All of a sudden high pulse on husbands pacemaker

High heart rate

by Gemita - 2020-10-28 15:29:49

Hello Fritzi,

My husband had stents placed (3 in number) and had chest pain for some time afterwards but he had complications during surgery and developed a pleural effusion (fluid on his lung).  You can expect pain following stent placement for several months which can be eased by a nitro spray and meds like isosorbide nitrate.  My husband still takes these meds, although less so now that his blockages have been successfully opened and his chest pain has therefore eased.

My feeling is that with an arrhythmia like Atrial Flutter, the fast heart rate will be causing some chest discomfort.  I have Atrial Flutter and a pacemaker.  A pacemaker cannot stop a fast heart rhythm, only prevent our heart rate from falling below a set minimum which seems to be set at 60 bpm for your husband ?

When I first had my pacemaker the Atrial Flutter and all my other arrhythmias temporarily increased in frequency and duration, leaving me feeling very symptomatic (chest pain, breathless, dizzy) but after several months (on a beta blocker) my heart rate steadied and my arrhythmias calmed.  I note they are trying Metoprolol to treat your husband’s Atrial Flutter and this should help slow his pulse.  In my opinion it is likely to be the Atrial Flutter causing his worsening symptoms rather than the pacemaker but it is worth getting a few pacemaker checks for peace of mind.

High heart rate

by AgentX86 - 2020-10-28 17:59:04

Gemita has the Aflutter thing pretty well covered. A pacemaker can only make the heart go faster.  SOMETIMES it can outpace Afib and stop it before it breaks through. A PM isn't going to do anything for Aflutter.

Aflutter is a reentrant electrical loop where a group of nerve cells create a signal that races around some section of the atrium and comes back to retrigger that same group of cells. ...and so it goes. The circuit is so fast that the atrium just quivers (flutters). A pacemaker can't get in the middle of that circuit to stop it. Remember, it can't slow anything down,  only make it go faster.

Beta blockers, like metoprolol, slow the nervous response if these nerve cells, and the AV node, slowing the flutter and heart rate down to a safe(er) level.

Chest pain is usually a signal that the heart is being starved of oxygen. Aflutter can do that because the atrium can become useless and can de a further drag on the cardiac output.

High heart rate

by Fritzi - 2020-10-28 20:34:44

Thanks for your two comments.  It is somewhat comforting to hear others experiences and suggestions.  We called our monitor company and they did a check on the pacemaker this morning and forwarded over to the pacemaker doctor's office.  They advise that the pacemaker is working properly with no problems.  We were hoping we could get an adjustment  on the pacemker and that the chest pains and high pulse would be corrected.  No such luck.  

We are now concerned that the chest pain and high pulse can further damage his heart unless the sitation is corrected.

We are off to the doctor again tomorrow for another ekg but no change yet with the high pulse.  Thanks again for your information and your quick responses.