Racing Heart and Shortness of Breath

Hi all, this is my second post. I have had my pacemaker 8 weeks suffering from AV Block 2nd grade. To date my pacemaker has been reset twice, first 60 bpm, after three weeks I developed arrhytmias, the cardiologist subsequently reset me to 70 and Rate Responsive and put me on bisoprolol (1.25 mg). As my arrhythmias continued my PC was reset to 60 bpm. For the last two weeks I have felt better, the arrhythmias have subsided but only while I am resting. As soon as I get up and move, my heart starts beating faster, I suffer from shortness of breath and get a tight feeling in my throat. While I feel well while I am resting, my heart starts racing as soon as I get up and walk around. As a result I feel increasingly less inclined to to walk longer distances or do any physical activity (which I had been looking forward to doing again). I am seeing my cardiologist on Friday. Please, what advice can you give me. Should the RR perhaps be switched off?

5 Comments

rate response

by Tracey_E - 2014-12-16 09:12:18

Ask them to turn it off! If all you have is av block, you don't need the pacer raising your rate for you on exertion and the pacer can compete with your own sinus rate. Honestly? I would question the need for the meds, esp if the pacer is what is getting your rate up. If you have afib or very fast episodes, then you need it but I would want to turn off RR, put the lower limit back to 60 and see how that feels first. Everyone is different so I'm just guessing at what could be going on, but I'd want to be darned sure the racing isn't caused by having rr turned on unnecessarily before taking meds to slow it down.

The minimum rate should theoretically be irrelevant for you because that's for atrial pacing. With av block, our sinus node works normally. We just need the pm to make sure the ventricles beat when the atria do. 70 is high so it might not feel good, as you found out.

rate response

by Grete - 2014-12-17 02:12:35

Many thanks for the advice. One of my cardiologists (in Italy) had said that the reason they had put on RR was because my conditioned had worsened and my sinus node was also not functioning now (but without dong any tests). I had told him that I did not seem to be able to get my heart rate up beyond 70 even when exercising. However, how could this happen four weeks after having the pacemaker, when my sinus seemed to functiong perfectly in October. I am now returning to my cardiologist in Germany. Can you advise what tests are needed to check whether my sinus node is functionig properly. I am new to all this and currently not feeling terribly well looked after. So grateful for this forum. Best regards to all.

raising your rate

by Tracey_E - 2014-12-17 06:12:59

Were you able to get your rate up when exercising before the medications? The medication will keep the rate down, so at the same time it stops racing it can also make it harder to work out. The treadmill can be useful in figuring out what is going on. Get on it while hooked up to the pacemaker computer and watch exactly what your heart does on exertion, when it's you and when you are pacing.

turn it off

by rolson - 2014-12-18 03:12:16

I had the exact same thing. Turned off rate response, feel fine. Out walk my husband now. Just turn it off.

RR probably needs to be switched off

by Grete - 2014-12-23 10:12:25

Hi, I went to see my cardiologist on Monday. They did another 24-hour ECG. I spoke with the technician over the over the phone today. She said my heart rate is indeed a little elevated when walking or exercising. She thinks that the RR may indeed need to be switched off. Unfortunately, the cardiologist has now gone on Christmas holidays and I need to wait until 7 January for any further adjustment. Meantime, I have started to feel a lot better; I continue to take the beta blockers and my extra systoles have largely stopped. I have also decided to join a three-week rehabilitation programme in January, as part of which I will have the opportunity to exercise under medical supervision. Things are looking up but could still be better. Thanky you all for your help and advice. I wish you a Merry Christmas and happy, healthy and peaceful New Year!

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