Heart Block and Ventricular Tachycardia

I had a Medtronic Revo Surescan pacemaker implanted in Feb due to sudden onset of complete heart block which resulted in heart rate of 35 and lower. Echocardiogram and complete monitoring for 4 days in hospital showed no signs of any other issues. Yesterday cardiologist told me he wants to do stress test because PM readout show I have had a couple episodes of VT (one at 3 in the am). They will have to do a nuclear stress test because I have knee issues preventing me from doing a treadmill. He did not seem to worried, and the test is not until Sept. Should I be worried? My dad had electrical issues in his heart (tachycardia) and died of a heart attack so I am very concerned.

Also, I have had adjustments made to settings already so that I am set to pace 60 - 150. Rate response turned off. I am pretty much 100% paced in atrium, and ventricle pacing showed at 10% on readout. I am back to doing laps in the pool for an hour or so 3-4 days a week. However, I have to be careful not to overdo and check my heart rate often. There have been several occasions when my heart rate drops to resting rate after 2 laps of freestyle, but after about a minute my pacer kicks back in with a rate of about 120. Other strokes don't result in this, just freestyle. I am confused as to why with a top limit of 150, I drop to resting rate so easily and go back to 120 after so short a time. Any ideas??? Thanks in advance!

4 Comments

questions

by Tracey_E - 2014-07-30 06:07:11

The vtach, how fast and how long did it last? Half an hour is more concerning than 10 seconds. A bad dream can suddenly make your heart race. If one of my dogs gets me up and I go downstairs to let them out at 3am, it's going to show a sudden increase. Not all increases are unnatural, and even if they do happen at random that doesn't mean it's dangerous. If your dr was worried, you would be in a lot sooner than Sept to study it further.

Electrical issues are unrelated to heart attacks. Heart attacks are when part of the heart dies because of decreased blood flow. That's plumbing. If you have known, dangerous tachy issues (as opposed to fast but harmless rates), they can switch your pm to an icd and/or give you medication to slow it down. Odds are you are being monitored much more closely than your dad ever was, and that's assuming you are even at risk for what happened to him. Don't lose any sleep over this.

Do you have those numbers backwards? Block generally paces 100% ventricle, little to nothing in the atria. Assuming that's the case, I'm wondering why you pace at all atria. It could be related to the sudden drops. Stress test is a great way to get some answers.

questions

by Tracey_E - 2014-07-30 06:07:45

The vtach, how fast and how long did it last? Half an hour is more concerning than 10 seconds. A bad dream can suddenly make your heart race. If one of my dogs gets me up and I go downstairs to let them out at 3am, it's going to show a sudden increase. Not all increases are unnatural, and even if they do happen at random that doesn't mean it's dangerous. If your dr was worried, you would be in a lot sooner than Sept to study it further.

Electrical issues are unrelated to heart attacks. Heart attacks are when part of the heart dies because of decreased blood flow. That's plumbing. If you have known, dangerous tachy issues (as opposed to fast but harmless rates), they can switch your pm to an icd and/or give you medication to slow it down. Odds are you are being monitored much more closely than your dad ever was, and that's assuming you are even at risk for what happened to him. Don't lose any sleep over this.

Do you have those numbers backwards? Block generally paces 100% ventricle, little to nothing in the atria. Assuming that's the case, I'm wondering why you pace at all atria. It could be related to the sudden drops. Stress test is a great way to get some answers.

Thanks

by Dee224 - 2014-07-30 09:07:32

Thanks TraceyE. You are right, I got it backwards and I guess the 10% pacing in the Atria has to do with the fact my resting rate is set at 60. Maybe if they moved it to 55 or even 50 there would be no pacing there at all. More questions to ask the doctor. What I don't understand is how can someone with bradycardia from complete heart block have episodes of vtach? I am not sure of the speed, but the tech said they were short episodes. I wonder if hot flashes would bring it on...

yep

by Tracey_E - 2014-07-31 09:07:37

I would think hot flashes could bring it on, yes. You are correct, it's possible that dropping the lower limit will mean less atrial pacing. You could ask to try it, see how you feel. It could be that you feel better with the higher rate so leave well enough alone.

Most of my atrial pacing (4%) is drops when I'm working out. I'll get up to 150 on my own, drop to 70 or 80 for a bit then go right back up. The pm kicks in with pacing so the rate stays level.

There is no good or bad number, the important thing is how you feel. If you feel good and can do what you want, then you are pacing the right amount.

AV block means the atria beats normally (in theory) but the signal isn't getting through to the ventricles. When we're not paced, the ventricles beat on their own more or less at random, so it's not unheard of to have some tachy runs. They can still do this when paced. If it's short and not dangerously fast, it's no big deal. Most everyone has little abnormalities in their beat! We're just being monitored so closely, we have that computer recording 24/7, so we pick up on little things others could have for years and never know about.

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