pm adjustment

hi all,
I went for a pm review last thursday after near fainting episode. The report showed i had 15000 pvcs in 5 months. i still get them a lot, almost all the time. i know they are harmless but why would they make feel like that? After the interrogation the dr. adjusted the lower rate to 40 from the intial set of 60. he also said the vdd pm implanted was not the right choice for me. the adjustment are not doing any good to me. im confused as im also planning to be pregnant after reading couregous stories in this site. the hope is now gone. i dont think if at 40 beats i will b able to cope with the preg. any advice please?

regards
luq

4 Comments

PVCs & lower rate

by golden_snitch - 2012-10-01 07:10:39

Hi Luq!

First of all, 15.000 PVCs in five months is not much. I mean, five months make about 150 days, so you end of with just an average of 100 PVCs/day. There are people with several thousand PVCs every day, I even know some with up to 20.000 per day. So, I don't think your PVCs alone would cause near fainting episodes, and maybe what you are feeling all the time are not the PVCs, but for instance the pacemaker stimulating.

The lower rate of 40bpm does sound a little bit low for me, too. I'd not want to run around with that. But with a VDD pacemaker, you do have a well functioning sinus node that "dictates" the rhythm/heart rate, and usually a sinus rhythm at rest is somewhere between 60-100bpm. So, the lower setting of 40bpm seems to be just a back-up in case your sinus node slows down unexpectedly. Have you taken your pulse? If you are not doing well and find that your heart rate often is below 60bpm, I'd ask the doctor to change the lower setting back to 60bpm. And in any case, if you feel worse after the settings were changed, you should ask for another appointment.

Did he say why a VVD pacer was not the right choice? VDD is not implanted that often, most people get DDD pacers, but if you have a completely healthy, well working sinus node, there is not really the need for a pacemaker lead in the right atrium. Many heart block patients nevertheless get a DDD pacer, just in case they one day develop sinus bradycardia.

Best wishes
Inga

Snitch is talking about...

by donr - 2012-10-01 08:10:50

...ME! I used to be the PVC King, for daily rates, but passed the crown to a lady who has had more than me in a day!

Luq, I like to talk about PVC's per MINUTE - that gives a quicker idea of how often you have them. 100 per day is 4 per hour - or 1 every 15 minutes ON THE AVERAGE.

Right now I am running ABOUT 1 per minute. Even at that rate, I never notice them. That's about 1500 per day. For me to even realize they are there, I have to get up to about 6 per minute (about 9000 per day) & that's not affecting how I feel or function.

I'll second her comment about the 40 BPM as a lower rate. Ifyou rarely get there, why put it so low? If you do drop that low, you can really feel like trash - especially if you have a lot of PVC's, & it's not necessary.

Don

thanks

by Luq - 2012-10-01 10:10:33

thanks inga n don for your advice. I will really need to see another dr for the second opinion. The dr. was of the view that i may require another type of pm. so he lowered my settings to 40 and see if it helps with my condition. if i dont improve he may change the pm. He was trying to explain things in medical jargons about why vdd was not the right choice for me. when i asked further he just could not cooperate...he just told me to sit back and see how the 40b works for me first. i have no heart block..my discharge card just indicate that i have a brady-tachy syndrome.

thanks again

Tachy-brady syndrome

by golden_snitch - 2012-10-01 11:10:17

Oh, if you have tachy-brady syndrome then your sinus node is most likely not functioning well all the time (sometimes it's too slow, sometimes too fast), and then the VDD pacer is indeed the wrong choice. Can't understand why anyone would put a VDD pacer into a patient with a sick sinus node! I guess when you go for a second opinion - which is a good thing to do - the doctor will wonder, too, why you had this pacer implanted, and not a DDD or AAI model.

Could it be that your doctor thought that with a lower rate of 60bpm, the pacer was kicking in too often and that since you complained about feeling something (PVCs or whatever), he concluded that you felt the pacer stimulating? That could be a reason why he turned the lower rate down to 40bpm.

Good luck with the second opinion!
Inga

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