Atrial tachycardia

Mary

by IAN MC - 2016-10-29 19:08:24

It is bad that your doctor hasn't explained everything to you. You ask a few questions :-

-  What does " pacing "  mean ?    It is very simple . Every time your heart beats ( contracts ) it is being paced , and something is making it beat . Before you ever had your heart problems , your natural pacemaker ( a few cells in your heart called the " sinus node" ) was doing just that. It was sending a signal to the heart muscles in your upper chamber telling them to contract i.e it was pacing your heart , telling it to contract every second or so.

Your sinus node has become faulty , it has become lazy so your heart-rate became too slow ( bradycardia ) , and you felt faint ( syncope ) . You had to have a pacemaker fitted  to put in extra heart beats . Every time your pacemaker initiates a heart contraction it is "pacing" you.  If you were 100 % paced EVERY heartbeat would be triggered by your artificial pacemaker. In your case 61 out of every 100 hearbeats are being triggered by your artificial  pacemaker , 39 out of every 100 are being triggered naturally by your sinus node.

You definitely DO need a pacemaker ; without it you would feel awful and you would probably die earlier than you would want to.

Now you have developed a new problem, tachycardia ,where your heart is occasionally beating far too fast. Your PM is not causing this; you have just been unlucky and the electrics of your heart have developed a new problem. Your PM cannot be adjusted to stop the tachycardia from happening . There are drugs that will !  You need to see your Dr a.s.a.p and he will treat your tachycardia.

As long as you are having tachycardia you need to stay on the Xarelto because your irregular heart rhythm slightly increases your chances of having a stroke.

I have the same PM as you by the way and had it fitted for exactly the same reasons as yourself.

Best of luck

Ian

Response

by MARYNEWSOME - 2016-10-29 19:16:39

Thank you  all  sooo much for your help. Has been really difficult getting an understanding of what's going on. Initially went in as an output for tilt test and possible EP study. Made it 10 mins  into the tilt with positive results from what they say and was rushed into OR .  Awakened later that afternoon with my arm in sling and told that my heart rate dropped too low and they had to put in a pacemaker. Thanks sooo much again😊😊😊

explanations

by Tracey_E - 2016-10-29 20:01:38

In a normal heart, the sinus node in the atria is the brains, it monitors the oxygen level in our blood and raises/lowers our heart rate accordingly. The sinus node tells the av node in the ventricles, the brawn of this operation, when to beat. That's the strong beat we feel as our pulse. Basically, your sinus node gets lazy and drops off 60% of the time. Some of the other 40% of the time, it goes a little crazy and races. Simply put, you've got faulty wiring. The pacer steps in when it goes to slowly, the meds try to prevent it from going too fast. 

St Judes has excellent animations to explain the various conditions what would lead to a pacer.

https://www.sjm.com/en/patients/arrhythmias/symptoms-causes-diagnosis/bradycardia-slow-heartbeat

Response

by MARYNEWSOME - 2016-10-29 21:26:20

Thank you so much for your help

AFIB

by BillH - 2016-10-29 22:28:50

The others have described the SSS and pacemaker.

In AFIB there are a number of places in the atria (upper chamber) that can fire off at random rates. It is so fast that the atria can't effectively beat and instead quivers. The ventricle (main lower chamber) can fire that fast and will only fire on on a limited number of signals from the atria.

In some cases people don't feel this, in others they do

THe PM can't stop this, but if needed it can be set ignore the atrial when you are in AFIB and independently trigger the ventricles at a regular rate.

The problem with AFIB is that the blood stagnates in the atrial and clogs can form that can cause a stroke. That is the reason for the blood thinner.

Recent studies have indicated that brief (less than 20 seconds) AFIB, only detected from the PM does not need an blood thinner.

SSS and AFIB are too different conditions although there might be some common celluar issues behind them.

A-Tach...

by donr - 2016-10-30 09:30:50

...has NOT been addressed or defined, yet.

I see you have a Medtronic PM.  I do, also.  As I recall from reading my PM downloads, A-Tach is defined by your Cardio & set in the PM's memory.  It is different from A-Fib!  A-Fib is an uncomtrolled arrhythmia that is uncoordinarted & so fast that the Ventricles cannot keep up with it so you have a totally uncoordinated functioning of the heart.
I don't know what your cardio defines as the LOWER limit for defning A-Tach, but mine chose 175 BPM.  A heart can function normally at that rate.  So... any time my PM records a "High Rate Episode" by the Atria, it means that the sinus node is functioning somewhere above 175 BPM. That is something to be concerned about, but not worried out of your gourd over.  ASK YOUR CARDIO about his setting for high rate definition.

Ian gave you the best discussion of why you need your PM that I have heard (Read).  I started right where you did, w/ SSS.  I fealt like garbage before & great after the PM implant.

Donr

Thank you

by MARYNEWSOME - 2016-11-01 19:13:07

I am forever grateful for the help in answering the questions I needed explained. It makes me feel so much better that I wasn't losing my marbles. Clearly I have developed atrial fibrillation which was evident for several mths although I was not told this. The blood thinners I am told should stop me from throwing a clot. Thanks to all again😊😊😊