Tachycardia with palpitations

Hey everyone. I am 30 years old and I have a dual lead St Jude pacemaker. I guess I should start from the beginning. In January of 2014, I started having a lot of issues. Constantly high heart rate, palpitations, dizziness, shortness of breath, headache and extreme fatigue. I could not walk 5 feet without my heart racing. After a few wrong doctors, I was finally referred to an electrophysiologist. By this time, it was April. She did a stress test, which I could not finish because y heart rate got to over 200 and I was gasping for breath. She also put me on a 30 day event monitor. When I got the results from it, she diagnosed me with inappropriate sinus tachycardia. The lowest my heart was during the 30 days was around 130. I had already been put on 75 mg of metoprolol. It did nothing. After a long discussion, my dr told me that I needed an ablation because I was so symptomatic. Surgery was scheduled for June 5, 2014. I was in surgery for 5 and 1/2 hours. She told my family that she had never seen someone who needed as much ablating as I did. I was released from the hospital 2 days later and all was good. On June 8th, I started to become very weak and nauseated. I checked my heart rate and it was 52. They told me not to worry about it as long as it didn't drop below 50 and stay. On June 9th, it dropped to between 44-47 and stayed there. I went to my family dr to have an EKG done (Electrophysiologist was 2 hours from me). My heart rate was 39 and my rhythm was very abnormal. I was sent back to the heart hospital where I had my ablation done at. After hooking me up to monitors, my heart rate dropped to 26 and stayed that way. I was told that I needed a pacemaker. That surgery was performed on June 10th. Everything was good for a while and when I went for my first check up, no adjustments were made to my settings. Pacemaker was functioning 67%.

A month and half later I started having very strong palpitations, dizziness and tachycardia. I called my dr and went in to have Some adjustments made. My pacemaker was functioning 89% at that time. All was well for a couple of months.

Starting a few weeks ago, these palpitations came back with a vengeance. Strong enough that I have to sit down because i feel like I can't catch my breath. I try to check my rate when these spells happen and it is always over 120. Takes around 30 minutes or so for it to calm down. It happens probably 10 times a day.

I know this was very long, but I felt like I needed to give a history before I ask these questions.

1. Has anyone else had this happen?
2. If so, what was done to help it?
3. What questions do I need to ask my dr when I go back? (Appt is scheduled for Jan 7.)

Thank you all in advance!

4 Comments

Rough time

by Theknotguy - 2015-01-03 10:01:19

You've had a rough time. Those sessions with high number tachy are no fun. Been there myself.

I go both ways. If no treatment, heart rate goes very fast and it will kill me. If they treat for fast heart rate, heart goes so slow it kills me. Between the proverbial rock and a hard place. What doctors did was - - give me medication to slow down my heart and use the PM to bring it back up to speed. Pacing is now above 80%. Don't care as the tachy was really bad.

I'm hoping they can find something to slow your heart. I'm on Metoprolol and Cardizem both. I can take extra Metoprolol if I go into an afib session. Metoprolol (for me) slows my heart rate so I don't go into the real fast tachy sessions. Cardizem helps reduce number of afib sessions. Between the two plus programming from my PM, it has reduced number of afib sessions overall.

Question in my mind is what they can use to slow your heart rate? Did Metoprolol work at all? Or did it not control the situation at the time?

Hope they can find a solution for you.

Curious

by tessenne - 2015-01-20 07:01:15

If there is an update here as it is after the 7th.

Results

by Nikki-porter - 2015-01-27 06:01:39

I had an episode while I was being interrogated. It was an arrhythmia that my pacemaker was not "capturing" because of some of the settings. My heart rate went from 62 to 175 for 4 beats, then went to 60 then back to 175. My pacemaker was set to record if my heart rate got to 150 for 10 beats. They changed it to 175 for 5 beats to see if they can determine how often I am having these episodes. They said that what I am feeling so often is probably this arrhythmia instead of pacemaker mediated tachycardia like I was initially told. I may be having a combination of PMT's and the arrhythmia. It was diagnosed as NSVT. I started taking metoprolol. I follow up in 3 months, sooner if this becomes worse. I am also in a pretty constant junctional rhythm. I am pacing at 98% now.

Tachycardia - do I need a PM?

by SBMom - 2017-03-13 14:09:49

Thanks for the posts it has helped me a lot. I posted a message and am trying to get more feedback. I would love to hear from "theknotguy" because my case sounds somewhat familiar but maybe someone else out there can help? I hope!! 

I am 86 and have a fast heart rate - no symptoms, perfect blood pressur and Echo checked out ok. Dr pushing for pacemaker. Currently on twice a day Diltiazem and Metroprolo. I find the metropolo makes me short of breath (on 12.5mg twice a day). I'd rather have her increase the Dilt and get rid of the Met but she won't. I take Diltiazem 120mg twice daily (240mg). Wearing 30 day monitor and average is 110-140 bpm.

Since Jan 2917 I have had (2) 4 second pauses and (1) 3.5 second pause - I also have sleep apnea and wear a respirator. My sleep therapist says that with apnea I can have pauses and under 5 sec is normal. Cardiologist feels this is a reason to get PM and then load me up with more meds. I have appointment tomorrow. Any advice? Thank you! 

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