Fast heart rate under a minute

Hello everyone. I have a dual chamber pacemaker for a complete heart block... and there have been a few times during the past year where I'll wake up in the middle of night really thirsty with a dry throat and I'll sit up to have some water but all of a sudden my heart rate will go a bit fast and I can feel my heart pounding on my chest. This usually last 30 seconds to a minute. And maybe has happened like 7/8 times in the last year... I have told my cardiologist and he says that can happen at times but I shouldn't be too worried. So it happened last night... and i was wondering if this happens to anyone else with a pacemaker and how do you cope with it? 
i do suffer from generalized anxiety disorder so I tend to worry and overthink a bit... 

thanks everyone 




by AgentX86 - 2021-07-12 18:38:44

What you experience can happen but there is little chance that it has anything to do with your pacemaker.  It's probably some sort of supraventricular tachycardia, or SVT (a non-specific tachycardia that occurs above the ventricles, i.e. the atria).  If your cardiologist isn't worried about them, there is little to worry about.  I'd try to find an electrophysiologist and not just because of the possible SVT.  Electrical problems need eletricians, not plumbers.

Why isn't this just a normal response to a bad dream?

by crustyg - 2021-07-12 18:50:51

You have a normal SA-node which connects to your ventricles courtesy of your dual-chamber PM which bypasses the CHB.

You wake up from a bad dream (dry throat, fast HR, powerful heart contractions), you sit up suddenly which reduces the blood supply back to the heart so each beat has to be stronger to keep your BP up and you're aware of your heart beating powerfully and quickly in your chest.

Sounds very normal to me: you sit there quietly for a few moments, the sympathetic drive diminishes, the circulating hormones are metabolised and your HR slows, the beats are less powerful and you take a sip of water and lie down and go back to sleep.

It certainly happens to me - waking from a weird dream, heart pounding, irregular pulse, and then I calm down, HR drops, becomes regular again, and I go back to sleep.

Your anxiety state only makes it worse.  Do you practice CBT?

Sleep study

by Persephone - 2021-07-12 21:42:58

Hi Nina - I hope you're feeling OK today.  While we all naturally get a little dehydrated while we sleep, awakening with a dry throat could indicate sleep apnea (which could be a reason for a sleep study) or GERD or various other issues. As crusty points out, awakening from a bad dream can result in release of hormones that can accelerate heart rate.  Maybe try keeping a journal by your bedside so you can log your feelings and the time they occur - this could help your conversation with your medical team.  

My next comment may be over-simplification, but what time of day is your PM scheduled for self-testing?  Could it be waking you up?  I only know about my PM - the pounding lasts about 8 seconds and then is gone, but it can be very disconcerting if I forget about it and am not anticipating it.

Could be sinus tachycardia, could just be higher than your norm, or could be SVT

by asully - 2021-07-13 02:14:46

If the problem is truly concerning you talk to your EP about it, your device should detect high rate events within a set of predetermined and programmed rates and record them for your next interrogation report.  If u write the dates and times it happens down u may see that u are having some short runs on your next interrogation that match up, as long as it isn't sustained VT, afib, a flutter or other dangerous arrhythmia your doctor will likely tell u it's nothing to worry about.  Note though that not ALL SVTs hit the "record event" threshold which is often set to around 180bpm unless your doc changes it.  If you and your doctor truly want a full picture of your rhythms and possible arrhythmias y'all would want to get a halter monitor done.  If your episodes are sporadic and not frequent they may even do a 30 day monitor.  I had one of these done in the last year and now a "halter monitor" can actually be a tiny little patch thing u put on your chest (mine was an MCOT patch).  Anyways long story short I had an SVT that was occuring frequently but was down in the 130-140bpm range so my pacemaker never detected it.  The 30 day halter (or in my case patch) picked it right up and a month or two later I was able to have the arrhythmia treated with ablation.  Since your SA node is still intact like mine it is possible you could be having some short SVT runs (it's not uncommon).  You will find many on here who have arrhythmias with a pacemaker and CHB.  

I also wouldn't worry and stress too much as it could just be your bodies normal elevated heart rate (aka sinus tachycardia if over 100bpm) caused by a nightmare etc.  I suffer from both anxiety and nightmares and know this happens.  CBT exercises or therapy, or mindfulness practice (aka meditation) help lower anxiety levels and may help you sleep better.  I know mindfulness/meditation may sound hoaky, but it really does help.

I also like to listen to "sleep tube" on YouTube while I fall asleep, it has relaxing meditation music and sounds plus each video walks you through a breathing exercise at the beginning to calm your mind and body.

The dry throat could simply be that you breath trough your mouth at night or snore, I do both and wake up with sandpaper mouth throughout the night.

Happens To Me Too

by Marybird - 2021-07-13 10:47:05

Not uncommonly. 

Good suggestions, 'y'all. Another thought that occurred to me was perhaps sitting up suddenly, or getting up might from sleep cause a big increase in the heart rate if the rate response in the pacemaker is turned on and settings are a bit high?  I've attributed the rate response in my case to my increase in heart ( sometimes into the low 100's)  rate when I flipped over to my right side in bed at night, it's happened so consistently. And with that rate response on like that you'd expect your heart rate to increase if you thrash around during sleep ( say, during a dream), or if you sit up or get up from a sleep where your heart rate is at rest, in my case the lower rate is set at 55, so that's about where it is when I'm asleep, I imagine. 

Though there may be something to the arrhythmias, as I've noted more of what you describe, Nina, as those big increases in heart rate are often occuring when I change to any position in bed at night, when I sit up, or get up. And sometimes randomly during the day. But I've lived with  paroxysmal tachycardia for a long time, and with the pacemaker ( for sick sinus syndrome- tachy- brady) and remote monitoring I figured if it was,significant I'd be notified about it, so I did my best just to take it in stride. 

And I have been notified, on several occasions, by my cardiologist's office, with instructions for an increase in medication, and this last time , instructions for me to see the cardiologist, a diagnosis of atrial fibrillation and prescription for Eliquis. They told me of a number of afib episodes, at least one lasting two hours, though I was only aware of a few palpitations, maybe lasting a couple minutes. Perhaps then, some of those night things for me have been afib. 

My cardiologist reassured me though, that afib doesn't have to be a big bear if it's under control and with the anticoagulant,( and I've read this as well), so at this point I tend to ignore the palpitations I get and keep on truckin', fortunately I'm not all that symptomatic otherwise. For me, the reassurance I've gotten, and knowing the remote pacemaker monitoring is doing its job ( ratting on me, as I call it, when indicated), has done wonders for my perspective on this thing. 



Thank you everyone!

by Nina38 - 2021-07-14 15:11:51

I really appreciate the feedback everyone. 
i made an appointment with my cardiologist to discuss this. I was also told the day before this happened to me... I had 4 fast heart beats which was picked up. Oddly I didn't feel it when it happened.

hopefully I can get some clarity when I see my dr. I do feel fine and I didn't have it happen again the last few nights. It could have been I got up a bit too quickly and my heart rate went up... or I was dreaming... who knows. But I did write it down. 
Thanks again everyone.... 


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