Pain and Syncope

I just recently had a dual chamber pacemaker implanted to help combat atrioventricular heart block which would cause bradycardia and hypotension which then resulted in pain, syncope and cardiogenic shock. Every time my pacemaker paces my ventricle, Vpaces, I feel it and it hurts. It feels like a horse is kicking me in my chest with every pace. I am also still going in and out of heart block and sometimes the pacemaker will pace me and sometimes it does not. Sometimes it paces when it's not supposed as well. Has anyone else had any of these issues as well? I have been to multiple cardiologists and electrophysiologists and every time it have to prove to them that I can actually feel the heart block and feel when the pacemaker paces. Every doctor I have seen does not know how to fix this or what to do about it. It's getting to the point where I have no life because if I go into the heart block there is a good chance I will pass out. I am only 29 years old and I cannot keep going on like this. I want my life back and I am at the end of my rope. One doctor went up through my femoral vein and paced different parts of my right ventricle and no matter where he paced it still hurt. He then paced my left ventricle and although it was uncomfortable it was not nearly as excruciating as when the right ventricle paced. He was going to implant a biventricular pacemaker but because it was uncomfortable he won't perform the implant procedure. I think the biventricular pacemaker would be much more tolerable than the dual chamber pacemaker I have now. Does anyone have a CRT/ biventricular pacemaker? Does anyone have an absolutely amazing cardiologist/ electrophysiologists who actually listens to them? If anyone can offer any words of wisdom or help I would greatly appreciate it. I feel beaten down and defeated and am absolutely miserable.

5 Comments

chest pain with pacing

by Selwyn - 2014-09-17 01:09:25

I did wonder whether your unipolar setting was activated. I had a lot of uncomfortable chest pain with the unipolar setting ( i.e. the return electricity is through the body to complete the circuit)- once changed to bipolar the muscular chest pain settled. It certainly does feel like a horse is kicking you in the chest! I certainly used to feel my PM 'kicking in' because of the above.

Check with the EP as to whether you are unipolar. If you are try the bipolar setting ( circuit return lead to lead) and let us know the outcome.

Also make sure your pacing threshold ( ie. that current which causes the heart to contact) is correct and not too high.

Keep on at the medics. If necessary ask for another opinion if all else fails.
There is always inflammation at the site of PM leads- some have steroids in the tip to reduce this in the long term

Settings

by Marine8914 - 2014-09-17 05:09:30

Selwyn:

Thank you for your post. I am set with a bipolar setting. I have had threshold settings tested multiple times. I just saw a Medtronic Rep yesterday to have it interrogated, mainly because I passed out and my HR was 38 with a BP of 72/48. He adjusted a bunch of settings. One of which was or make sure I was bipolar not unipolar but also to change my lower limit to 60 bom and put me in a DDI pacing setting. Unfortunately I have been Vpacing on and off for the last 20 hours and I am in significant pain. The ER doctor discharged me so I am back home am absolutely miserable.

I am seriously considering requesting to have my pacemaker removed.

Pericarditis?

by Selwyn - 2014-09-21 05:09:51


Pericarditis after PM implantation
Posted by carolinagirl27 on 2014-09-20 15:00. 3

I see this post now- you may want to compare notes!

Further thoughts re. chest pain

by Selwyn - 2014-09-21 05:09:57

Sometimes pericarditis ( inflammation of the outer covering of the heart muscle) can cause pain, worse with movement. It is a know complication of PM insertion.This may not be related to the PM, as it does have many different causes.

The Vpacing could cause a sufficiently strong contraction of the ventricle to reach the point of contact for pericarditis. Treatment is with anti-inflammatory tablets of one sort or another. Again, this is worth discussing with a medic.

Thanks for feed back,
Selwyn

Not Pericarditis

by Marine8914 - 2014-09-23 06:09:12

I have been checked for pericarditis and all tests were negative. They even treated me for it just in case and nothing got better. This past week I went into Wenckebach, became bradycardic and hypotensive. The pacemaker didn't pace and I passed out and fell down a flight of steps. Cardio/ EP at hospital ran more tests. They believe the lead in my ventricle is short circuiting. I have surgery tomorrow. Fingers crossed.

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