Occasional Irregulat heart rate After PM

Had a St Jude dual chamber 2240 PM implanted early Oct.2015 to help with AF and AV block. The procedure and 6 week recovery went smoothly as planned.No problems or complaints. Was put on Tikosyn in attempt to control the AF. One month after the implant I was in NSR 66% of time. I am trying to understand why I get an irregular heart beat about 5% of the time I take a BP reading(Microlife device confirmed by manual observation). Is that normal and simply a manifestation of the AF that the PM can't control? The one month diagnostic test measured VP at 99%. PM is set to DDDR mode. I think my problem is that I don't understand how the PM is working. Can anyone help me understand? Thanks in advance.

2 Comments

acronyms

by Tracey_E - 2016-01-31 06:01:18

I forget what all the D's stand for but DDDR means dual chamber sensed and paced and the R means rate response is on.

A high ventricular paced percentage is pretty typical of av block because the signal is not getting from the atria to the ventricles.

If your atria is beating irregularly, the pacer can't stop it. It's pacing the ventricles, playing follow the leader and letting your atria set the pace so if that pace is irregular, your pulse will be also. It can't prevent the heart from making extra beats, half beats, etc. All it will do is make the atria beat faster if it's too slow (A pacing) and make the ventricles beat when they don't keep in sync with the atria (v pacing).

It may put you in an artificial block when you are in afib, only pacing one ventricular beat to two atrial beats. That will feel irregular and probably make your monitor show funky readings.

Great explanation

by Jayp - 2016-01-31 07:01:44

Tracey,
Thanks much for a great explanation. That's exactly what I was looking for.

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