Can a Pacemaker help You Function and Feel Better with heart Failure?

https://www.medicalnewstoday.com/articles/pacemaker-for-heart-failure
There are several types of pacemakers, and a bilateral one can help a great deal with low ejection fraction and CHF (chronic heart failure).

This study: https://onlinecjc.ca/article/S0828-282X(23)01606-9/fulltext suggests that it works better in some cases than in others, such as if left bundle branch block is involved, and that some caution needs to be taken for those with cardiomyopathy as it can exacerbate it when paced or actually commence that problem.

As usual, this is best run past your cardiologist to make sure you are fully informed and fully in agreement with anything he/she proposes.

The article is informative. I have found the PAs I work with to be more informative than the dr. Feel frustrated with this. Thanks for your reply!

@retirement75
I have cardiomyopathy. Diagnosed back in 2001. I had non treated high blood pressure but my cardiologist determined my cardiomyopathy diagnosis as my heart Catherization revealed no signs of cardiovascular disease.

You mentioned the 30 number for recommendation for pacemaker. When I got my recommendation for a 30 EF the recommendation was for ICD not pacemaker. Cardiology stated to me back then (2006) that is the number at EF that a ICD is recommended.

I went to Mayo Jacksonville for second opinion with EP. There the EP agrees with recommendation for ICD but wanted to add pacemaker dual device. Reason is electrical problems caused by virus infection caused scar tissue, LBBB, and conduction delay. EP wanted to have pacemaker to provide heart a continuous and steady pulse with good conduction.

He referred me to heart failure doctor at Mayo. That doctor put me on two new medications that brought my heart rate down into 30s and lowered my BP also. The pacemaker would then be used to pulse my heart to the right rate based on me and what doctors thought was best rate.

The ICD was there to address tachycardia which can happen with low EF. That it where the 30 EF needs ICD but you mentioned them saying pacemaker. I was told ICD needed at 30 EF not a pacemaker. Pacemaker was there to improve electrical function of heart which is common with cardiomyopathy

Are you seeing a electrophysiologist? Are you seeing a heart failure specialist for your EF. A normal EF is 50-70. I would suggest seeing those specialist even if you have to travel. Those specialist will work with your local cardiologist if you cannot see them on regular basis.

So when you get to 30 that is where cardiology says ICD is needed (per Mayo and a local cardiologist who was treating me prior to me changing to Mayo).

You stated your heart rate going up and down which is why pacemaker would provide constant and specific pacing of your heart if needed. The ICD would be statistically recommended when EF reaches 30.

To give you some inspiration. I had my ICD/Pacemaker in 2006. I am on my 3rd device. My EF had gotten to 25 until I was put on two new medications and my ICD/Pacemaker surgery. Since then (almost 20 years now) my EF had remain at 25% and the decrease in EF stopped.

I am very active and have no medical restrictions of exercise other that at 78 try to stay a moderate level which my HF doctor says he would say to any patient who was 78.

Thanks for your story. Very informative. I was initially diagnosed with HF at Mayo Clinic. My journey started with first heart attack with 5 stents. A second heart attack after surgery. 16 yrs later the stents were occluded. Third heart attack. They wanted to restent but couldn’t which left the choice of bypass during Covid. The dr at Mayo mentioned a device is used if EF goes to 30 as there is a risk of cardiac arrest. I have ischemic cardiomyopathy. My EF is stable at 46 but I do not feel well a lot. Compromised life. I’ve read that Cleveland Clinic gives patients a treatment plan which I think makes so much sense. I think drs here wait for changes in symptoms and then address. Doesn’t work so much for me. Thanks for reply!

@retirement75
Yes my cardiologist were saying same thing about the EF of 30. When gets at that point carries a high chance of tachycardia.

Reference Cleveland Clinic (CC). CC is known throughout the world as best and most experienced medical institution for heart disease and treatments.

I have non ischemic cardiomyopathy which is very different from ischemic cardiomyopathy.

Your EF at 46 is almost normal (50-70). But what my HF doctor at Mayo told it not so much the numbers but how you feel.
Good luck!

@gloaming - It's been my experience, over years, that MedicalNewsToday is not always a reliable source of information. I realize that the second link you included is from a reputable medical journal. However, because of that, it's so technical that most of us could easily misinterpret the findings.

So I second the recommendation if your last sentence: "As usual, this is best run past your cardiologist to make sure you are fully informed and fully in agreement with anything he/she proposes."

My younger sister and I had pacemakers two weeks apart me for Atrial Fibrilation. My sister had been in heart failure for 18 months her ejection fraction went down to 13% they thought they could get her heart functioning better with the exercise and medication. She got her ejection fraction up to 31%. Then she had a new knee installed. She had a pretty hard time with medications clashing but came good. She then became unwell ended up in hospital for 6 weeks then they decided to go ahead with a pacemaker, defibrillator and synchroniser. Her ejection Fraction is now 51%. She's really well. My pacemaker is to regulate my heart beat. I'm due to have a knee replacement any day now. Pacemakers are great I still get AF but not anywhere as bad. They say 20%. I had an ablation to. All will be well talk to your cardiologist all the best for the festive season

@ann3838 Loved reading your response and story. Thanks for input!