Pacemaker Aches (and Pains)

My Pacemaker was installed back in October, 2020. To make a VERY long story short, I had  immediate (and painful) complications with the placement of the bottom lead which was tweaked   repeatedly, then repositioned (twice), and then (when all that didn't solve the problem) was just simply shut off. My Electrophysiologist says I am incredibly sensitive to the bottom lead when it paces, so  you'd think that shutting of the bottom would do the trick, and it has—for the most part. I'm doing pretty super, but occasionally, I'll still get what I call these short "thumps". Anyone  else going through this?

Also, much of the time I hardly notice (or don't notice whatsoever) the PM. BUT sometimes I am  VERY aware of the device. It's not so much painful as it is a pronounced ache that can radiate   down my left arm. Cold weather is one spark, I'd say. Did some lifting the other day which made everything just plain hurt. Is this normal?

Thanks in advance for the advice and info.


PM aches

by Julros - 2021-02-08 17:50:25

I am a year and a half out and yes, I still get some achiness, usually from sleeping in the wrong position. And yes, it does ache when it gets cold, or gets bumped. 

And yes, I get some weird thumps. If I I sit with my knees drawn up, my belly will jump at about 60 beats per minute,  due to my diaphragm getting stimulated. I am guessing this is from my LV lead. 

Thumping and left arm aching

by Gemita - 2021-02-08 19:15:01

hello Cardboard Guy,

I have done a quick search of the Club under thumping and there are a few entries which you might care to read.  Use the search facility and type in thumping which should bring up a few pages of posts.

I am not surprised you may be getting discomfort from all the difficulties you have encountered with your lower lead.  You have been through a lot.  I too am very sensitive to being paced in the right ventrical, although I am mainly right atrial paced which is far more comfortable.

I got my dual chamber pacemaker in 2018 and I too still get discomfort in my left shoulder and upper left arm.  Veins and nerves in the region can take a long time to heal and they can easily get traumatised during the implant procedure but my discomfort has improved and I can sleep again on my left side now.

Give yourself a little more time to heal but if there is no improvement and you are concerned I would perhaps ask your doctors to check the position and function of your leads and some of your settings.  Maybe the voltage is set too high and is causing the "thumping" sensation.  It can do no harm for them to carry out some additional checks to give you peace of mind.  I hope for the best

Sensitive ventricle

by Gotrhythm - 2021-02-08 20:25:18

I too have a ventricle that doesn't like to be paced one little bit. You have my sympathy. For a couple of years, it worked to just turn off the ventricle lead, but when my type 1 heart block became symptomatic, It took an EP to do some very skillful tweaking of the settings, so that the ventricle paced as rarely as possible--but still often enough.

As for the thumping--do you know if you are having PVC's? I found the sensation of the ventricle being paced to be indistinguishable from a PVC. In fact, pacing in the ventricle would set off a run of PVCs. (PVCs, by the way, are not dangerous--not a sign that something terrible is going wrong. They just happen, even to people with perfectly normal hearts.)

It's time for a real sit down with your EP about the "thumps." He/she is the only one who can tell you what's happeneing. The better you understand what's going on, the easier it is to deal with.

As for the pain/ache in the shoulder...It happens. The simplest explanation is a bit of scar tissue that has tightended up the area. Try warm compresses to loosen up the area, and then some gentle strecthing, a little at a time and just a little more every day. You can find easy to carry out shoulder range of motion exercises on line.

But if you talk to the doc about the shoulder/arm pain, don't be surprised if all you get is a shrug. Cardiologists don't do shoulders and arms.

Aches and Pains (the long of it)

by Cardboard Guy - 2021-02-09 19:22:47

As Gemita says, I’ve been through A LOT. October to November, 2019: Heart attack (my 3rd). 4th stent. PM placement. Ablation (which actually worked like a charm and instantly). Effusion to alleviate pooling of blood around my heart (procedure fails).

The effusion turns out to be caused by the PM bottom lead screwed a tad too deep into the muscle; this combined with being on multiple blood thinners are the culprits.

Over time, my body did its thing and naturally took care of the effusion. But these thumps! Oy! So now comes a parade of many voltage tweaks (not fun, and doesn’t work), slightly backing off the lead (doesn’t work) And then moving the lead to the bottom of the bottom chamber. (Doesn’t work). Finally, the bottom lead was simply turned off. Somehow, I still have an occasional thump, but now it’s more an oddity than the norm. The top lead is picking up any slack admirably.

Gotrhythm—I don't know If I am having PVCs. No one has mentioned this and it's the first I have heard of this term. Fill me in please.

My EP says my situation is highly atypical/unusual (of course!) and I hate to be the poster boy here. But we have sat down (numerous times) and he, along with 3 different St. Jude techs, as well as my cardiologists have explained everything all along the way, in great length and fine detail to both my wife and myself.

I believe it’s more of a “shit happens” situation than incompetence. Everyone on my new cardiac team makes me feel that I am really the most important part of the team so if anything goes south I will not hesitate to have a heart to heart (sorry, couldn’t resist) at anytime with any of my team.

Thank you again for listening to a more unedited version of my initial post. It's really appreciated and I value your input and advice.

PS: In my initial post I inadvertently wrote 2020 for the heart attack and aftermath. Heart attack was actually October, 2019.



by AgentX86 - 2021-02-09 21:48:01

PVC == Premature Ventricular Contraction

Basically it's when the ventricals contract before they're told to (by the AV node or PM).  Everyone has them but most don't notice it or put it in the back of their mind, rather like a burp.  We tend to be far more atuned to every bump and glitch of our hearts.  We also have more going on with out hearts.  ;-) 

PVCs are rarely dagerous and generally not so until they approach 30% of the heartbeats.  Strings of them or bi(tri)geminy (every other or third) can feel awful but aren't often a serious health risk.  IMO, strings make AF seem like a walk in the park and EPs just brush them off.

Related to PVCs are PACs (premature atrial contractions) and junctional rhythms.  These are "heartbeats" caused by an abnormal source.

So good to hear from folk who know.

by Malley - 2021-02-25 22:13:21

In January this year, I had a 2:1 partial heart block, which saw me taken to hospital, then an op (for a dual chamber pacemaker implant), very quickly performed. I had 3/4 hour notice; my heart rate had been 33 BPM.

I had complications and a further week in hospital (total of 9 days), due to vomiting and post procedure pericarditis/pericardial effusion (fluid around heart). I have made slow, but steady progress, but last night slept on my right side and awoke with awful pain in left chest area, up my neck and into left arm. I don't know if this is a common thing, or something to be in any way to be concerned about; and would appreciate any helpful comments. I had always understood that a pacemaker insertion was a "walk in the Park", but this has not been my experience.  I feel I should be well on my way to normal life again but, as I haven't done this stuff before, I really am a novice, and am not really sure what to expect.  

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