Initial Low HR Setting - Update after Adjustment
I had my appointment with the EP, that ended up being an appointment with his Nurse Practioner, this last Friday. The 30 min appointment ended up being over 4 hours and was exhausting. I did get the PM adjusted. They didn't change the HR but adjusted other settings that had an immediate impact and I felt 100% better. However in the testing it appeared that only one of the leads (to the ventricle) was working properly. The atrial lead was intermittent and they were concerned it may have come loose. So off to x-ray I went. While waiting to check in there I had some, what I will say were very disturbing, scary, symptoms where it felt like the PM itself was beating and going to jump out of my chest. You could actually see it moving and it made my entire shoulder and arm move/twitch hard, as well. Needless to say I was freaked out as was the receptionist and she called a nurse for me and 4 came...lol. They wanted to call 911 but I told them it wasn't a heart attack and I really just needed to talk to the EPs office. So they finally got in touch with the NP who told me if I could, to go have the x-ray and then they would decide what to do. If the lead was loose in my heart I would have to go have emergency surgery to remove/re-attach it or if it had just moved and was working erratically they would turn it off and I could have surgery the following week to replace it. The good news when I went back to the EP's office was that the lead was still in the same place it had been after surgery (whew!) but the PM thumping or whatever you want to call it was still continuing intermittently. So they started testing again with different adjustments to see what was going on. One of the techs (I saw 4!) actually found what was causing the weird issue and said what I was feeling was the PM pacing (on the lead that is having the issue) but the output was high, she played with it a bit and could actually make it happen from a little to severe and eventually turned it way down. The atrial lead is still not working all the time but it is enough that it is not necessary to put in a new one right now.
I felt so much better but when I finally got home I was exhausted both physically and mentally and my entire left side, shoulder to waist, front and back, was sore as if I had done a really hard workout. I am also all bruised now at the implant site. I was pretty sore all weekend but managed a 3 mile walk yesterday and another today that felt great.
I won't be going back to the EP's office any longer for adjustments as they have referred me back to my regular cardiologist for that.
My questions now are regarding what should I be concerned about with the atrial lead working only intermittently? Is this a concern/should I be concerned? What are the implications? I am concerned that it may cause the CLS to not function correctly since from the information I have seen from Biotronik it uses both leads to form the closed loop?