Second opinion

Hi
I posted in october about my pm adjustment and dr's opinion that the pm implanted april 2011 was a wrong mode for me. I was implanted with a VDD pacer. The 2nd dr is also of the same opinion. He was said i have a sinus arrest in which the heart pauses for sometime before going back to a normal rythm. I have done again the echo, stress and holter tests which turned out normal structually but with a lot of ventricular and supraventicular premature beats.

My pm was interrogated a day before the holter and only 12,000 were noted since october 2012.the following day After holter
results, the pm was interr again and only 3 pvcs were recorded. My conern goes to..1. Does the pm miss some pvcs? Why was yhere a diff btn the holter records and pm? I was feeling a lot of extra beats
And dr. said u had only 3! What could the feeling be? 2. Should i go for a change? If i dont change for now, am i going to have acrdiac arrest? I have a lot of what i think pvcs and last week i had a bqd episode of near fainting. When the heart pauses i feel shaked and i will end up in a cold sweat and panic.

Sorry for a long story but im a bit troubled and in need of your advice.

Merry christmas
Luq

2 Comments

PVC's

by donr - 2012-12-25 10:12:16

Luq: answers in order.
1) PM's usually don't miss PVC's - NOT if it is functioning correctly. Also, not if they are bad enough to make you feel them. I am assuming that your period for the recorded PVC's was 60 days ( You said since OCT). 12,000 in 60 days is about 200 per day - on the average. That's LESS than 10 per hour on the average. Not very many. BUT - if you have them as long runs, as opposed to singles, you would be more sensitive to them & could feel much worse.

NOW - you say the day AFTER the Holter they only found 3 for a 24 hour period. That is completely possible. IF you had a lot of runs of PVC's in the 60 days.

A couple thoughts on PVC's. I have had them by the THOUSANDS per day & rarely felt them. BUT - I can recall the very first one I ever had. To the unwary or uninitiated, they are a shocking, unnerving, scary event. They can also be caused by psychological state of mind. For instance, when you had the Holter on, you relaxed because the Dr. was doing something that you hoped would help you out.

Also, PVC's feel like "Skipped" beats to most people, NOT extra beats.

All the symptoms you mention can easily be caused by fear from PVC's that are not understood. They can also be caused by other problems - like supraventricular problems. that only your cardio can explain or diagnose.

Normal PVC's can be extremely debilitating & stressful. But, at the same time, if they are normal PVC's they are not dangerous in the quantity you have experienced. You may trust me on that part. I've had them for years, both as a lot of singles & as runs. The runs can really leave you disabled if they are frequent enough & LONG enough.

Let me add - IF, as your cardio describes it, you have long pauses in heart beat at some times, you could easily feel the way you describe. Why you have a VDD mode PM I do not understand. Seems to me that a DDD would take care of the pause in the Sinus node functioning. But even a VDD PM should give you a ventricular contraction without an atrial contraction. You should ask about that part of your problem.

Don

Thanks

by Luq - 2012-12-27 01:12:30

Thanks Don. I will work on that. Godbless and happy new year

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