Ectopic beats or blood pressure?

Hi everyone,

I'd love some advice, I've had my pm coming up 4 years for SSS and occasionally I'll get a really quick dizzy spell and feel a bit breathless for a second or two. It happened again this week and began worrying me a little because I could feel my heart going a little fast too.

I end up seeing my cardiologist who did a pm check and said that nothing that showed up, that I'm 'disgustingly healthy' and I'm pacing less that 1%. He then mentioned something about blood pressure, but also told me that he's going to give me a holter monitor to wear for the next month and then when I take it back, they'll do an echo....huh? I briefly spoke to a friend who is a GP and she said my cardiologist would be giving me the holter monitor to check for ectopic beats...but shouldn't that stuff show up on our pacemaker downloads if I'm having them? I'm just a little confused as to why I have to wear the holter for the next month if my pm already watches my heartbeat...this could be really daft of me, but I thought they monitored our rhythms too?

Has anyone else had to do this or had similar symptoms and got to the bottom of it? My cardio didn't seem overly concerned about anything, so I feel like it could be a precautionary thing as I told him the dizziness makes me really anxious and I'll have a panic attack straight after it happens. If I am having ectopic beats, is that something to be concerned about?

I should have asked my cardio all this and he is a lovely man, so was more interested in talking about my husband and I trying to start a family when I mentioned it and proceeded to give us a lecture about the difference between midwives and obstetricians.

If anyone can help with some answers, it would be greatly appreciated, I just feel like I'm going to spend the next few weeks worrying. :(

4 Comments

You really should ...

by donr - 2013-08-11 02:08:26

...have asked your Cardio what he was looking for.. Now you will stew for a month.''Guess what...that's a natural thing to do - stew over uncertainty & the unknown.

I've gotta say it, & you know it..."Don't worry about it." Yes, it's the elephant in the corner of your living room that you must ignore.

There are some things that the PM does not do - like tell when things happen. This depends on the mfgr of your PM, however. Yours probably does not have that capability. Besides, the Holter will determine other characteristics of your heart 's ECG that will give him more information for diagnosis.

Have YOU seen your download report , or do you just rely on the cardio to tell you what he sees? If you had the printout in your hot little hands right now, we could answer some questions - like what was the history of your heart's arrhythmias during the last reporting period? Perhaps he saw a report of a bunch of PVC's - or A-fib - something that your PM cannot correct for. He didn't tell you for fear of getting you all excited. I'm only guessing, but that's all I have to go on.

I can tell you with certainty that you are already suffering some anxiety - you felt your heart going faster after the event you experienced. That can be one of two things - something electrical in your heart - OR anxiety making your heart race. Natural reaction! You at least recognize it - you said so.

If you are having ectopic beats - most likely little events called PVC's (Premature Ventricular Contractions)- they are nothing to worry about - but that is easy for me to say - I'm not having them & you are. To quote my Cardio, his EP & his head nurse (all right trio, all together now "They won't kill you.") Gee, why would they say that to me? Could it be because I have PVC's by the hundreds of thousands every reporting period? Could it be because I was an anxious, quivering mass of humanity when I first had them? Nah, nothing like that! Ha!!!!! They are, indeed, terrifying to the new sufferer of them.

Now - that is just a GUESS on my part, but I'm pretty confident that I am correct. Here's what you look for in sensing your HB. "Thump * thump**THUMP***Thump". "Thump" = a normal HB; "thump" = a wimpy HB that comes after a shorter than normal pause (Premature, get it?), hence the single *, "THUMP" = the slightly delayed heavier beat that is the signature of the pattern. Heavier because the heart has more blood in it than the wimpier beat had, so you sense it easier. Followed by a slightly longer delay. Then your rhythm returns to normal for a while. You can expect the pattern to repeat at random intervals.

It will only be as miserable as you make it & anxiety will work you to the hilt, so do your best to relax & accept that it will probably be something, but most likely nothing that will be serious. Note my use of MOST LIKELY!!!!! Neither of us knows what will be found.

The best to you. Any questions, just ask. Someone will have an answer.

Don

dizzy spells

by busby - 2013-08-11 07:08:11

Hi pmgirl
I am also from OZ and have contacted you before and we decided that we probably have simillar problems. I think the dizzy spells are probably due to blood pressure issues. I used to get dizzy spells also after my PM. It took a while to have the rate drop response turned on. The PM detects a rate drop (which would have been a pause before the PM) and paces at a rate of 75 bpm for 2 minutes. With SSS we sometimes have a vasovagal episode, where not only does our heart try to pause, but our blood pressure will suddenly drop. The PM can change your heart rate, but not your blood pressure. The increased heart rate to 75 for 2 mins sort of puts your blood pressure up enough to get blood flowing to your brain and helps prevent a dizzy spell. I wouldn't worry about the ectopic beats unless you are having symptoms from them.
Hope this helps
Robin

SSS

by ebfox - 2013-08-11 10:08:24

Sick Sinus Syndrome is kind of a catch-all name for several different rhythm problems. Tachy-Brady is one of the more common ones- the heart beats too fast at times and too slow at times. The fact that you are only being paced 1% of the time means that you aren't very Brady (that's good) but your dizzy spells and breathlessness are concerns are probably what your doctor wants to figure out. It could be a number of things but the holter will give him a good look at what the real deal is.

Like Don said, the PM reports some things but depending upon what type you have there may not be enough detail for the doctor to figure out exactly what's going on.

Regarding your question about ectopics- lots of people have ectopic beats- some people have a whole bunch of them. In many cases they are not even detectable (unless you are wearing a holter), in some cases they are uncomfortable and in some cases they indicate an underlying problem that needs to be addressed. Don't jump to any conclusions, wear the holter and then ask the doctor about it. I want to repeat what I said earlier, the fact that you are paced so little is probably a good sign.

Take Care,

E. B.

Thanks

by pmgirl - 2013-08-12 08:08:43

Thanks for your comments everyone. I have a Medtronic Sensia DR Pacemaker if that helps at all?

While I don't read the actual print out from the downloads, my Cardiologist does send me a copy of the report that he sends to my GP. In the last one I got about a year ago, he said that 'No arrhythmias were detected'.

Robin, I do remember you, I hope all is well! What you say about blood pressure makes sense...I guess I'll find out soon enough and Don, I have no doubt that my anxiety condition plays into it all too!

Thanks again for the feedback guys!

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