New settings and a new episode


hope all had a nice Thanksgiving! On Monday Nov 25, I went to see my EP for a follow up. PM surgery was on 9/12/19. I have SSNS Bradycardia/Tachycardia. Pm has helped with Bradycardia, meds have not been successful for the Tachycardia. After reviewing my interrogation, he told me that 3v3n during exercise my hr is not going up very high, so he adjusted the pm to be reactionary to exercise. ( not sure if that is correct terminology, but I hope you can understand what I am trying to explain.)  I’ve done some limited exercise, since the adjustment, without issue, I even shoveled snow this morning, and was fine. My daughter is a nurse and advised me not to shovel, but I told her dr didn’t give me any restrictions, I think she worries too much about me. Btw, I’m 62. For the past two days, I’ve been having more episodes of Tachycardia, which have been pretty annoying, I’m making excuses that maybe I’m drinking too much coffee, or the meds have run through my system, I came off the meds about two weeks ago. The issue was after shoveling,I went to my Zumba Gold class. It’s a Zumba for older adults, low impact. After the warm up song, and about 30 seconds into song number two, I started having extreme discomfort in my chest. My heart felt like it was going to pound out of my chest and it hurt, brought tears to my eyes. I was not out of breath or trouble breath8ng. It felt like when they do the interrogation and make your heart race, constant zapping. I went to sit down, with the class surrounding me, ( nice to know that people care) and they called for medical assistance ( there are medical staff onsite).. eventually symptoms disappeared and I continued with dancing, although I was extremely cautious not to overdo it. Has anyone had anything similar happen to them? Was this just them kicking my hr up? Should it hurt? I’m switching cardiology practices this week, as I don’t particularly have faith with my current team, so I haven’t called them with this yet. Any advice or comments are appreciated.





by AgentX86 - 2019-12-03 08:28:34

You mention your "cardiology group". Are you also seeing an electrophysiologist? If not,  you need to.

In this case a cardiologist may indeed be called for. The pain is not right. It could be angina, which can be serious. Your cardiologist should have tracked this down already. You are reporting all of your symptoms to everyone who will listen,  right?



by Gemita - 2019-12-03 16:31:44

Dear Denise, lovely to hear from you again.  I am glad your pacemaker is helping with bradycardia but disappointed to hear about your tachycardia.  When I first got my PM I also went through a period of tachycardia every night for several months and it was really interferring with my sleep.  I thought at first it was PM mediated tachycardia or something like this, but it eventually settled down without any PM setting changes.  However I did stop both Digoxin and Flecainide and only now take a beta blocker (Bisoprolol).  It was finally agreed that Flecainide was pro arrhythmic for me personally and was triggering tachyarrhythmias, including Atrial Flutter.  I still get many different arrhythmias, sometimes at very high heart rates, but my PM is effectively subduing so much at the moment which is unbelievable.

I understand your Zumba classes are low impact, but is the music loud Denise ??  Last year my 81 yr hubby decided we were going to the Nottinghill Carnival.  I didnt have any say in the matter - nothing unusual there !!  Well Denise the crowds were overwhelming, the music loud and penetrating, the drums were beating wildly and my heart decided to take off.  I was close to collapse.  My husband had disappeared in the crowd.  I had to find a seat to recover and escape the noise.  What I find is that any "loudness/vibration" can set off my arrhythmias/tachycardia, so I am wondering if this is the same for you ?  Of course with tachycardia or any arrhythmia, blood flow from our heart to the rest of our body is compromised or is certainly not as effective as when we are in normal sinus rhythm and ticking away at a comfortable steady pace.  When my arrhythmias/tachycardias first start or if they continue beyond a few minutes, they can cause chest pain (mid central) and this does alarm me, but I have been totally reassured by my EP team that my heart is structurally sound and that it is just being out of rhythm, particularly at high heart rates which is the cause of my chest pain.

I am not a pacemaker technician Denise and I hope others will come in here and help out in regard to your heart rate not going up well enough to cope with the extra demand during exercise and the need for changes to your PM settings to help with this.  However, I do not believe your chest pain was caused by any changes your EP may have made to your PM settings.  I would be more inclined to think that with the excitement, the music and the extra flurry of activity, combined with perhaps any tachycardia occurring at the time, your heart exceeded the rate which you could comfortably cope with and then you experienced chest pain, if that makes sense ?  Either way, you need to tell your doctors what happened and they can interrogate your PM and get the info they need.  Try to jot down the time and date it happened to help them identify what your heart was doing at the time.  

Also on re-reading your post I would try cutting down on coffee because it can be stimulating and cause palpitations/tachy symptoms for many people.  I cannot even take tea anymore and my cardiologist mentioned caffeine in chocolate can also cause symptoms.  You also wrote about stopping your meds recently.  Do you still take a rate control medication for your tachycardia?  I take a low dose beta blocker to try to prevent my heart rates going too high during tachyarrhythmias without lowering my blood pressure too much during periods of normal sinus rhythm.  It is a balancing act as I well know. Good luck Denise

Called the doc

by Ddefalco326 - 2019-12-05 01:50:15

so, I called both my EP and cardiologist. EP thinks it has nothing to do with the pacemaker and told me to call the cardiologist. Cardiologist wants me to come in so they can interrogate the pacemaker to see what happened. Going in today. I thought they could pull the data without me having to go in. Hopefully can get some answers. Thank you Gemita and AgentX86

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