Feel pacemaker kick in when lay down

I'm 32 year old guy. Got my PM bc of bradycardia/syncope. I had a dual chamber PM inserted 3 weeks ago. I've had 3 EP visits to adjust my settings (which have helped a LOT!). They've made a lot of adjustments and have turned my voltage down. But I still can feel it kicking in when I do 3 things:

1) Lay down on my back (about 30 seconds of completely feeling the PM kick in)

2) Crouch down (think tying shoes crouching to look at a lower cabinet, etc.)

3) Bending over (picking up stuff)

I can even tell when it's pacing my upper vs. lower chamber (different sensations). The laying down is the most aggressive and easiest to replicate. As soon as I get on my back it kicks in. Anyone else feel this?

I've read often on the site ppl saying "You are simply more aware of the heart's beats", while true, this is a specific feeling that is replicated when the EP runs my pacing tests...so I know it's my PM kicking in. 

Is this common during the recovery period? Anyone else experience this?

Thanks- you guys are great.

 

8 Comments

Kicking in? More questions

by Gotrhythm - 2019-06-04 13:03:43

Most people cannot feel it when their pacemaker is supplying beats, but some can. I can't. That's all I know.

I don't have any answers for you, but I do have some questions.

You say you know it is the pacer "kicking in," and you can tell if it is upper or lower chamber.

1.Before you got your pacemaker were you aware of being able to feel your heartbeat at rest--without taking your pulse or putting your hand on your chest?

2. Do you feel your heartbeat when you are not being paced?

3. What percentage are you being paced? 

4. Is this a problem?

 

Deja Vu

by CatDad - 2019-06-04 16:18:22

IrishCat, your symptoms were precisely mine when my atrial lead  dislodged and began pacing my diaphragm. That first became evident four days after my original PM surgery and worsened for three days until I was able to have lead revision surgery exactly one week after the first try.

Curl your middle finger inward, clamp it with your thumb and then flick it hard on your other arm. Thats the sort of thumping/popping I felt inside my lower left ribcage with every heartbeat when I wasn't either standing or sitting bolt upright.

Luckily, interrogating the PM clearly showed that something was wrong and my surgeon immediately scheduled me for revision surgery that same day.

Be a nuisance like I did until they got me back into the pacemaker clinic with my thumpy chest to interrogate mine and decided to fix it. Just had a routine interrogation yesterday: since revision surgery I'm pacing at 74% upper chamber and 20-something% lower chamber, and I haven't felt a-one of them.

Yikes

by happy2bealive - 2019-06-04 21:07:44

@CatDad- yikes. Not ideal but gets me a step closer to identifying this feeling. Did it happen every time you laid down? Or just randomly? And did it stop? Mine will go for 30 seconds and then stop (almost the same beat pattern and everything). 

@Gotrhythm- see my answers marked >>>>

1.Before you got your pacemaker were you aware of being able to feel your heartbeat at rest--without taking your pulse or putting your hand on your chest?

>>>>Not really actually

2. Do you feel your heartbeat when you are not being paced?

>>>No

3. What percentage are you being paced? 

>>>>I'm told 50% in atrial and 4% in bottom chamber

4. Is this a problem?

>>>>>Don't know yet :) It freaks me out, but goes away so I can "live with it", but if it's a lead dislodged I'd rather not feel the syncope episode again

Progressive Onset

by CatDad - 2019-06-04 21:41:06


Irish, my pacing symptoms came on gradually over 4 days.

Thursday: Noticed "popping" sensation below heart when bending to scoop litter, tie shoes and the like. Thought, "Well, OK, I guess that just means it's working. Great!"

Friday: Began noticing stronger thumping/popping when laying flat in bed in addition to when bending/slouching.

Saturday: Any deviation from strictly vertical brought on thumping. Learned to stretch straight enough lying on my back so it subsided enough to permit sleep.

Sunday: Began having symptoms even while standing and walking in grocery store. Also began feeling occasionally light-headed and nauseated while walking about. Got very proactive with health provider's weekend staff. Fortunately, my regular cardiologist was on call that weekend and he arranged a visit to our pacemaker clinic first thing Monday morning.

I would say it behooves you to get very determined on the phone and get yourself into wherever they interrogate your PM.

BTW, do you have a home monitor? Sending in even its more limited interrogation should set off some alarms in whomever looks at it and help get them to take you seriously. Maybe you don't have a misplaced lead but if you do, yanking it out and repositioning it will only get harder as scar tissue continues to envelope the lead.

Tell ya what... that shopping trip on the Sunday before my revision surgery seemed like the longest outing of my life.

Hope this helps.

Wow

by happy2bealive - 2019-06-04 22:56:53

I'll definitely call EP tomorrow morning. Yea I do have a monitor that sends info to my cardiologist. 

I can only imagine. Just the thought of a syncopatic episode gives me hives, what a terrible experience. 

Thx to your comments, really helpful.

Excellent!

by CatDad - 2019-06-05 04:51:28


Glad to pass on my experience. Hope all goes well for you! Let us know what they find out.

Update

by happy2bealive - 2019-06-10 12:02:47

Hey everyone thought the "outcome" may benefit some ppl reading this. Had some interesting events this past week that gave me some answers.

June 5th- called EP - left message to get answer on what they think. They said they'd get back within 24 hours.

June 6th- still hadn't heard from them, but was driving home from work and had Presyncope! Thought I was going to black out again! ER visit after talking to cardiologist, EP came on call and EP/cadiologist said that my settings were too low on dual link PM (was at 50 bpm) So bumped me up to 70 bpm and turned my rate response on high (was at lowest setting). 

June 7th- Went back in as 70 bpm was WAY too high. So they brought me down to 60 bpm and delayed my bottom chamber response. They were able to identify when it was kicking in and basically noticed that when I lay down it was kicking in. 

So my leads aren't out, pm is working great, but for some reason my heart rate declines a lot when laying down, so PM kicks in, and the position I'm in when laying down causes me to feel the pacing more pronounced. 

Bottom line- it is me pacing (not something drastically wrong with my leads) that i can feel when laying down. No pain, just glad my PM is working like it should.

 

 

Presyncope While Driving

by CatDad - 2019-06-10 12:48:31

Wow... so glad you came through that and that you finally got your EP to pay attention!

Also glad that it could be fixed with just a settings change; no surgical do-overs.

You just gotta be pushy when it comes to proper care for your heart. Well, done, Irish!

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