110 BPM sustained for 30 minutes whilst asleep.

Hi all

In August 2017 I had a dual lead Metronic pacemaker implanted for a 20 second pause during the night discovered by the Reveal Device reading implanted previous year for dizziness and actual near fainting spell. It was a shock but I'm well used to having the pacemaker now

Recently, For a year or so probably since Autumn of 21, I had been experiencing what I thought was indigestion. It was very intermittent but did get worse during this Summer. Often it would stop me in my tracks so I paid a visit to my cardiologist. He took it quite seriously,  the pain never increased on exertion but I did feel slightly breathless when I walked uphill which I think is quite normal I am nearly 73! 
He put me on Lansoprazole to see if it improved and arranged for a CT Angiogram. I couldn't tolerate the drug so came off it. Had the CT after organising blood tests first. Was hoping all would be well. I heard from my cardiologist a few days later. I had a 95 to 99% blocked right coronary artery which was critical and a possible angioplasty was organised for two days later. I was told there was a surgical team standing by in case stents couldn't be inserted and bypass might be necessary. It was all pretty scary!  Thank goodness the angioplasty worked. I had two stents inserted as I also had disease in the Ostium which I've never heard of? 
I'm on a cocktail of drugs now, Clopidogrel, aspirin, and 80 mgs of Atorvastatin. I am told this is genetic as I eat a very healthy diet and am small and very slim.

I only had a CT Angiogram in February 19 which showed  plaque of only 30 to 40% 
I have now got over the shock but I have noticed since the stents I'm having more palpitations often quite a run. Also for a few times now my Apple Watch is picking up a heart rate of 110 beats per minute whilst I'm asleep. It happened last night and was sustained for 30 minutes. A couple of weeks ago it went to 116 but it was only for five minutes or so. 
whenever I ask the electrophysiologist anything about Apple Watch data she always seems to disregard it?  
my question is I have the next pacemaker check mid January but I'm thinking about bringing this forward as my last check was a reading I sent in pre stents beginning of July. 
I would like like some reassurance all is ok. 
Any comments would be greatly appreciated to help me decide. 
thanks in anticipation 

kind regards 

Sue


3 Comments

Palpitations following stent surgery

by Gemita - 2022-11-22 11:00:32

Hi Sue, you have had a few interventions and I hope generally you are feeling a lot better now, except for the higher heart rates at night?   I know when my husband had his stents put in and his blood was flowing properly again, he felt less breathless, had more energy and his chest discomfort on exertion eased considerably.  He also had a stent placed in his right coronary artery as well as his left anterior descending artery.  The latter artery was almost totally blocked, so he was in danger too.

Sue I found the following helpful about the location of the Ostia.  Coronary ostial stenosis refers to the narrowing of the ostium part of the coronary arteries and disease here I have read is a challenge for the cardiologist because it can often involve the wall of the aorta.

Location:
The coronary arteries originate as the right and left main coronary arteries, which exit the ascending aorta just above the aortic valve (coronary ostia). There are three cusps of the aortic valve: the non-coronary cusp, which contains no ostia, the right coronary cusp, which contains the ostia of the right coronary artery, and the left coronary cusp, which contains the ostia of the left (main) coronary artery. The ostia of the left and right coronary arteries are located just above the aortic valve, as are the left and right sinuses of Valsalva.

Function:
Oxygenated blood is pumped into the aorta from the left ventricle; it then flows into the coronary artery ostia. Blood flow into the coronary arteries is greatest during ventricular diastole.

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I can imagine you are on a cocktail of drugs to protect your stents. Our doctors recommended dual anti platelet therapy with three months Clopidogrel, 12 months Aspirin after drug-eluting stent placement to prevent late stent thrombosis.  My husband was also on an anticoagulant so was at risk of a bleed.  Have you had any genetic testing and do they intend to investigate further Sue?

Palpitations after stent placement or indeed after any trauma can be expected unfortunately and providing these don’t last for longer periods and heart rate doesn’t go any higher, your doctors may not wish to intervene, although mine would probably recommend a beta blocker to calm everything down.  Are you taking a rate control medication like a low dose beta blocker?

You could always transmit data to your clinic if you have home monitoring at the time of your palpitations, since your doctors aren't too impressed with your Apple watch!  You could ask your doctors/technicians to have a look to see whether anything important is happening.  If you are concerned or have any unusual symptoms, like breathlessness or chest pain, please don’t be afraid to seek help.  After stent surgery, you want to make sure you remain safe and well and I would have thought that your doctors would want to keep your heart rate under 100 bpm in any event.  Anything over 100 bpm is defined as tachycardia.  I feel this is probably all very normal since I had increased palpitations following pacemaker implant;  my husband did too and also following his three stents.  You have had several interventions, so it will take time for your heart to settle again.  I wish you well Sue

Stent Surgery

by Foxy49 - 2022-11-22 18:42:15

Gemita

Thank you so much for all your endeavours explaining this to me. I have to say much more than my cardiologist told me! There was indeed difficulties inserting my stents. One wire tip actually broke off and remains under the stent in the Ostium. It was very uncomfortable and I had to ask for pain relief whilst it was being carried out. I have contacted the hospital where my pacemaker is checked and brought my appointment forward to three weeks time. I will report back afterwards if I am really worried tho I will send through a reading remotely before this. Once again thanks a million! 

Stent Surgery

by Foxy49 - 2022-11-22 19:00:15

Just to add Gemita. No I'm not on any beta blockers nor has my cardiologist suggested any genetic testing. My father had triple bypass at 71, stents in his 80s, pacemaker at 90 and finally heart failure for last few years of his life but lived to 96. He also had three DVTs and a pulmonary embolism oh and was in permanent AF for last two years of his life. my Mum had AF and TIAs which resulted in vascular dementia so I think enough genetics there which I have spoken about with my cardio! He doesn't want to see me now for six months? Stay well! 

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