Pacemaker Malfunction?

I have had quite a few different arrhythmias over the years; but since my replacement in November I get intermittent "episodes" that can last for up to 3 mins in which time I feel strong palpitations a slow heartrate and presyncope which brings me to a point I have to stop and sit, After I get myself together I am fine until the next one.

I am wondering if I have some kind of intermittent malfunction of the battery or leads.
I have a Medtronic epicardial pacemaker, the battery is in my abdomen. I have been almost 100% dependent for 12 years.

Just thought I would get some input/suggestions before I inform my EP.

Thanks

3 Comments

Different reasons

by golden_snitch - 2013-07-08 02:07:18

Hi Kate!

Could it be that your new pacemaker has some features for which the self-test is switched on? The slow pulse and the palpitations sound a bit like what can happen when the pacemaker tests the atrial and ventricular threshold. Some pacemakers nowadays have auto threshold testing and adjustment. However, if this would be the cause, you were very likely to have those symptoms every day at the same time.

What it could also be is a "loss of capture" in one of the leads. Failure to capture occurs when paced stimulus does not result in the heart muscle contracting. That would lead to a slower heart rate or even a pause. This loss of capture is usually caused by scar tissue around the tip of the pacemaker leads; the electrical impulse coming from the pacemaker doesn't get through the scar tissue. In many cases it helps to increase the pacemaker's electrical output (amplitude), so that it stimulates with a stronger impulse. However, this will ultimately lead to a shorter battery life.

I'd suggest you ask your doctor for a holter or event monitor, so that one can correlate those episodes with your heart rhythm and possible arrhythmias.

Best wishes
Inga

date and time

by Tracey_E - 2013-07-08 02:07:58

If you write down the dates and times it happens, they can check for incidents when they interrogate, see if anything was going on.

I had some odd incidents and they put my pm in a diagnostic mode and gave me a magnet. Next time it happened, I swiped the magnet across it and it functioned like a marker so they knew where to look in the report. Nothing showed up any of the times I swiped it, so whatever was going on, it wasn't paced.

Sinus node awarenes

by ebfox - 2013-07-08 05:07:09

Hi Kate,

You should know what your minimum setting is (say 60 bpm for example); if it is letting your rate drop below that, then there's something amiss with a lead or the PM; as Tracey says, make a diary and write the date and time of the incident.

It is more likely that your own autonomic system is rearing it's head and causing some form of arrhythmia.

Good luck,

E. B.

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