a little discouraged by PVCs on my interrogation

So I am seven weeks post implantation with my first CRT-D. I've really had trouble sleeping since day one, as I can't get into a comfortable position with my CRT-D. I also notice that since about the first month I've been having episodes of shortness of breath, but not as bad as I used to have pre-implant. I also still get tired walking fairly short distances but not as much as I used to. I try to be reasonable and tell myself I am still adjusting to the CRT-D.

What worries me is that my EP found PVCs on interrogation last Monday. We hadn't noted any during the three previous interrogations we had done. He turned on the trigger mode and advised me to increase my carvedilol dose. I only recall one ECG pre-implant where I had an isolated PVC.

I am confused why my heart started getting irritable now that I have a CRT-D. I am seeing my cardiologist Friday. For me it is quite a discouraging finding and I am hoping to hear if any of you have had a similar experience. Feeling so down these past two days.

Thanks

2 Comments

Two Questions, First...

by donr - 2014-09-24 04:09:00

Are you REALLY a Cabbie?

Does your cab have a sign on the rear stating "I Shall return"?

Now to PVC's. You did not say how many you had in that interrogation. Unless you had huge numbers of them in runs, I'll quote my Cardio, his head nurse & his EP who took care of me - "PVC's won't kill you!" I'll add to that - they will make you feel like they'll kill you, but they won't.

I have had PVC's at a rate of about 33% of my heart beats over a period of several hours. They really made me feel like trash, & I wanted to just go to sleep, but other than that, no real problem.

Normally I average about 3 PVC's every 2 minutes. In a three month period, that adds up to a whole bunch of PVC's but I never notice them any longer. I only notice longer runs now. It took me a long time to accept them as benign, but once I did, they are nothing.

I take two meds to control them Acebutolol & Flecainide. Between them & My PM they have ceased to be a problem.

I know exactly how you feel about the PVC's - been there, done that. I promise you that they are NOT a problem, only a nuisance, unless you have long runs of them very frequently. They are a normal arrhythmia that just about all people experience - even those w/ normal HR's. People have them & just don't sense them. It is also not unusual for them to start up in greater numbers after getting a PM planted. No one knows why, it just happens.

I just re-read your note & see that you have a CRT-D. That probably makes your Cardio more concerned about you developing long runs of PVC's. They can trigger ventricular tachycardia or Ventricular fibrillation - that could cause your Defibrillator to trigger - an unpleasant experience at best.

Donr

Don't be discouraged

by Grateful Heart - 2014-09-25 12:09:55


It's still pretty new for you and it is typical to need some tweaking, whether it be your device or your meds.

The Doctor gradually increased my Carvedilol dose in the beginning too, slowly doubling it every few months to see if I would tolerate it. He explained the optimum dose was 25 mg. twice a day. It took a while to get there and they even decreased it at one point and then tried again about 6 months later. That time I was able to tolerate it.

I find what Don said about PVC's increasing after implant very interesting. After my implant I had PAC's.... 94,000 over a 3 month period. As time went by, the number decreased dramatically.

So try not to feel down, it sounds like this is just a bump in the road. You being a cabbie (if you are) can relate to that I'm sure. :-)

Grateful Heart

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