Feeling the pace

You are absolutely no trouble at all !!

by Gemita - 2020-09-22 06:13:51

Dear Maureen,

I feel pacing 100% when it is in my right ventricle !  Some folks have no trouble at all.  It depends on so much:  whether we have arrhythmias, what our pacing requirements are and what has been set up.

I have a dual chamber pacemaker which is almost 100% pacing my right atrium at 70 bpm, with only minimum ventricular pacing when my "pacing mode" automatically switches from AAI<=>DDD mode, to a non tracking mode during atrial arrhythmia detection.

 Because my arrhythmias are happening sometimes multiple times a day (albeit for brief periods) I may go in and out of these mode switches and I can really feel those sudden changes and the beginning of pacing in my right ventricle and I just find it hard to tolerate . . . thumps in the chest and neck too.  In my case, this might be due to sudden switches in pacing mode or due to my arrhythmias.  PVCs (premature ventricular contractions) and PACs (premature atrial contractions) can really cause these sensations too Maureen.  Do you have these ectopics I wonder or other arrhythmias ?

I note your right atrial lead is no longer functioning and has been switched off and that you are mainly pacing in the right ventricle.  Even so, no doubt you still have some function in your atria, providing some support and it could be that is what you are feeling too (the dysynchrony between right atrium and right ventricle).  Only monitoring your symptoms will throw light on what is causing this.  Either do some downloads while it is happening or ask for external monitoring to detect what is causing this.  But as we have always said, you need that atrial lead so ignoring it, in my opinion, is not an option.  Did you have this problem while your atrial lead was functioning?  If the answer is no, then you have your answer.  If these beats are causing troublesome symptoms, i do not think it is unreasonable to ask for help.

How do I cope with the discomfort?  I am so used to it now, particularly since I am no longer afraid of those feelings and this has made such a difference.  However, when I next see my EP I want to ask him whether mode switching "sensitivity" can be toned down a bit in whichever direction.  Good luck Maureen  

Be thankful!

by crustyg - 2020-09-22 08:01:29

It's a really good sign that your heart muscle can generate a powerful beat to keep your BP up despite sub-optimal filling.  It's keeping you alive.

I notice all of my contractions when first lying on my L side to sleep.  And then I choose to ignore them. Sometimes I am aware of very powerful beats in my chest when seated quietly (as yesterday, in hospital OPD waiting area) - obviously at an emotional level I cared more about my appt than I was willing to acknowledge to myself at a conscious level.  Sigh!

I can see my neck pulses when shaving (or gazing at the beauty in the mirror - no that can't be right...).

Things would definitely be easier for you (less noticeable heartbeats) with a working atrial lead.

I'm afraid you have to choose!

Best wishes.

unipolar?

by Tracey_E - 2020-09-22 08:56:28

Ask if they switched you to unipolar when they turned off the bad lead. They tried this on me when one of my leads went bad. I went from years of not having felt a thing to every beat feeling like a shock. I didn't even get out of the office before I went back in and begged them to change it back. I believe they tried this setting to conserve battery while working around the bad lead.