pounding heart

I had a pacemaker implanted two months ago. The reason was a Mobitz 2 heart block.After A number of ups and downs my pacemaker now seems to be very well-adjusted, And I feel good and seem to be up exercise as vigorously as I want. My right ventricle is being paced one hundred percent of the time.
I have two questions:
1. I experience that I can feel my heart beating all the time now, but before my pacemaker was implanted I would have to be very quiet and relaxed to feel my heartbeat.It's not beating too fast, but it seems like it's beating hard. Has anybody else had this experience after pacemaker plantation?
2.how could I go from having connection problems through the AV node only when I placed my heart under some mild exercise stress and then after having A pacemaker implanted, having no conduction at all across that node? Has anybody else had this experience?
Thanks for your consideration,
Lewis

6 Comments

AV-delay

by golden_snitch - 2014-05-25 03:05:49

Hi!

On your second question:

You probably do still have a working AV-conduction most of the time, but the pacemaker is not waiting long enough to let it work. Happens in many patients, if settings are not optimized. With a Mobitz 2 heart block that happened only intermittently under some mild exercise/stress, the aim should be to reduce your ventricular pacing to an absolute minimum. Can be done by prolonging the AV-delay, the time the AV-node gets to do the job on its own. If this delay is programmed too short, then the pacer starts pacing the ventricles before the AV-node even got a chance to pass a signal coming from the atria on to the ventricles.

Another option would be to switch on a special pacemaker feature that is designed to reduce ventricular pacing, but your Boston Scientific pacemaker unfortunately does not have it. Medtronic and Sorin pacers have it. It's a feature that does not pace you out of every single heart block; instead it makes the ventricular lead kick in when a certain amount of heart blocks appears within a certain period of time.

Ask your doctor about the AV-delay and possibilities to prolong it a bit. That might already reduce the amount of ventricular pacing significantly.

Same Here

by NiceNiecey - 2014-05-26 08:05:18

Hello Lewis.

I also Mobitz Type 2, Second Degree Heartblock. I got a PM 5 months ago.

Concerning the first question (no idea about #2), I, too, was constantly feeling my heart beat. It was annoying and I was trying to "ignore it" to make it go away without much success. It was most problematic lying in bed at night trying to fall asleep.

As time has passed, however, it has subsided. There are times when I still feel my heart beating but for the most part, it has passed.

In addition, each time I have an adjustment (and I've had several for lots of reasons), it takes about 10 days to 2 weeks to stop feeling every little thing. I have no idea why but that's my experience and I hope it encourages you that things will eventually regulate.

Niecey

Thanks

by LEW49 - 2014-05-26 12:05:27

Hi golden snitch:
I have been thinking along the same lines, but the pacemaker nurse told me I had no conduction through the AV node. I did have retrograde conduction, however, which caused me to have an adventure with pacemaker mediated tachycardia.

But it makes no sense to me that while waiting in the hospital for my implantation I had a nice normal resting heart rate, With the exception of an old right bundle branch block, and then a month later to have no conduction at all. On the other hand, the exercise-induced heart block was getting rapidly worse at the time of my implantation. I am going in for my three month follow-up a month from now and I plan to ask for a copy of the pacemaker interrogation report (that's an idea I got from Reading comments on the pacemaker club website). I have made contact with a friend of a friend who is a Medtronic pacemaker representative. When I get that information I'll run it past him.

Do people ever consult cardiologists or electrophysiologists for second opinions?
Thanks so much for having given my situation that's careful thought,
Lewis

That's nice

by LEW49 - 2014-05-27 02:05:44

It is reassuring to hear that your sensation of having your heart pounding settled down over time. I sincerely hope that I can report back that I have the same experience.

Thanks very much, Lewis

pounding heart beat

by Pookie - 2014-05-28 09:05:24

Hi.

For years after receiving my pacemaker I had exactly what you describe. Five & a half years to be exact. Pure hell it was. Anyways...

The fix was: the Optimization setting, which is part & parcel of the Rate Response, was ON; which in 99% of the pacemaker population that is okay, but as soon as they turned it OFF that awful feeling went away for me.

I can't explain what the Optimization does exactly, but it wouldn't hurt to ask your PM Tech (or whomever adjusts your settings) to try this to see if it makes the pounding go away.

Take care,
Pookie

optimization

by LEW49 - 2014-05-30 12:05:20

Hi Pookie:

Thanks so much for your response. Is rate response turned on in your pacemaker? I don't believe it is in mine because my sinus node is working ok--but my AV node is passing the signal to my Ventricles. In any case, I am going to get a pacemaker interrogation report from the pacemaker nurse at my next visit and I will check to see if optimization is turned on. If it is I will ask them to turn it off. Thanks again for providing this avenue for me to explore.
Lewis

You know you're wired when...

You fondly named your implanted buddy.

Member Quotes

I've seen many posts about people being concerned about exercise after having a device so thought I would let you know that yesterday I raced my first marathon since having my pacemaker fitted in fall 2004.