Turning off Ventrical Pacing

I had a St Jude Medical dual chamber PM2224 inserted less than 6 months ago and I am still having troubles adjusting the settings.  The PM was inserted after I was diagnosed with chronotropic incomptence (inability to raise heart rate during activity).

I require atrial pacing, but so far there is no indication I need ventrical pacing.  My PM is set to DDDR "just in case" and I am told that it does on occasion pace my ventrical.

When I start moving (chasing my kids, playing soccer, doing chores) I often get a wooshing feeling in my stomach and shortly after I start shallow panting and have to stop moving.  My exercise watch shows a sudden increase in heart rate and my breathing doesnt return to normal until my heart rate settles again.  On some occasions it can be distressing.  Obviously this is very discouraging as it is during these types of activities that my PM was meant to assist.

 

During a recent tuning I was shown the impact of a magnet on my PM.  The magnet sets the PM to DOO and I immediately felt the wooshing sensation.  The speculation is that the sensation is my ventrical being paced and that it is this pacing that is linked to my poor response during activity.

 

Is it possible that ventrical pacing is affecting the efficiency of my heart as a pump?  If so is it reasonable to have my PM set to AAI rather than DDD?  Is there an alternative explination?

 

 

2 Comments

Yes, yes, and I don't know

by Gotrhythm - 2016-08-28 14:09:05

Yes.  Although the PM is designed assist in providing the electrical signals that cause your heart to pump, sometimes ventricle pacing causes interference with the normal heartbeat. It happened to me. The result was a condition called Pacemaker Mediated Tachycardia, ie the PM was making my heart beat faster and faster. It mostly happened when I was exercising. It was very distressing, many times brought me close to passing out, and got worse over time.

Yes. The treatment, since I had no blockage, and the ventrical was responding just fine to the signal from the atrium, was to simply turn off the ventricle lead.

I don't know an alternative explanation, but then, I wouldn't since I'm not a doctor. 

Don't be satisfied with being told "Your pacemaker is working fine." It probably is fine, but the settings might not be ideal for you. If you don't get local help, if possible go to a major medical center where they see more unusual cases.

 

Thanks!

by Tox - 2016-08-30 08:22:48

Thanks for your detailed response!  Its great to hear that this is a reasonable explination and I now have the confidence to talk to my technician about it.

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