Funny feeling

Hi Again,
I`m still having these funny feeling when not really doing much. I`m fine when active and quite happy with my exercise program.
This has been on going since repairs to broken wire 11 months ago. Nobody seems to find anything wrong and I`ve had several settings on the Pm . I have noticed recently when checking my BP and HR when relaxed the HR some times reads lower than the base PM setting of 70 . If taking my pulse I have missed beats . How does the PM read these? This has only started in the last few weeks. Should the Pm smooth this out?
Thanks mg

3 Comments

Funny feeling

by Theknotguy - 2015-01-06 04:01:44

Funny how we sometimes get the same question on the forum from two or three people almost at the same time. Must be the electrical field from the aurora borealis or something.

You've mentioned the "funny feeling" at least a couple of times. Don't argue you are feeling it - obviously you are. One possible explanation for you.

I'm one of those rare individuals who can feel my afib when it kicks off. With digital clocks, I can tell you the exact minute I go into afib. Not everyone has the extra nerve endings in their circulatory system and can feel what is going on.

Right after they implanted my PM, I'd go into coughing jags because I could feel when the PM kicked in and initiated a heartbeat. I'd be expecting my heart to do what it used to do, instead I'd get the tickle from the PM and the thud from the initiated beat. Found out later they had the voltage on my PM set at a higher level at first. It is to my understanding they set the voltage higher to help get the leads implanted into the heart. (I'm sure someone will correct me if I am wrong.) But in any case, they had the voltage set higher for about the first 90 days. During that time period I'd often feel the PM kick off. Sometimes it would wake me up at night. About the 90 day period they dropped the voltage - was sitting in the chair watching my tech do it - no big deal. Afterwards didn't feel my PM kick off a heartbeat as often.

Question in my mind is if you are one of those people who are more sensitive to electrical charges and the "funny feeling" you are getting is when the PM kicks off and initiates a heartbeat? At your next PM reading, discuss it with your tech and EP. I think there is some leeway on what voltage they use to initiate a heartbeat (mine is now set to 8 tenths of a volt) so they might be able to lower yours a bit.

Even with the voltage lowered I still occasionally feel the PM kick in. Was driving the other day and I could feel the PM initiating a beat for about a minute. Then the feeling went away and everything went back to normal. (Or maybe it was the sauerkraut and ribs for New Years?) Anyway, I don't seem to be as sensitive to the PM when it initiates a beat. And if I do feel it, I'm happy to know its working.

Hope you can find a solution.

Eureka!!! I'll Betcha I can tell...

by donr - 2015-01-08 11:01:00

...you what is going on.

Sounds like a classic PVC event. PVC=Premature Ventricular Contraction.

You claim to have a CRT-D-PM running in the DDIR Mode. That tells me that You most likely do not suffer from 3rd Degree Block, but have a pair of Ventricles that needed re-synchronization (The CRT portion of your PM Type) with Defibrillation capability (The D part of the PM Type) and you are set up for pacing AND sensing in both Atria & Ventricles (The pair of D's in the operation mode), also that the Pm is set to inhibit its own creation of a pacing signal if it senses anything going on in the heart (The I part of the mode) and (FINALLY) that your Rate response is turned on). You & Selyn have exchanged notes on the R part of functioning already.

So - on to the PVC Business. There is a condition where the heart's ventricles will contract EARLIER than they should - and without a signal from the Atria that it is time for them to contract - hence the "Premature" description. When that happens, what you will feel is best described as follows: Thump, Thump, Thump, thump, pause, THUMP, Thump, Thump... (Where Thump is a normal contraction of the ventricles - what you sense as your "Pulse"- and thump is a wimpy contraction due to it being premature & the ventricles are not full of blood. The THUMP is a hard contraction because of the pause while the heart's electrical system sorts itself out & gets back in sync for normal pulse rate. During the very short pause, the ventricles over fill compared to normal.

IF it feels like a "Skipped beat": to you, it means that you are NOT sensing that "thump" wimpy contraction. That pause in the string of beats is so short that you cannot feel it anyway.

I do not know how you take your pulse, but until you get very practices at it, you may well NOT sense it w/ a finger on either the wrist or throat. MOF, many HR sensing devices are not sensitive enough to pick it up. That is especially true if it is NOT an electrical sensing device, like an ECG or a monitor. If you have one of those & it puts out a "Beep" for each heart beat, you will hear one beat being a bit early - the premature one.

Again, I don't know what kind of HR device you have, but many of them use a small computer chip to measure the time between heart beats & converts the elapsed time between beats into a heart rate. If it does not sense one beat, due to the premature beat being too wimpy, it senses a very long time between beats & calculates a much lower HR for that period & displays it.

Hope that all makes sense to you.

BTW: PVC's are benign & only make you feel strange. Unless you have them so frequently that they approach 33% of your beats (That's every third beat) you will have no real impairment of life other than feeling odd when they occur.

The PM CANNOT smooth these out because they occur EARLIER then expected. The PM can only fix things that are either late or missing.

Donr

Funny feeling

by mg - 2015-01-09 04:01:59

Thanks for the comments.
I do not feel any extra thumping as such . I`ve only really noticed the missed beats recently because my `cuff` type BP/HR monitor has shown HR below the 70bpm that the PM is set at. I`ve checked my HR/BP regularly every few days over the last 12months with this same monitor and it is always 70/71 resting.
With the on set of these funny feelings it makes me feel really poorly and can last for several hours. Post this feeling I can feel pretty `yuk` for a few days then I seem to get back to normal firing on all cylinders and feel really well. Out of interest I can`t get my `new` Garmin HRM to read properly but I think this can be a common problem. I also have had problems with `pulsing ` in my stomach because the PM wire are affecting the Vegus? nerve . The Techs tried dropping the voltage to stop this but only made the `funny feeling` worse . It does seem to have quieted down recently although the voltage is back to original setting.
Thanks mg

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