PVC's after AV Node abaltion

Hi everyone - I had an AV node ablation on 28th March, having had the pacemaker implanted prior to this in February.    After the AV node was ablated the rate was set to 80 - this I understand is to prevent develpment of Ventricular Tachycardia.

All was going ok - except I was getting a fast rate on increased movement - but this was remedied at my pacemaker 6 week check.  One of the sensors was lowered and all was well.  The rate was reduced to 70 at this point.

Now, 10 days ago - I have suddenly started having awful bouts of PVC's.  Got an emergency check up with the device clinic who confirmed it was PVC's.  They are thinking about some meds - but I am not hopeful that this will help.

Why is this happening?  Has anyone else experienced it?   I wonder if the rate should have been left at 80 for longer.

5 Comments

Yep!

by AgentX86 - 2019-06-07 09:10:23

I have been fighting the EXACT same issues. Including the heart rate settings, reasoning, and timeline (but a year and change earlier). The bottom line is that they had to set my heart rate back to 80bpm (but allowed me to reduce it to 50 for sleeping, as long as I can put up with the PVCs).

Even at 80bpm, I still get the bigeminy PVCs but my EP told me to treat it like others deal with headaches. They aren't dangerous and won't cause any long term problems. Any cure would be worse than the disease. The good news is that since telling me that, mine has been getting better.

Oh, and they pushed my metoprolol up as high as possible, while still being able to function. I take the extended release 25mg twice a day. I used to be able to handle a lot more but it makes me really sleepy anymore.

PVC.s

by Theresa52 - 2019-06-07 15:34:36

Thanks for your message - I did read up about the setting the rate after the AV node ablation, and the recommendation was to leave it at 80 or even 90 for some time.  I was okay at 80 and all this trouble has only happened since it was reduced.  I think it was reduced too soon, and now, having spoken to the arrythmia team this morning, I have to wait for another appointment for them to put it back up again.  In the meantime I will have to go very slowly.  Glad to see you are dealing with it okay.

PVC's

by Dave H - 2019-06-07 17:51:52

Unlike the Agents experience, the bigeminy PVC's that would wake me up in the middle of the night  were sorta kinda resolved for me in this manner: I changed my beta blocker from 100mg Metoprolol every day to 2 doses (AM, PM) of  3.125 mg carvedilol. PVC's are still hanging around but, they seem to now leave me be at night when I'm asleep.

--Dave--

Reduced from 80bpm to 70

by AgentX86 - 2019-06-08 15:05:24

They did that reduction at my 1-month check. My EP was going to further reduce it to 60bpm at my next appointment but the bigeminy got there first, so he raised it back to 80bpm to try to mask the PVCs. I helped, though I don't much like a heart rate of 80bpm. I doubt he'll even try to reduce it again.

Why do you have to wait so long for an appointment. I made an appointment with the device clinic on Wednesday and got in yesterday (Friday). They have an EP on staff that approves any changes (just had my clock set to DST - so no big deal).

PVC appointment

by Theresa52 - 2019-06-10 06:22:59

.  It was me who raised the idea on the telephone as to whether the PVC development could be because the rate was lowered too soon and the arrhythmia nurse agreed that it could be that.

  Now that they know the pacemaker is working okay, I have to just wait and suffer until I get an appointment.  It is so frustrating to have to wait for it to be adjusted, when if they had considered it more carefully when I was there, they could have done that last Tuesday.  They also mentioned having a holter monitor first to check how many PVC's I was having a day.  My answer is 'too many'.

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