Pauses & PVCs Definition

Next week marks my 2 year anniversary to PM implant. I have been experiencing a little lightheadedness and a feeling of strong heart beat in my neck. I am going to get this checked out, just waiting for a call back from the clinic. I had the same feelings last year at this time (leads me to think it is seasonal or weather related) but they were way more intense. They increased a time setting so that it waits longer before firing again (sorry I don't know the exact technical terms) and that solved my issues last fall.
After reading a few posts, I was wondering if anyone could tell me what a pause and pvc is? Maybe this could point me in the right direction.

5 Comments

Pauses & PVC's

by donr - 2013-09-19 01:09:15

Below is something i wrote in the past summer for someone. It explains PVC's. But first - I guess the best way to describe a pause is any elongated time during which something SHOULD have happened but did not - In short, something is LATE or MISSING, like a beat that does not occur. You read msgs all the time where the person reports PAUSES of a few seconds up to 10 + seconds.

Begin Paste:
"I can give you insight to only one of your symptoms - the successive heartbeats that go "thump-THUMP" w/ an apparent pause in there before the next regular beat, since the sequence is accelerated a bit. All that in place of "...two pretty even beats." That's called a PVC for "Premature Ventricular Contraction." It's where the first beat comes sooner than it should under normal timing (Premature - pretty neat, huh?) & is kinda wimpy because the ventricles were not FULL of blood. The second, stronger beat is the result of extra blood from the early previous contraction being in the ventricles & the heart works a bit harder to pump out the extra blood. Absolutely terrifying, aren't they? Make you think your heart quit on you - temporarily. Fortunately, they may be terrifying, but absolutely benign & harmless. Also, in small numbers - like a couple each minute, they don't do anything for them. You have to have them tens of times per minute for anything other than intervention by meds. Generally speaking, a PM can do nothing for, to, or about PVC's. Given enough time & hearing it from your cardio & us enough times & you will finally believe me "They won't kill you!". Took me a long time hearing that till I believed. I had 103,000 of the little suckers last month & did not sense a single one of them.
Final word - you are not being pathetic - you are struggling to survive in a strange & foreign land. We all understand, as does your Cardio - I hope.

Don

Junctional Rhythm

by ebfox - 2013-09-19 03:09:00

TB,

Feeling your heart beat in your neck is a classic junctional rhythm symptom. If your sinus node is non- operational, your AV node provides a backup beat and that is junctional rhythm. If your junctional pace is faster than your set minimum on your PM, then you will feel the junctional. If it gets over 100 bpm it is called accelerated junctional. Sometimes the doctor will want to increase your PM minimum so that PM paces rather than the junctional.

One other thing, Don explained PVCs, there also is something called a PAC (premature atrial contraction). PACs feel like skipped beat, but usually there is a rhythm to them (ie beat,beat, beat, skip, beat, beat beat, skip etc.) Sometimes you get multiple PACs that feel like a longer pause. Back in my afib days it was not unusual for me to feel 3 PACs and then I went right into afib. That's a bad feeling.

You need to check in with your EP about the pauses and to find out if you have accelerated junctional-

Good luck,

E. B.

PVC's

by t-bee - 2013-09-19 09:09:24

Thanks that all makes sense and will help when I get my appt. Question for Don: can they tell from the downloaded pacemaker readings that you have had a pvc?

And for EB: My lower chamber is paced only and my pacer is used less than 1% of the time. They said the lower chamber doesn't always receive signal to pump. So I'm not sure that is the sinus node you are referring to EB? I really should ask the technical terms for my condition some day

PVC's in records

by donr - 2013-09-19 10:09:37

Your PM will record every PVC that occurs - I mean every stinking one of them. It even differentiates between singles & runs.

PVC's have a very distinct & recognizable pattern on an ECG. They jump out at you like a thumb in a purple cast .

Mine, every time it is downloaded, is just chock full of recorded PVC's - measured in the hundreds of thousands.

Stop & follow me in some math: Your heart beats about 3 MILLION times per month (Picked because it is convenient to follow - but not far off normal HR's.) Supposing that 1% of them are PVC's; that's 30,000 individual PVC's. Divide that by 30 for PVC's per day & you get about 1,000 per day. That's in the vicinity of 1 PVC every 1-1/2 minutes. Summary: Small percentage, but BIG sounding number.

You can tolerate up to about 10% PVC's, or roughly 6 per minute w/o feeling like pure, unadulterated CRAP. (Would you like to ask me how I know?) When you hit about 33% PVC's you are pretty much incapacitated. (Don't ask!)

Currently I run about 3 PVC's every 2 minutes, which brings me close to 100,000 per month.

I never notice the singles. If I have a fairly long run - say 10 in a row, I will sense that & make an off-hand comment about it.

Remember - PVC's will NOT kill you!

Don

EKG

by ebfox - 2013-09-20 10:09:57

The signal for the ventricle to pump can come from 3 places: 1)the sinus node, located on the top of the right atrium, sends a signal to contract the atria, then the charge flows down through the AV node to the ventricle. This is sinus rhythm, the way it supposed to work. 2)if the sinus node has a problem, the AV node, which is located on the bottom of the atria, sends a signal and the ventricle pumps, the atria pumps also however it is not as coordinated as sinus rhythm. When the atria pumps against a closed valve, you sometimes feel that in your neck. 3)If neither of these human pacemakers work, your electronic pacemaker contracts the ventricles.

You probably need to go in for a pacemaker interrogation to see if everything is working properly-

EB

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