What to Expect

I have paroxysmal AFib which was not cured by two ablations and cardioversions. Then I got atrial flutter as well which would not respond to drugs so I now have the pacemaker, followed by AV node ablation and I have to say, I am doing really well these days.

I know that the upper chambers of the heart now are isolated from the lower ones, so that the random electrical impulses are not transmitted through and the lower ventricles are paced.

Just puzzled though, as some nights I get a very jangly, fluttery feeling, but the pulse is steady. Am I right in concluding that although I may be in AFib in the upper heart, only the activity of the lower paced chambers are felt in the pulse, ie I will always feel a regular pulse, no matter whether in AFib or not?

6 Comments

you are correct

by Tracey_E - 2015-03-12 12:03:07

That is why you had the ablation and got the pacer, so it could keep you at a nice, steady rhythm regardless of what your atria is doing. It's nice to hear success stories.

What to Expect

by JoMarie - 2015-03-13 05:03:25

Thank you for your reply. I have always had pulsatile tinnitus from time to time and although I feel and know the pulse beat is steady, sometimes I can hear the chaos in my ears and sometimes become aware of a sort of heart disturbance, although it is not now alarming. It is good to know that this is now confined and contained.

I had to have one adjustment to the pacer to turn it up from 80 to 115 bpm as it was not coping at the higher beats, but since then, which is now several months ago, I have been just fine. With the correct information, then I am able to forget all about it for days on end, especially since I am now on Pradaxa (dabigatran) instead of the dreaded Warfarin which doesn't allow you to forget your condition.

Similar Condition, Doing Fine

by PJinSC - 2015-03-13 09:03:00

I have the exact condition, going into my third year. Two ablations, three cardioversions, three lead PM installed with two leads to the ventricles, initially set at 80 bpm for a month of healing and then set at 70 bpm. This is what I have learned: The atria have remained in atrial flutter at a heart rate above the setting of the lead in the atria. They are basically doing nothing, fluttering chaotically, which is why they keep the anticoagulant being administered (Xarelto for me). And that is what I feel at night and sometimes during the day if I do strenuous activity. They were cut off electrically from the ventricles by the AV node ablation which created a heart block. The ventricles are doing all the work, and that is what you feel in your pulse and ears (I have tinnitus also) and what the blood pressure machine detects. What you feel in your chest and ears are PVCs and the fluttering of the atria. Remember that the typically, a PM does not slow your rate down, it only can correct a slow beat. There are some that do correct tachycardia. Right now, if my PM quit, I would roll down to 40 bpm, which is where the natural ventricle pacers kick in to keep me alive but feeling really bad. The pacer lead in the atria is just there in case, and is basically just reading the rate. I don't understand your rate setting, which seems high to me, but ask your PM lab nurse to explain it to you next visit. My guy is great, and keeps me informed of everything. We have become friends. I also have a home monitor, and they keep track of me remotely.

Good Luck and Good Life,
PJ

What to Expect

by JoMarie - 2015-03-13 09:03:38

Thanks PJ for your interesting post. I am not sure what happened prior to the adjustment, only that I woke in the night with what was an AFib attack and I had all the old symptoms and felt as ill as I always do when this happens. I was alarmed and disappointed and made an appointment with the Pacing Clinic immediately. They did their printout and after lots of discussion, including calling in an expert, they adjusted it upward in some way (I am sure I heard it was set at 80 and they adjusted it to cope with 115) as it was apparently displaying a wave pattern which should have been tuned out.

That does sound vague and you can be sure I will ask for a better explanation on my next visit. However, in the interim I am just enjoying a run of good health as the AFib used to pull me down into fatigue and looking as white as a ghost for at least 24 hours recovery from it.

Similar but not quite the same here.

by Suledan - 2015-03-14 05:03:01

I'm in permanent AF and on CCBs to control the rate and had a PM fitted late last November set at 60 as my HR was going really slow with regular 4 second gaps. I haven't had an ablation though.
Sometimes I can feel my atria doing a dance but my pulse is usually between 60 and 80.
I feel so much better since getting the PM, much less tired, no near fainting and I am able to think more clearly.
Having said all that - I'm a bit worried as my PM had flipped on its end under my skin when I woke up the other morning, it's still working but the pocket is sore.

Can it Do That?

by JoMarie - 2015-03-15 09:03:10

Flipped on its end? What does that mean, sort of sideways? I would go back with that immediately for a manipulation back to its proper position - otherwise of course it will be sore which could lead to infection. I have thought in the past that my PM had moved slightly under the skin and looked more prominent, but other than that I would get help to right it.

I am reassured to learn that others are aware of the atria being chaotic, in my case, from time to time only. If that is the worst it can now do, then I can settle for that! My jangly nights are spent listening to it all in my ears and running constantly to the loo, which seems to be a side effect for me. But I feel nowhere as ill as I used to when I went into AFib.

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