Pacemaker Mediated Tachycardia

In September this year my cardiologist/EP diagnosed me as having PVC induced PMT.  The St. Jude/Abbott rep was called in and she changed a setting with my pacemaker and all was right with my world again!  Plus most of my severe fatigue issues were resolved... a most appreciated benefit.  

Just in the past couple of days I have been experiencing arrhythmia, mostly fluttering.  Before I get too concerned I wonder if any of you have this issue and could it simply require another p/m adjustment?  

Also, I've been so fortunate and have avoided Covid up to this point.  In the back of my mind I'm thinking could this possibly have something to do with Covid?  Have just not felt real good for two days.  I will take a test but after combing the internet find no mention of arrhtythmia as a Covid symptom, only that it can occur after one has been sick.  

Once again, I thank you in advance for your thoughts and suggestions.


I developed a new arrhythmia with a respiratory/Covid infection

by Gemita - 2022-12-27 19:27:51

Dear Benedeni, yes with any illness, however mild and especially with an infection, either viral or bacterial, it can trigger an arrhythmia.  As a matter of fact I developed a new arrhythmia during a Covid attack in 2020 before my first vaccine and I was quite poorly.  The arrhythmia was diagnosed as Multi Focal Atrial Tachycardia and my cardiologist was not at all surprised that I experienced difficult symptoms.  In fact he said in the presence of a severe illness it was to be expected.

My doctors at the time treated me for a respiratory bacterial infection too. The tachycardia acute symptoms were managed with a slightly higher dose of my beta blocker.  I needed three different courses of antibiotics to clear the infection but as the infection resolved, so did my arrhythmia and it was such a relief.

It is difficult to know what has happened to you, whether you do have Covid or some other viral infection.  There is so much flu and Covid going around, even here in the UK.

Try not to panic.  Get plenty of rest, have some warming soups, keep fluid levels up so you don’t get dehydrated, treat any bacterial infection and hopefully in a few days you will be feeling better.  I hope you have not worked too hard over Christmas.  Whatever you do, please do not panic about your arrhythmia but let your doctors know if the heart rate cannot be controlled or your episodes last for long periods, when medical intervention might be necessary.  If you get symptoms of breathlessness, chest pain or dizziness then of course you should seek help.  

Where do you feel the flutter sensation?  Is it coming from your chest or from the upper abdomen.  I often feel my arrhythmias in the epigastric region and they can be caused by a digestive problem too . . . and we have just enjoyed lots of Christmas treats, haven’t we?

Yes it is possible that your pacemaker settings may need further adjustments, but it looks more to me that this might be a new acute symptom from whatever is ailing you, so hopefully it will disappear as quickly as it came.  You could get your electrolytes checked.  I will say goodnight but will be around tomorrow if you need any help.  Now promise me you won't worry and if you have difficult symptoms you will seek help?

Covid and arrhythmia

by benedeni - 2022-12-27 20:31:44

Thanks Gemita.  What you say makes a lot of sense.  The sensations are coming from my chest.  I know what you are talking about re the abdominal region.  I am nursing an ulcer with carafate 4x daily and have been for 2 months and that causes some stomach distress as well.  And yes, I promise!

How was the covid test?

by Lavender - 2022-12-27 21:38:56

As you're aware, we get free covid test kits in the USA. Those on medicare can also get them free at a pharmacy. It's easy to do with quick results. Hoping your test was negative. 

Since getting my pacemaker, I've noticed that I am hyper aware of my heart beat, changes in it, and times of PVCs. On Christmas day, all day, my heart seemed to beat differently. I was busy with a houseful of guests, serving foods, playing with the children, up and down making everyone comfortable and taken care of. The next day all seemed normal again-well MY normal weird feeling inside. 🤪

I think we just get up each day and move forward. If something is really out of whack, we call the dr. As I age, I wait longer to call because I see if it improves on its own first. I'm less willing to wait in an office or ER. I'm more aware of the limitations on what can be fixed and more accepting that there are things with which I will learn to live and will adapt. 

I took carafate for a long many months after ibuprofen caused stomach erosions. I had pericarditis and the cardiologist said to take 3200 mg ibuprofen daily. She knew it would damage the stomach but said the heart was more important. So in time the pericarditis healed, leaving me with more months healing the belly. The carafate made me so itchy but it also did its job of healing the stomach. 

May God completely heal your belly-as well as stabilize the arrhythmias you're sensing. May peace rule your world. Feel better soon. May 2023 be the start of a long season of blessings for you!


by AgentX86 - 2022-12-27 23:01:12

Lavender, Medicare recipients can also get the test kits sent to them in the mail.  I get an email every four to six months with an order form.  The form is really, "do you want them?".  They'll send four test kits per household each time. The shelf life is only a few months so they repeat the "offer" to keep them current.

The USPS actually fulfulls the orders.

Tested for Covid

by benedeni - 2022-12-28 11:06:06

I did take a Covid test and the results were negative.  Feeling a bit better today except for the arrhythmia.  That let up entirely when I went to bed last night so feeling better about that too.

It's great that we are provided the test kits through the mail.  This is the first time I've used one and it says to repeat in 24 hours if negative.  Guess I'll do that but feel sure results were accurate the first time.  Recently ordered 4 more that are arriving today.  Did not think about the shelf life being just a few months.  Good to know.  Thanks, Agent.  Also many thanks Lavender for your kind words.  I so agree that the older we get the more time we take before "taking action" to make dr's appointment, visit? not the word for a trip to the ER!  Torture is more like it.  After what we've all been through, we are learning more and more about our bodies and what's going on.  Happy New Better Year to each and all.

This might be relevant - but not to do with Covid

by Penguin - 2022-12-28 15:46:37


I have the same PM as you and this may or may not be useful, but maybe take a look at this link. It's a very short resume of some research into the PVC response setting on Abbott Assurity pacemakers.

If your PVC response is set to 'atrial pace', this can trigger atrial arrhythmia. See link: which explains that this happens in Abbott Assurity devices.  

I'm getting lots of arrhythmia with the same device and looking into reasons for it. 

As I say, may or may not help you. 

Best Wishes


PVC Response

by benedeni - 2022-12-28 16:40:27

Penguin, thank you.  A possibility for sure.  I will print this link and show it to my cardiologist.  Certainly won't hurt!  If and when you discover more reasons for arrhythmia with this response setting, please let me know.  I appreciate it.  

PVCs still causing problems

by Gotrhythm - 2022-12-31 13:49:51

Happily, I have not had Covid, but I did have PVC induced PMT. The problem was taken care of with an adjustment of the PVAARP.

Unfortunately, the presence of one or two arrythmias makes it more likely that others will arise as time goes on. About 8 years into that pacemaker, my heart developed PSVT--Paroxysmal Supra Ventricular Tachycardia. Essentially, what that means is my heart developed a rogue conduction pathway that produces runaway atrial contractions. Fortunately, it only lasts a few seconds. I can't prove it, but it feels like the PVST happens most after I have a few PVCs.

The piece of pacemaker wisdom I'm attempting to share is that with or without Covid our arrythmia-prone hearts, like the "best laid schemes of mice and men" can "gang aft agley." (Somehow the glancing reference to Bobbie Burns seems appropriate this New Year's Eve.)

Best Laid Schemes..

by benedeni - 2022-12-31 14:47:56

Aww.  Great analogy!  Gotrythm, thanks for your input.  Sounds like we have some of the same issues.  Take care and Happy and Healthy New Year.

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