Resting basal rate sensing and pacing

Hi, has any one noticed an occasional burst from the A paced V sensed rhythm at rest to both A and V paced ( wide complex V on Kardia ) for a few minutes and then slowly reset to the baseline ( A paced, V sensed)? I have a DDD. The rate of this burst is a bit higher than the baseline rate and resets as the rate approaches the baseline. I feel the change as a slight stirring feeling in my stomach and I check with my Kardia! Could this be set off by an ectopic beat? Thanks in advance!!!!!

1 Comments

Not sure that I can answer your question with any certainty

by Gemita - 2022-08-02 15:19:42

Hello Rich,

You have given us a challenging question.  How clever of you to feel the difference and to be able to observe the changes on a Kardia printout.  We often discuss Kardia here.  It requires a trained eye to be able to read the “paced” rhythm present.  

Not sure that I can say with certainty that I would know the exact moment when I go into an Atrial paced/Ventricular paced rhythm from my usual Atrial paced, Ventricular sensed rhythm.  I can though tell from my symptoms alone the moment I come out of normal sinus rhythm and go into an arrhythmia like an ectopic beat, Atrial Fibrillation (AF) or Flutter.  Yes an ectopic beat in my case is often the cause of a change in my pacing since an atrial ectopic beat frequently leads to a tachy arrhythmia like AF and Flutter.  I also have ventricular ectopic beats triggering non sustained VT.

As you describe, I can feel the slight stirring (or dipping sensation) in my stomach as I slide into an arrhythmia or when my mode changes (see Medtronic link), so as not to track the atrial tachy arrhythmia.  It switches back to my normal pacing mode (AAI) on cessation of the arrhythmia.  I am paced AAI to DDD.

I only have limited pacing in the right ventricle anyway. I am 100% atrial paced.  I know I don’t like being paced in my right ventricle but I don’t like being out of normal sinus rhythm either, so it is difficult to know whether occasional right ventricular pacing or the loss of normal sinus rhythm is the cause of my symptoms.

https://www.medtronicacademy.com/features/mode-switch-feature

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