Ventricular-Pacing symptoms

Atrio-ventricular pacing .

by Selwyn - 2018-06-19 13:56:35

I think you can tell when you are switched over to ventricular pacing. I do experience some 'palpitations'. Like yourself, the vast majority of the time I am atrial paced.  My flutter ablation was very successful- I am sure yours will be also. 

As your PM is relatively new, I do wonder whether your pacing thresholds need to be adjusted- this should be such that the electricity needed is just enough to initiate the contraction of your ventricle.

You should be having your first check up shortly. Worth mentioning, along with your symptoms. 

Any chest tightness ( not pain) is worth mentioning to your doctor. It is always hard to tell whether this is angina you are experiencing. It needs to be taken seriously.

Welcome to the club.

Selwyn .  

Atrio-ventricular pacing

by nlt999 - 2018-06-19 14:30:41

Thanks for your comments Selwyn!

I do have an appointment with the EP cardiologist (sooner then their scheduled follow-up) just because of all this.  Unfortunately, they are so busy I can't see him til 7/5.  It feels very uncomfortable when it switches to V-pacing, especially the lightheadedness.  It gives me a kind of 'sick' feeling.  Hasn't happened while driving yet, but that concerns me.  It can happen any time... just sitting quietly for instance.  Another thing I have noticed is that very often when I lie down after being up and about for a while, my chest gets that feeling of discomfort, sometimes feeling like my heart is flipping around..... does that happen to you?

Thanks again!  Nick

Palpitations after PM insertion

by Selwyn - 2018-06-20 19:47:54

Hi Nick,

I used to get palpitations after PM insertion. I had to have a number of fine adjustments to get the pacing right. They tend to aim for 'Mr Average', however we are all individuals. I would be quite open with telling them  what is going on so that the fine tuning can be got right. 

The big problem is of anxiety/worry. It tends to highten the sensations we feel. Palpitations ( a sense of aweness of the heart beat) tends to be anxiety related, as well as PM related.  Perhaps the biggest change for me was when I was changed from unipolar pacing to bipolar pacing  ( I could not believe how one little switch made such a big difference in chest sensation). 

What happens after period of rest is that when you get on the move your blood pressure drops ( as BP xHR=CO   , where HR is heart rate, and CO is cardiac output) . TO compensate for this fall in BP your heart rate increases.  Sometimes ( especially if warm and sitting for a while after exercise), I stand and go lightheaded ( as my BP drops). It takes a little while, and a few decent heart beats to raise the cardiac output and stop my dizziness. I expect this may relate to my resting paced heart rate ( which could be adjusted to be a big higher, but then the battery life is shortened). I just know this is going to happen now and take my time for a few seconds before setting off walking after sitting for a period ( What the medics call 'postural hypotension').  The flipping around of your heart is that it is beating more vigorously and perhaps a little quicker in trying to keep your blood pressure up ( otherwise you too would go lightheaded. )

Some medications, especially beta blockers slow down the heart, lower blood pressure and make you more prone to these changes.

Palpitations after PM insertion

by nlt999 - 2018-06-20 22:49:04

Thanks for the additional input Selwyn!  Especially appreciate the tip about bipolar pacing.  I just got an appointment tomorrow morning with the EP Doc's PA...... I will ask her what kind of pacing is set up in my pacemaker.  I know the LEADS are bipolar (checked on that) but don't know how it's programmed yet.  Hopefully she can change the programming to make things more comfortable for me.......

Nick

Palpitations

by unsinkable - 2018-07-06 14:30:38

Hi Nick, 

Hope things went well with your Doc and that you received the answers you were looking for. I too have sick sinus and an episode of fainting led me to the ER where I experienced several episodes where I suffered bradycardia. At one point 15 billion. Scary stuff. I had surgery the same day and now have a PM. It does take getting used to. Mine is a dual lead and I can feel the change in my heart rhythm from time to time. If your dr has prescribed a beta blocker that can cause dizziness especially when going from sitting to standing or sitting to laying down. I just give myself a moment ant it passes. It's been 12 weeks now since my surgery and while I am aware that I have a PM, each week that passes gets a bit easier and I find that it is not too of mind as much as it was initially. Best of luck and welcome to the club! 

Palpitations

by unsinkable - 2018-07-06 14:32:54

You got to love auto correct, 15 beats per minute, bpm is what I was attempting to say.🙄

More reprogramming

by nlt999 - 2018-07-06 15:22:42

Thanks for the comments!

Saw the EP Cardiologist yesterday and got my 3rd reprogramming.  Thought I was finally out of the woods because everything went well yesterday after the reprogramming (had been having bouts of V-pacing multiple times every day til then, lasting as long as 45 minutes).

This morning, just standing (doing nothing physical at all) the V-pacing started and my heart rate suddenly jumped from the programmed 60 BTM up to 106-111 BPM.  It stayed there for 11 minutes, then dropped back to 60 with no V-pacing.

Anyone experienced similar symptoms?  I don't understand what's going on...... is it problems with my heart? with the pacemaker?

Thanks again!  Nick

New year issues

by Clovemyheart - 2018-07-23 17:03:09

I got my PM 7/10/18 and am having similar issues. I have been encouraged to trust that my PM will ultimately give me peace of mind. In the interim to give myself time from sitting to standing to equilibrate. Try not to panic when the palpitations overtake is easier said than done, but I have been trying to focus on my breathing and let it pass. It has helped. Be sure to be safe, share with family and no driving while these symptoms are still transient.

I am supported by hearing others experience so thanks for posting. I hope you feel better soon!

Update

by nlt999 - 2018-07-23 21:37:13

Thanks for your comments!

For the last three days my symptoms have changed yet again.  Now my heart rate is constantly about 70 (instead of the programmed 60), and my EKG shows mixtures of V-Pacing (a LOT!) and regular heartbeats.  Often the regular heartbeats are not at constant timing.... varying like maybe from Atrial Fibrulation.  In a 30-second EKG, there could be ALL V-Pacing beats, or a mixture of about equal numbers of paced beats and regular beats.  It's not terribly uncomfortable like it was when my heart rate was in the low-100's, but it feels abnormal and bothersome sometimes.  Other times I can hardly tell that anything unusual is going on.

I see the EP cardiologist August 9th, so hopefully I will learn something then.  I'll let you know if it's anything significant....

Nick