heart racing and pounding feeling in chest

Hi, I'm new to this forum and so glad I found this group to share some of my feelings .  I was recently implanted about 4 days ago, a dual chamber pacer for high grade second degree AV block ( Mobitz type 2) occurring during exercise with HR over 120. I also have tachy brady syndrome wherein my HR sometimes keeps rising even on minor exertions like walking up a flight of stairs and then stay high around 120s for a good half hour before gradually slowing down to baseline. I get the pounding feeling when HR goes over 120 or so. With the pacer in place, I still feel about the same when the rate goes up. Does it mean the Pacer is not properly set up yet to handle higher rates or it's expected to be so? Appreciate any advice.Thanks




Speak to your doctors for better control of your arrhythmias while you heal

by Gemita - 2022-07-28 07:12:26

Hello Rich, welcome to the Pacemaker Club.  A problem shared is a problem halved hopefully.  I see your implant was only four days ago.  When I look back to those early days of my implant (I too have a dual chamber pacemaker for tachy/brady syndrome), I also experienced lots of palpitations as my heart got used to being paced.  The implant procedure may initially cause worsening rhythm disturbances but these should settle as you heal.

Reading your message it seems that your doctors didn’t perhaps explain fully what a simple pacemaker system (without a defibrillator) can and cannot do for you.  A simple pacemaker can take care of a slow heart beat and prevent a drop in your heart rate below the Base Rate (lower set rate) but cannot treat or stop an arrhythmia/fast heart rate. If a more serious ventricular arrhythmia had been seen prior to your implant, you would have been given a pacemaker with a defibrillator which could stop a dangerously fast tachyarrhythmia by shocking the heart.

So what can be done about your palpitations?  Firstly be patient, wait for healing to take place.  Healing can take up to 2-3 months but over this period you should slowly notice an improvement in all your symptoms.  Your doctors may suggest a higher dose of a beta blocker or another rate control medication while you are healing, to better control your heart rate and help you to feel more comfortable.  It doesn’t necessarily mean that the pacemaker is not set up correctly for you, but yes you may have some way to go before your pacemaker is adjusted to suit your personal needs, but one step at a time.

Plan, I would let your team know what is happening, the symptoms you are getting.  I went back after 6 weeks for some pacemaker adjustments, most of us do.  Initially I believe some of the lead settings in particular may be set slightly higher than normal while scar tissue is forming where the lead tips are attached to heart tissue.  Some of us may experience diaphragmatic stimulation or other sensations from these early higher than normal settings.  I could, strangely, feel my palpitations in my stomach until the lead settings were lowered.  

You could also ask whether the Rate Response setting has been activated and whether this could be the cause of your worsening symptoms and whether this setting needs adjusting, turning on or off?  Good luck Rich.  I am confident it will get better

Heart racing

by Lavender - 2022-07-28 08:59:07

I just wanted to say that I had heart pounding and lots of PVCs after my implantation of a CRT-P.  I was used to a slow rate and at first they set it to 70bpm. I felt like I had a pot of coffee. I also felt anxious.  I was told they initially set the rate higher because the leads aren't yet fully grown in with fibrous tissue. When I went back for the one month pacemaker interrogation, the rate was turned to 60bpm.  I no longer feel like my heart is  pounding and am used to the new rate. I still get frequent PVCs. 

Perhaps when you go in for your one week wound check you can share your concerns with your cardiologist.  

It's so new to you.  What you feel is just for now, not forever.  Your heart muscle is not happy about the recent surgery and must heal. You can see the wound where they went in but you cannot see the internal wounds healing. As you see your entry wound get better, the same process is happening inside you.  

Four days is very early in the process.  It will get better. I'm glad you're here, and sorry you're dealing with this. Hugs 


by Rch - 2022-07-28 14:51:56

I will be seeing my Cardiologist next week for the wound check . He said he would ask the Pacemaker clinic to check the recordings of my rhythm to r/o any Fib/flutter events. Thanks !!!! 

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I have an ICD which is both a pacer/defib. I have no problems with mine and it has saved my life.