These days we are learning quite a bit about the electric conduction system of the heart in general and our daughter's in particular.
Here is my regurgitation of what I believe her cardiologist said today:
The AV node (which is the size of a bean) relays the electric signal via two branches to the ventricles. Her previous surgeries had already resulted in one of the two branches not working properly before we even arrived here. (I think he said that she had left anterior hemiblock but am not 100% certain.) They could see that in her EKG.
This is due to scar tissue which alters the muscle fiber's ability to transmit the electric signal from the AV node to the ventricle.
The scar tissue is a response of the body to an injury such as open heart surgery. After surgery, the heart muscle swells in the area of the assault (just like your finger does when you cut yourself) which can result in heart block.
Once the swelling is gone, the conduction system can work again unless the body produced scar tissue. The latter depends on how an individual heals. Some scar more than others.
Since her heart has already formed scar tissue due to injuries from previous surgeries, it is likely that the most recent surgery will also result in scar tissue. If that turns out to be true, we will find out everything we ever wanted to know about modern pacemakers.
Meanwhile, Sophia is getting some help from her new friend. She takes him everywhere she goes. They are quite the team. Sophia gives the marching order and Medtronic 5388 relays the information to the troops. Almost like a married couple.
We will re-group on Monday which is seven days post-op. Up until then, it's walks on the floor of the ICU. Unfortunately, she is not allowed to leave. Bummer. They have a wonderful garden on the first floor that we may not get to see anytime soon.