PVC's

Hello all,

Does anyone know if having a pacemaker implanted increases the likelihood of having increases PVC's?

Are these PCV's defined by the pacemaker's settings and definition?

Does the average person have them also, who don't have a pacemaker?

Any feedback would be great!


>^..^<

6 Comments

Hi Moner

by BillMFl - 2013-12-07 05:12:40

Funny you should ask. I never was aware of any PVCs before getting a PM. If I had them they were few and far between. Now I am averaging just over 100 per day which isn't a huge number but, and there is always a but eh? They are occurring in bunches or runs. So the discomfort is substantial while they are happening. I saw my cardio on Thurs and he was unconcerned. Easy for him to say. So in the past year I have gone from pacing 30% to pacing 50%. And the PVCs have become a daily thrill. When I asked why his genious response was you are getting older! I already knew that. Sheesh. I suspect that for at least some of us, the constant mild electrical jolt of the pm can become an irritant to ones heart. After 11 years I think that may be the case for me. Only a theory and no proof. Did have a cardio (not my regular guy) tell me that there is a condition called pacer syndrome that causes side effects like pvcs.

PVCs

by philip.thecyclist - 2013-12-07 07:12:32

Average people do have PVCs, although they may not be aware of them. I had them before my first PM implant, and I still experience them now, especially after some physical activity like stair climbing. Like BillMF, they often occur in runs. It's probably fair to say that I am more aware of them now, even though I may not be actually having more. This may be because the PM deliberately inhibits a beat after a PVC, so you become aware of a pause, followed by a thump. The medics have witnessed this whenever I am tested and they are not concerned. The settings of the PM may affect the frequency of PVCs. The lower the base rate, the more likely it may be that you experience them, as I understand it.

Philip

Thanks

by Moner - 2013-12-07 07:12:47

Hi guys,

Thanks so much for your input, my lower rate limit is set at 40bpm, so maybe that's why I've seen a high number of PVCs. I didn't realize that after a PVC the pacemaker deliberately inhibits a beat.

Moner

>^..^<

PVCs

by golden_snitch - 2013-12-08 05:12:03

In the compensatory pause after a PVC, the heart muscle cannot be stimulated. It's a so called refractory period. This is not a pacer setting, it's physiological. Even if the pacemaker would stimulate, nothing happens. The atria will react, but not the ventricles as they are still in a kind of reset-phase after the PVC.

Pacemaker settings cannot really affect PVCs as they are extra beats that happen outside of the normal rhythm. There is no data that indicated that pacemakers trigger PVCs or PACs.

Everyone has PVCs, although, as Philip said, some don't feel them. They're benign. Cardios usually don't do anything about PVCs unless they happen very frequently, like 20.000 per day or the patient has a damaged heart muscle.

Inga

Thanks for the input.

by Moner - 2013-12-08 06:12:06

Thanks for your reply Inga!!

Moner
>^..^<

PVCs - different understandings

by philip.thecyclist - 2013-12-08 07:12:57

I am not an expert, so I hesitate to question Inga's input, but my understanding is that PMs can be set to inhibit beats after premature ventricular contractions, which is what the I stands for in behaviour modes such as DDIR. My point about lower base rates possibly affecting the occurence of PVCs is not that the PM may cause them, but that higher base rates mean that fewer may occur. I base this on my cardiologist's advice given me when my first AV nodal ablation was only partially successful. His advice was that paroxysmal AF could be triggered by PVCs, which were more likely to occur at lower heart rates. After it became clear that the ablation had not been successful, he increased the base rate from 60 to 70, although my resting heart rate prior to the implant had been in the mid forties - I was pretty fit. I have complete heart block now, so although I now have permanent AF, it is no longer an issue, but my base rate has been kept at 70.

Philip










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