His-pacemaker technique

Posted by corjianne @corjianne, Fri, May 17 6:56pm

Hi everyone, My cardiologist/electrophysiologist has just recommended a new technique, the His-pacemaker technique to insert a pacemaker. (He was unable to insert a pacemaker in the normal way.) This is my last hope to have a better quality of life, but I’m hesitant to do it because it’s so new. Does anyone have experience with this? Thanks.

Hello @corjianne

While we wait for others to respond to your question about the His-pacemaker technique (I have not heard of this before) I was wondering how you are doing. You mention that. "This is my last hope to have a better quality of life." As you are comfortable doing so, could you share a bit about how you are feeling now?

I did not find much information about this pacemaker technique, did your doctor explain how this technique is different than the others?

Liked by corjianne, lioness

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Hi Teresa, I have congestive heart failure with an ejection fraction of 25. I am breathless much of the time, even when I perform simple tasks, such as tying my shoes. I'm exhausted and have no energy. I take frequent naps. My med.s include Entresto, Coreg, and Furosemide. My cardiologist said there is nothing more he can do, but he suggested that I see this doctor. A few years ago, the latter attempted to insert a pacemaker but was unable to do so because of a "twist" in my blood vessel. I don't know how to explain the His-pacemaker technique because it's too technical for me. It involves placing leads in another area of the heart, I think. The electrophysiologist said the success rate is 70%. I was hoping someone would know something more about this. I've looked it up and still don't really understand it. Thanks again.

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@corjianne

Hi Teresa, I have congestive heart failure with an ejection fraction of 25. I am breathless much of the time, even when I perform simple tasks, such as tying my shoes. I'm exhausted and have no energy. I take frequent naps. My med.s include Entresto, Coreg, and Furosemide. My cardiologist said there is nothing more he can do, but he suggested that I see this doctor. A few years ago, the latter attempted to insert a pacemaker but was unable to do so because of a "twist" in my blood vessel. I don't know how to explain the His-pacemaker technique because it's too technical for me. It involves placing leads in another area of the heart, I think. The electrophysiologist said the success rate is 70%. I was hoping someone would know something more about this. I've looked it up and still don't really understand it. Thanks again.

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Hello @corjianne

I appreciate the details about your symptoms and problems with the traditional pacemaker technique. This does sound complicated and your symptoms do sound like they warrant some additional help. You have not mentioned your age nor how long you have had this heart issue. As you are comfortable sharing more about yourself, please do so.

Have you asked the electrophysiologist (who spoke of the 70% success rate) how many of these procedures he has done and/or where he trained for this procedure? Knowing a little about his experience and training might give you more ease as you consider this. Also, are there any hospitals in your vicinity that are considered major heart centers where you might find expertise on this problem? Personally, I would be willing to travel a bit in order to be able to have this done at a major heart center. However, this represents my own personal opinion and I cannot speak for you.

I would like to invite another mentor into this conversation, Martin, @predictable. He has dealt with a lot of heart problems and may be able to shed some light on this. Also, Connect's moderator, Kanaaz, @kanaazpereira, might be able to offer some more ideas and information as well.

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@corjianne

Hi Teresa, I have congestive heart failure with an ejection fraction of 25. I am breathless much of the time, even when I perform simple tasks, such as tying my shoes. I'm exhausted and have no energy. I take frequent naps. My med.s include Entresto, Coreg, and Furosemide. My cardiologist said there is nothing more he can do, but he suggested that I see this doctor. A few years ago, the latter attempted to insert a pacemaker but was unable to do so because of a "twist" in my blood vessel. I don't know how to explain the His-pacemaker technique because it's too technical for me. It involves placing leads in another area of the heart, I think. The electrophysiologist said the success rate is 70%. I was hoping someone would know something more about this. I've looked it up and still don't really understand it. Thanks again.

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Hi, I’m not a dr or specialist but I did see something called “his bundle pacing” and as suggested I would talk to your dr to find out exactly what this procedure is called. My niece had a bundle pack and EF rate of 15 and had to get a defibrillator and meds to help her cause of other issues, and she has what’s called a bundle pack. With your “twist” it made me think it might be similar to her situation. Please, I suggest you check further to see what this is called so you can get a better understanding what your dr. Is talking about. So much info out there it can get confusing. I pray you find answers and wish you the best. I have heart failure and had an EF rate of 30 which improved for now.

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@hopeful33250

Hello @corjianne

I appreciate the details about your symptoms and problems with the traditional pacemaker technique. This does sound complicated and your symptoms do sound like they warrant some additional help. You have not mentioned your age nor how long you have had this heart issue. As you are comfortable sharing more about yourself, please do so.

Have you asked the electrophysiologist (who spoke of the 70% success rate) how many of these procedures he has done and/or where he trained for this procedure? Knowing a little about his experience and training might give you more ease as you consider this. Also, are there any hospitals in your vicinity that are considered major heart centers where you might find expertise on this problem? Personally, I would be willing to travel a bit in order to be able to have this done at a major heart center. However, this represents my own personal opinion and I cannot speak for you.

I would like to invite another mentor into this conversation, Martin, @predictable. He has dealt with a lot of heart problems and may be able to shed some light on this. Also, Connect's moderator, Kanaaz, @kanaazpereira, might be able to offer some more ideas and information as well.

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Hi @corjianne. I'm glad Teresa @hopeful33250 asked me to look in on your conversation. But I have to start by saying I have no first person involvement with Pacemakers. A brother-in-law had a Pacemaker installed and updated at Mayo Clinic in Rochester, but we have not discussed his experiences in detail. In addition, my wife recently contracted supraventricular tachycardia, and as a result, our house is building confidence in our own electrophysiologist for the first time. We're approaching a decision point on whether to have medication cardioversion procedure in June or July.

I can say, however, that the advice Teresa has provided is spot-on and will advance your chances for improved understanding of what's ahead with the new pacemaker-installation protocol. I also can strongly recommend that you pay close attention to anything you get from @kanaazpereira; she has unusually close connections to the cardiology teams at Mayo in Rochester. Martin

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@camaroyo

Hi, I’m not a dr or specialist but I did see something called “his bundle pacing” and as suggested I would talk to your dr to find out exactly what this procedure is called. My niece had a bundle pack and EF rate of 15 and had to get a defibrillator and meds to help her cause of other issues, and she has what’s called a bundle pack. With your “twist” it made me think it might be similar to her situation. Please, I suggest you check further to see what this is called so you can get a better understanding what your dr. Is talking about. So much info out there it can get confusing. I pray you find answers and wish you the best. I have heart failure and had an EF rate of 30 which improved for now.

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Hi camaroyo, Thank you for your response. The doctor told me it's called "His-pacing." I also have a defibrillator. I'm happy that your EF has improved. Your niece sounds as if she's been through a lot. I'll research this further. Thank you for your prayers.

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@hopeful33250

Hello @corjianne

I appreciate the details about your symptoms and problems with the traditional pacemaker technique. This does sound complicated and your symptoms do sound like they warrant some additional help. You have not mentioned your age nor how long you have had this heart issue. As you are comfortable sharing more about yourself, please do so.

Have you asked the electrophysiologist (who spoke of the 70% success rate) how many of these procedures he has done and/or where he trained for this procedure? Knowing a little about his experience and training might give you more ease as you consider this. Also, are there any hospitals in your vicinity that are considered major heart centers where you might find expertise on this problem? Personally, I would be willing to travel a bit in order to be able to have this done at a major heart center. However, this represents my own personal opinion and I cannot speak for you.

I would like to invite another mentor into this conversation, Martin, @predictable. He has dealt with a lot of heart problems and may be able to shed some light on this. Also, Connect's moderator, Kanaaz, @kanaazpereira, might be able to offer some more ideas and information as well.

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Hi Teresa, Thank you very much for your insights. My electrophysiologist hasn't performed this procedure before, but he said one of his partners has. I'm in CT, so the best place to travel might be Boston.

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@camaroyo

Hi, I’m not a dr or specialist but I did see something called “his bundle pacing” and as suggested I would talk to your dr to find out exactly what this procedure is called. My niece had a bundle pack and EF rate of 15 and had to get a defibrillator and meds to help her cause of other issues, and she has what’s called a bundle pack. With your “twist” it made me think it might be similar to her situation. Please, I suggest you check further to see what this is called so you can get a better understanding what your dr. Is talking about. So much info out there it can get confusing. I pray you find answers and wish you the best. I have heart failure and had an EF rate of 30 which improved for now.

Jump to this post

Hi camaroyo, Thank you very much for this information. I also have a defibrillator.The doctor called this "His pacing," and there isn't much info. out there, but I'll continue to look. Thanks for your prayers. I certainly need them. Congratulations on the improvement in your EF!

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@corjianne

Hi camaroyo, Thank you for your response. The doctor told me it's called "His-pacing." I also have a defibrillator. I'm happy that your EF has improved. Your niece sounds as if she's been through a lot. I'll research this further. Thank you for your prayers.

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Hi Everyone, I apologize for putting my replies in the wrong place. I'll come back to this and correct them as soon as I answer some phone calls. Thank you!

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Hi again Everyone, I have not been able to figure out how to correct the placement of my replies. I do appreciate your input, though.

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@corjianne

Hi again Everyone, I have not been able to figure out how to correct the placement of my replies. I do appreciate your input, though.

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Your replies are coming through just fine, @corjianne

Liked by Dee

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Thanks, Teresa.

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Hi @corjianne,

Your electrophysiologist is right about His Bundle Pacing (HBP) which has emerged as a feasible, reliable alternative to traditional pacemakers. Multiple studies now show that HBP offers much better outcomes – here are two established studies:
– His Bundle Pacing: A New Frontier in the Treatment of Heart Failure https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6020230/
– Long-term outcomes of His bundle pacing in patients with heart failure https://heart.bmj.com/content/105/2/137

@corjianne, I completely understand your concerns about the uncertainty of a relatively new therapy, but I hope this brief Q&A will reassure you about the potential and safety of this technique; I’ve copied some notes for your convenience –
"The barrier is educational and teaching physicians exactly how to do it. But I think that’s easily accomplished and we will see that in the near future and I think we will see far more physicians using His-bundle pacing than ever in the past.”
https://www.practiceupdate.com/content/permanent-his-bundle-pacemaker-registry-implications-for-clinical-practice/65304

Boston would probably be the closest for you, in terms of travel; might I ask if you would consider coming to Mayo Clinic? Mayo Clinic cardiovascular surgeons are on the leading edge of treating cardiovascular and cardiothoracic conditions, including those that are rare and complex – they use the latest innovations in heart surgery. You may also wish to view some of the patient stories that attest to the fact that Mayo Clinic is recognized as one of the top Cardiology and Heart surgery hospitals in the nation: https://www.mayoclinic.org/departments-centers/cardiovascular-surgery/sections/mayo-clinic-experience-patient-stories/orc-20123433

Please let me know if you need any more information, @corjianne; have you decided on a time-frame for the procedure?

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@kanaazpereira

Hi @corjianne,

Your electrophysiologist is right about His Bundle Pacing (HBP) which has emerged as a feasible, reliable alternative to traditional pacemakers. Multiple studies now show that HBP offers much better outcomes – here are two established studies:
– His Bundle Pacing: A New Frontier in the Treatment of Heart Failure https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6020230/
– Long-term outcomes of His bundle pacing in patients with heart failure https://heart.bmj.com/content/105/2/137

@corjianne, I completely understand your concerns about the uncertainty of a relatively new therapy, but I hope this brief Q&A will reassure you about the potential and safety of this technique; I’ve copied some notes for your convenience –
"The barrier is educational and teaching physicians exactly how to do it. But I think that’s easily accomplished and we will see that in the near future and I think we will see far more physicians using His-bundle pacing than ever in the past.”
https://www.practiceupdate.com/content/permanent-his-bundle-pacemaker-registry-implications-for-clinical-practice/65304

Boston would probably be the closest for you, in terms of travel; might I ask if you would consider coming to Mayo Clinic? Mayo Clinic cardiovascular surgeons are on the leading edge of treating cardiovascular and cardiothoracic conditions, including those that are rare and complex – they use the latest innovations in heart surgery. You may also wish to view some of the patient stories that attest to the fact that Mayo Clinic is recognized as one of the top Cardiology and Heart surgery hospitals in the nation: https://www.mayoclinic.org/departments-centers/cardiovascular-surgery/sections/mayo-clinic-experience-patient-stories/orc-20123433

Please let me know if you need any more information, @corjianne; have you decided on a time-frame for the procedure?

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Kanaaz,
Thank you very much for this information. I'll read it now. I haven't decided on a time frame because I haven't decided if I'm going to have the procedure. I believe the information you sent me will help me to make my decision. Mayo Clinic is a possibility.

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@corjianne

Kanaaz,
Thank you very much for this information. I'll read it now. I haven't decided on a time frame because I haven't decided if I'm going to have the procedure. I believe the information you sent me will help me to make my decision. Mayo Clinic is a possibility.

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corjianne @corjianne ,
I would like to comment the discussion ( I'am a bit late, but all the posts of mayo clinic connect did not come in the mail entry, but in the bulk mail , I do not know why). I do not know ,if you have even heard of digitoxin.it is a very old substance. nowadays it had a come back, there is a two year trial in a university clinic /Germany. the aim is to investigate, if digitoxin can reduce the numbers of patients with congestive heart failure , when they need a treatment in the emergency department..
let me explain my history: Since jan.2018 i have a two chambers pacemaker because of a block in the electric transport between the right chambers..I had no problems, but since last december I noticed gain weight, I lost my energy, I had problems with breathing. To cut a long story short, I felt miserable. the cardiologist confirmed the bad situation, serious congestive heart failure, most probably, induced by A-fibrillations/pacemaker electrode. the right ventrikel 's reaction was an serious arrhythmia. in spite of a betablocker (and bloodthinner). the cardiologist decided to give me digitoxin in addition to the other substances.
After 10 days I had a full recovery !! , also confirmed by the echocardiography., no heart failure anymore. I got the bicycle out of the garage, I was very relieved. I still take a low dosis. I would be very interested to hear, the opinion of american cardiologists. I'm a dutch woman living in germany.

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