Posted by SuLynn Mester on November 25, 2001 at 16:50:52:
In Reply to: Update at Thanksgiving posted by Roger Meyer on November 22, 2001 at 23:47:05:
Hi Roger,
Happy Holidays! Glad to hear that you are doing well, inspite of your complications. Randy had many of the same complications that you have described minus the staph infection. He too was in the hospital for an extended period and was very disappointed initially. He developed pericardial and bilateral pleural effusions and had daily echos with the doc's wavering back and forth as to wheather he would have to go back to OR. Thankfully he did not have to go back for open chest again, although he did have to go back for a pacemaker revision as the doc's thought that the pacemaker wire through the tricuspid valve had been moved in such a way as to interfere with the proper closing of the valve. Although it was not open chest, it was a huge set back for Randy and he had a tougher time recovering from there on. (There was a little frail 85 year old lady that had an by pass surgery several days after Randy's Maze and she was released about 10 days before Randy. That really bummed him out!!!!)
Hopefully your junctional rhythem will sustain you through even your exercising. You may already know this, but a junctional rhythem is a regular rhythem and usually the rate is around 30 to 50 most of the time with the ability to accelerate up to the 70's if needed. The junctional rhythem is very close to the sinus rhythem minus the atrial contraction or activity. (In A-fib you also lose the atrial contraction or activity except in Afib the heart rhythem is very irregular and totally unpredictable in its rate, can be anywhere from 40's to 200.) The atrial contraction or activity can contribute up to 30% of the cardiac output with each beat so if you do go into a sinus rhythem you most likely would feel a bit more energy, endurance and less shortness of breath, however if you are maintaining OK even with activity then the junctinal rhythem is probably working fine for you. Randy had a pacemaker prior to the Maze, as part of a failed attempted treatment at an earlier date. When Randy came out of surgery he was in a sinus rhythem and maintained that for several months post op. They had adjusted his pacemaker so that it would not kick in and compete with his own heart beat. All of a sudden Randy started feeling tired, sulggish and short of breath. We went in for a check up and found that he had gone into a junctional rhythem. His pacemaker was not kicking in due to the way they had programmed it earlier. The doctor had to adjust his pacemaker and now he is about 90% paced but no Afib. So even though he has to have the assistance of the pacemaker, physically he feels as if he is in sinus rhythem. The pacemaker gives him back the atrial activity, which means that additional 30% of the cardiac output he was missing in the junctional rhythem. He was very symptomatic when it happened, but others never know the difference. Hopefully, you will be one of those who never knows the difference. But just in case you do, don't be discouraged if you need a pacemaker. It is such a mild procedure compared to what you have been through and after a short time you will not even remember that you have it. Good luck in your progress.
SuLynn Mester