“Are Pacemaker Implants Common After Heart Valve Surgery?” Asks Frank
By Adam Pick on November 8, 2010
I just received an interesting question from Frank about heart rhythms after heart valve surgery. Frank writes, “I had a tricuspid valve repair, a Patent Foramen Ovalve (PFO) repaired and a Maze procedure performed in July. Now, it appears I will need to have a pacemaker put in next week. I was told that my Atrioventricular (AV) node may have been damaged and I am now in “heart block”. I was wondering if this is common? Thanks Adam!”
Diagram of Pacemaker Implant
Frank raises a great question. As we have seen in prior blogs, several patients receive pacemakers after heart valve surgery. However, Frank’s question addresses two, other surgical considerations which you may not be familiar with — The Maze procedure and heart block.
- The Maze Procedure – You can learn more about the Maze Procedure by watching this video.
- Heart block – According the American Heart Association, sometimes the signal from the heart’s upper to lower chambers is impaired or doesn’t transmit. This is “heart block” or “AV block.” This does not mean that the blood flow or blood vessels are blocked. Heart block is classified according to the level of impairment — first-degree heart block, second-degree heart block or third-degree (complete) heart block.
Given Frank’s situation, I contacted Dr. Marc Gillinov, a leading heart surgeon from The Cleveland Clinic, to get an expert opinion specific to Frank’s question.
Doctor Gillinov shared with me, “After a Maze procedure or any sort of heart surgery, it is occasionally necessary to place a pacemaker. In the case of a Maze procedure, the pacemaker is usually required because of pre-existing sinus node dysfunction–basically, the heart’s own internal pacemaker, which is called the sinus node, does not work properly.”
Dr. Gillinov also noted, “It is also possible to develop the need for a pacemaker after heart valve surgery. When this occurs, it is usually a result of some interruption of the conduction system by sutures placed in or around the heart valve.”
I hope this helps Frank (and perhaps you) learn more about the need for a pacemaker following heart valve surgery. Thanks to Frank for his question. And, thanks to Dr. Gillinov for his continuing support of this patient and caregiver community.
Keep on tickin!