also put me into bradycardia. My heart rate was in the 30's, and I passed out. I then received a pacemaker which has controlled my heart rate well. However, after 1 1/2 years with the pacemaker, I went into Afib. I spontaneously converted after a month. A year later I was in persistent Afib for 3 months. I had a cardioversion and am now on Flecainide daily to (hopefully) prevent another episode. Your electrophysiologist will determine the best course of action for you. I resisted the cardioversion because I know so many people for whom it did not work. However, it has been 5 months since I had it, and I have not had another episode. If your pacemaker is monitored, your electrophysiologist knows when you are in Afib. They called me both times I went into Afib after my pacemaker. As gloaming said, you may need a catheter ablation. I was surprised when I went into Afib the first time because I thought the pacemaker would prevent that happening. Obviously, it does not. Good luck!

Very helpful. Thanks.

The pacemaker is not used for Afib. I believe Afib is a not uncommon side effect after pacemaker surgery. https://pmc.ncbi.nlm.nih.gov/articles/PMC6221846/
Analyses of risk factors and prognosis for new-onset atrial fibrillation in elderly patients after dual-chamber pacemaker implantation
https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1412283/full
Pacemaker-induced atrial fibrillation reconsidered—associations with different pacing sites and prevention approaches

It is true, unfortunately, that long-standing persistent and permanent AF are extremely difficult to treat. You could say that permanent AF is impossible, and that's one of the modern thinking in why it gets that label.

I'm no expert here, but I would think you need another electrophysiologist working for you who can improve, just for giggles, the misplaced leads....for one? While your apparently diagnosed HF might just be due to the long-standing AF, it could be exacerbated by a misapplied PM.

You need a really, really, really (one, two three...) REALLY good EP who can do whatever procedure has the highest probability of success, and the goal would be to improve heart rhythm, minimize ectopy, and to slow the slide into HF. It could very well be that the fullblown MAZE procedure is likely to be the best for you in your current condition....I don't know, don't have any experience or learning about it.

If you have the means to fly and to be operated on by him ($$), Dr. Andrea Natale at the Texas Cardiac Arrhythmia Institute in Austin if about the top EP in the land. People come from all over the planet because he's that good. He has privileges in at least five major hospitals in the American west, so he does get around. Give his office a call and see if he thinks he can put you right. Note that I don't know him, never called the office....I just have read about him from any enthusiastic people who say he did them a world of good.

All I can tell you is that Natale has a huge fanbase at affibers.org. I wouldn't call Natale a celebrity doctor, and if you look for videos that he makes, you won't find them. He sells his knowledge and skillset. He may no win every case of arrhythmia, but he's consistently in the top tier of EPs in America. So, what I mean by a really good EP is someone who has done literally thousands of them, who specializes in complex cases, and who has a terrific and veridical record of achievement in ridding people of their arrhythmias. It sounds like the person you saw was too busy to care much about individual cases, or he just didn't like you or the way you dressed...who knows? No wonder you took it personally.

I can't respond to the plans and their individual problems since I am in Canada with a whole 'nuther set of problems associated with the state monopoly on healthcare.