Erratic beat

My single lead pacemaker has been in ten years.
For the last six months most of the time my pulse is giving 2 beats then pause, with variations of six beats or when asleep, I think down to 1 then pause, because I wake up gasping for air.

Technician says my pacemaker is supplying an even 70. My BP monitor reads 44. I am 100% dependant.

Cardiologist has just given me my 6th angiogram that confirmed no blockages, but he says output is down to 30%. Recheck a week later showed output at 40%.

Since the last angiogram and being put on Carvedilol and Ramipril, I have angina most of the time.

What should I do?

2 Comments

Where are you paced?

by golden_snitch - 2013-01-02 10:01:00

Hi!

What you are describing reminds me a bit of the times when I had a second degree heart block, but only a single-chamber pacemaker stimulating my right atrium. I often had between two to six normal beats then a pause, then normal beats again, then a pause, and so on. So, I was wondering, if you are paced in your atriums only.
Can very well be that the pacemaker is pacing you at 70bpm all the time, but if it's an atrial pacemaker and you have a heart block, then not all of these 70bpm might reach the ventricles, and therefore your BP monitor shows a lower heart rate.
But if you have a ventricular pacer lead, the skips in your heart beat cannot not be caused by a heart block.

Another arrhythmia that can cause these pauses are premature ventricular contractions (PVCs). PVCs are often accompanied by a so-called compensatory pause, and some people have episodes where they get them every couple of beats. However, most people complain about a very strong heart beat or a stumbling of the rhythm when they have PVCs.

Regarding the angina pectoris, I'd give your doctor a call immediatly. It should not be that you end up with being in pain every day because two drugs have been added. Maybe the dosage needs to be changed, or the drugs.

Hope this helps a bit.

Best wishes
Inga

Change of Setting

by peter auliff - 2013-02-28 02:02:15

I use precisely the same method for taking my BP and Pulse every day.

I was on medication for a few weeks up until 20 August 2011. My pacemaker was set at 60. I was happy at this setting.
On 19 April 2012 my pacemaker setting was raised to 70 with a rest rate of 60. This is when the problems started. I complained about the problems, but my Tech said that the pacemaker was working perfectly.
I felt the need to request a return to 60 when my pulse appeared to be down in the 30s. I decided to act independently of my GP and ask for a reduction in the setting when my BP monitor Errored out 6 times in a row because it could not read the low pulse.

My GP has tried without success to find out what is happening and I have requested all the hospital data relating to this period of the angiogram. I am still waiting.

I go to Cardiology Clinic every second year. I last saw the cardiologist four years ago when he gave me a lecture on the dangers of having too many angiograms . He then wanted to give me one then and I had to point out that he had done one the last time that he had seen me.
Two years ago I saw the cardio Registrar who gave me a lecture on my risk of stroke.
This year 16th October 2012, I was seen by (I was told) an assistant registrar who ordered a category 1 angiogram because the Echo cardiogram showed out put down from 40 to 30%. This was a comparison with the ECG done when I was on the 60 setting.

I would still like an explanation as to why, when the pacemaker is set on 60 I have no problems with BP or pulse and my general health, yet when the pacemaker rate is upped to 70, my pulse drops to below 30 and all readings become wild as well.
For example; a reading of 101/61 and 56 two minutes later is 136/104 and 36. I have had many readings like this and many error readings too when on 70. Yet this never occurs on 60 setting.

As for medication. All angiograms say that I have large calibre arteries. I have normal BP. And a second Echocardiogram gave out put at 40% even though Iwas still on 70 setting.
My veins on hands and arms now look double their size since going on medication. Why do I need medication?

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