Tired - PVCs & PACs

About ten days ago I went for my first post PM checkup. I told the nurse practitioner I was more tired than before. She told me this was typical and it would take time to heal.
The following week I became more tired upon walking to the point I could not complete a grocery shopping trip. A week after this first checkup I was back but had a different nurse practitioner. This time she said I am having PCV's and PAVs and that was causing the tiredness. She prescribed 12.5mg Metoprolol. (I haven't try it yet). I also take Sotalol.
In January this year I was dx'ed with afib and put on Sotalol. In July I had a PM implant because of low heart rate. Two months later I have an irregular heart beat which I never had before. I seem to be getting progressively with each new intervention.
This week I will finally see a cardiologist and they have me schedule for an ECHO cardiogram in two weeks.
It is my understanding that the PM will not correct irregularities and meds won't fix it either if the irregularities are caused my the PM. At this point I wish I had just had stayed with the afib untreated.

10 Comments

My Understanding

by Artist - 2015-10-04 02:10:54

My PM was implanted to prevent my bradycardia so that medications that control various heart rhythm problems can be administered without making my heart rate even slower. This absolutely worked for me. My heart rate does not fall below 60 BPM and the low doses of Flecainide and Bosoprolol have made heart rhythm problems almost non existent. So, I'm not sure why you say that medications will not correct irregularities. There are many medications designed to treat heart rhythm problems and often that involves a period of trial and error to find out which medications work for you and what the appropriate dose is. This takes time. When an effective mix of medications fails to satisfactorily control rhythm problems, then oblation is an option. It sounds like it has only been about two months since your PM was implanted. You were prescribed a medication but decided not to take it. That complicates the situation and in my opinion is counter productive. If you have no confidence in the nurse's prescription, verify that by asking to talk directly with the doctor. Nurses have prescribed medications for me, but that is after getting the direction and approval of my doctor. That procedure involved some trial and error to find what worked. How can progress be made in your treatment if you make your own medical decisions and disregard the doctor's orders? If you give it a fair trial and have bad results, that is a starting point to look at other medications and treatment options.

Feel the same

by Hartje5 - 2015-10-04 03:10:06

I've had a hybrid ablation because of persistent afib and a pacemaker (sick sinus syndrom). Now I'm no longer in afib but have a lot of PVC's. The outcome of all the procedures done so far has been that I feel worse than I did in afib. I'm unable to ride my bike or exercise, I get seriously out of breath. Did not expect this outcome at all.

Unfortunately no solution from me, but I understand your frustration.

Hope it gets better for you soon.

Meds

by donsabi - 2015-10-04 05:10:18

Thanks for the post.
Let me clarify. I am always compliant with meds unless I find a reason to question it. i.e, once prescribed a med that was contradicted by a med I was taking. I brought this to the attention of my GP who confirmed it and thanked me for pointing that out. Normally I would have tired this new med prescribed by the NP. However I have only had the med for two days and I see my cardiologist in three more days. I don't think waiting to see him to confirm this additional med is causing a problem.
Months ago when afib was dx'ed I was put on Plavix, Aspirin, and Pradaxa. I was bruising all over. When I met with my cardiologist he blew his stack at these prescriptions. He stopped the Aspirin and Pradaxa and had me on Plavix and Warfarin.
I am not saying I have no confidence in a NP, but in this situation where I can confirm the NP's script with my cardiololgist within days I see nothing wrong with waiting.

Hartije5
Sorry you are having so much trouble. I feel the same way. Bad enough with the afib alone but with all the medical intervention I feel worse. What is going on?
Try another cardiologist. Don't give up.

First few months

by Theknotguy - 2015-10-04 07:10:46

My first few months were a constant moving target. As soon as I'd find out about one thing going on, it would drop off and another would crop up. All in all it took seven months for a lot of things to settle down. I also had the situation where my heart didn't like being under new management and decided to throw a major temper tantrum. That ended with me back in the hospital.

My EP didn't want to make too many changes for the first five months which was frustrating but, in hindsight, I can see why he did that. Didn't like living through all the thumps and bumps, but with a sudden cardiac arrest, I didn't have the choice of going back to the way it was.

At five months I was able to have a program turned on that my PM had. It took another year for changes from that to stabilize. Today I'm at the two year anniversary of my initial collapse on the trail. I still have a few more things to go even though it's been two years.

With microwave ovens we're accustomed to almost instant gratification. No need to cook when you can nuke it within a few minutes. For some reason people think sticking a pacemaker in will immediately solve all problems. Sorry, it doesn't work that way. Different people heal at different rates. We adjust to medications at different rates. Add an underlying heart condition and all sorts of stuff goes on.

On the forum we see people who are training for a marathon post PM in two weeks. We also see people who are still having problems after a couple of years. Most people fall somewhere in that range. It's hard to know personally where you'll fall in that spectrum.

Take your meds. Discuss situation with your EP. Hang in there. Hopefully it will get better.

A-fib

by Roys - 2015-10-04 11:10:39

Go to an EP not a Cardio, I went to a Cardio for 8 years, and got no help. I then went to an EP, and things improved for me. Why is a nurse prescribing medication for AF, when my GP would not?
Cheers Roy

Lightheaded

by donsabi - 2015-10-05 11:10:50

Thanks for the post

TheKnotGuy

I did start the Metoprolol today and that made me tired but in a different way. This evening I felt very lightheaded. I knew little about pacemakers and when they told me I needed one they also told be it would heal all my woes. I expected to be better in a few weeks. Now a little more than two month I seem to be getting worse or having more symptoms which ever best describes it. I find it very concerning if not nerve racking.

Roys

I have one of the top rated cardiologist in my area. I don't think there is an EP in this area. The nurse was a nurse practitioner and they can prescribe. I was thinking about waiting to see my cardio on Wed. but then thought I would give the Metoprolol a try so I could tell him my reaction to the med.

Doctor Appointment

by donsabi - 2015-10-07 08:10:03

I finally got to see my cardio/EP. He was not happy that a nurse practitioner prescribed metoprolol with me taking sotalol. He told me to discontinue the metoprolol.
There happened to be a rep from St. Jude's with him and he made an adjustment to my PM which will allow my heart to beat a little faster when the demand is there. Hopefully this will alleviate my tiredness/fatigue.
The bad news is my cardio/EP was not happy to see from the the PM that my afib rate was around 7%. He said this leaves only one or two meds he is reluctant to prescribe and that I should consider ablation.
I still have an ECHO next week.
Thanks to all who posted. I really appreciate your help.

A-Fib control

by Roys - 2015-10-07 11:10:56

Hi
Before you consider ablation, do some research on Magnesium and Potassium, I found it a big help with my AF. Doctors won't tell you. Google a-fib.com by Steve Ryan, there is a lot of info on that website.
Cheers Roy.

Ramipril Added

by donsabi - 2015-10-11 02:10:35

I am the OP. I saw my cardio/EP 4 days ago. They made an adjustment on my PM. The doctor also put me on Ramipril 2.5mg HBP. Today I am so tired I can hardy function. I am not sure if it is the PM or the additional med Ramipril.
Tomorrow I have an ECHO. Maybe that will show something.

Ramipril

by Grateful Heart - 2015-10-11 04:10:11


Ramipril is one of those meds that can make you very tired. My Doc said to take it at night, since you will be going to sleep anyway.

Talk with your Doc about it but you may want to try it at night (if you aren't already) before any PM adjustments.

Feel better.

Grateful Heart

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