Atrial Tachycardia

So I had a generator replacement on Dec 15. I posted before about this because during the procedure and an hour after I went into afib and developed what they told me was an atrial flutter. They used the pacer to trick my heart back into a normal rhythm and gave me meds to control it. Today at my follow up, after they had time to review the events of that day, said it was not really a flutter but atrial tachycardia. Has anyone else had this after a gen change? I was 30 when I got my first pacer, this is only my first change, and I am just about 40. They are treating it with meds (Bisoprolol). They took me off the other one they gave me that day, which I'm happy about because that one is know to have terrible long term effects. I'm just curious as to why this happened? Has anyone one had it repair itself in a way? Or is this just another level of having completel heart block? I asked these questions but there was not clear answer as to why, just that it could of been wire tugging, anxiety, stress of the procedure, etc. I was awake and I can assure, the next change I am requesting they knock me out for me out. I felt fairly calm going into this, I'm not looking forward to the next one!  


2 Comments

Atrial arrhythmias following generator change

by Gemita - 2021-12-31 07:41:44

As other members have already mentioned in your previous post Janine, stress can certainly cause many health problems and trigger arrhythmias.   A generator change will certainly be stressful for many of us.   

Lead trauma is unlikely to have occurred during your generator change unless you had a lead replaced which you said on your previous post didn’t happen.  Discomfort would have been felt when they opened the pocket to replace your old device, but “lead tugging trauma” is unlikely to have occurred.  This is because they always allow some slack on the leads during initial implant so that normal daily stretching movements can take place without pulling on leads and traumatising tissue, especially where lead tips are attached to the heart.  Often there is so much lead slack that they tuck it behind the device.

My EP places all my arrhythmias like Fibrillation, Flutter, atrial Tachycardia under one umbrella since they are all atrial tachy arrhythmias and it is not uncommon for one arrhythmia to unmask/trigger another.  At 73, my EP is more concerned about "how I feel generally", control of my heart rate and anticoagulation protection rather than what my pacemaker has recorded.  In any case, it can sometimes be very difficult to correctly identify the arrhythmia present, particularly without a surface (external) ECG at the time of your symptoms.  A short ECG recording obtained from our pacemaker downloads may not give the detail required to fully assess the actual arrhythmia present during an event, so it is not uncommon to receive a completely different diagnosis at another time - ie from Flutter to Tachycardia in your case.  Interpretation of data may differ.  The level of expertise of the technician reading the report in my experience is key.

Repair itself you ask?  Yes once stress levels reduce and healing occurs, your heart should calm and your arrhythmias settle without further intervention.  If not, your doctors may change or increase your medication or discuss other treatments.  It took me three months before my arrhythmias calmed following my implant procedure, although a generator change should be less traumatic.  Remember heart block, like arrhythmias, is caused by electrical disturbances so heart block may also worsen during stressful periods or other illnesses.  Although your pacemaker cannot stop your arrhythmias, heart block is successfully treated by your pacemaker

Atrial Tachy

by TAC - 2021-12-31 11:30:19

In short, arrhythmias are disturbances of the natural electric system of the heart. Pacemakers don't cure arrhythmias. Pacemakers only insure a steady  pumping action of your heart despite the arrhythmias. The arrhythmias are treated with ablation and drugs. Many things can disturb the electric system of the heart, congenital malformations, myocardial injury, mycardial ischemia, electrolite imbalance, stimulation of the autonomic nervous system, etc. Something disturbed your heart's electric system during the procedure triggering the arrhythmias. Most likely things will gradually return to their baseline now that you have a new battery. Anyway, the arrhythmias you had, didn't disturb significatly the pumping action of your heart, because of the PM.

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