Happy New Year to all.  Another happy pacemaker year has passed and more happy ones are to come.

I had my first battery change in May 2022, Biotronik.  I found out the battery and leads do not have to match.  My leads are from St Jude's inserted in 2011.  The Biotronik "sales rep" who was very nice, mentioned in the operating room he was surprised I was not on a blood thinner.  I have rapid heartbeat since the battery change.  I went to see my cardiologist, who prescribed me Pradaxa.  My acid reflux did not agree with it so I was prescribed Xarelto.  Pharma doctor said I should not have the same stomach side effect with this new medication. 

 I have a recent ECG abnormal result.  My cardiologist messaged me that my EKG shows normal pacemaker activity.  Nothing to worry about.   I am now curious to know from those taking Xarelto if it helps with a rapid heartbeat, in addition to thinning my blood to prevent blood clots.  

Thank you.  You are an awesome group of pacemaker wearers.  



by Gemita - 2023-01-01 02:50:26

Hello Moana,

Happy New Year to you too.

I am glad your device change went well and I am sorry to hear of your recent abnormal ECG although I am reassured that on review of your pacemaker data, your cardiologist has not seen anything significant.  However clearly your cardiologist must have seen an arrhythmia initially that required treatment with an anticoagulant?  

It would only take a short episode of an arrhythmia like AF (atrial fibrillation) for example, to put us at risk of an AF related stroke if we have risk factors?  See link below to determine if you have risk factors Moana.  You will need to copy and paste link into your main browser to open it.

I suppose we could say that all anticoagulants like Xarelto (Rivaroxaban) should help with an arrhythmia, especially an irregular one like AF, mainly because they will help blood to flow smoother through our veins and arteries.  As you may know as an arrhythmia sufferer, when we have a slow, fast or an irregular heart rhythm it can hinder blood flow through our body which is one of the reasons why blood clots can form and why arrhythmias can be so dangerous for those who have risk factors for a stroke.

Having said all of the above, an anticoagulant is not used to stop or to try to calm an arrhythmia directly, or to prevent an arrhythmia from starting in the same way as an anti arrhythmic medication, or a rate control medication will work, but anticoagulants and arrhythmia control meds will work together to help to protect you from the effects of a fast, slow or an irregular heart rhythm, so you should feel better.

From personal experience when I first started having AF episodes, prior to anticoagulation treatment, I could often feel my blood pounding in my head at the start of an episode.  This was due to my AF causing irregular surges and falls in blood pressure and heart rate.  It was frankly, frightening and I felt as though I could have easily suffered a stroke.  Now with my anticoagulation and a rate control beta blocker, I no longer thankfully get these awful attacks.  They are well controlled and I feel safer and less anxious.

I hope you do well on Xarelto Moana.  If not, there are other ones you can try too, like Eliquis (Apixaban) which may be even kinder on your gastric system than Xarelto, but hopefully this won’t be necessary.  That’s it.  Stay well and safe and make a new start.



by Old male - 2023-01-01 02:57:31

I've taken Xarelto about 4 years now to help prevent clotting. Don't think it decreases heart rate.  Prescribed because of A-fib.  Also take other meds for arrhythmia. 

Change of Battery

by Penguin - 2023-01-04 14:40:43

Hi Moana, 

When they change your battery they can really see and understand your underlying heart rhythm without a pacemaker. 

Although technicians check your underlying heart rhythm at every pacing appointment, they can't completely assess exactly how your heart rhythm is behaving until that device comes out. Sounds like the Rep found something (an arrhythmia) requiring anti-coagulation. 

I'd push for confirmation of what exactly was found (a diagnosis) and then ask about the medication prescribed to treat it and how it may be affecting you.  Keep in mind that if it is an arrhythmia the operation itself may have been a trigger for a more noticeable episode than you usually get because an invasive operation could 'upset' the arrhythmia and it may need time to settle back down.

Ask your EP to explain what the abnormal ECGs show and whether this confirms what the Rep found when the device was taken out.  

'Normal pacemaker activity' doesn't tell you very much. It just means that the pacemaker is doing what your doctor would expect it to do given those ECG findings.  What you really need to know about is whether or not there is an arrhythmia diagnosis. 

Sorry if that sounds concerning and the questions you ask are ultimately your choice, but this may explain what's going on. 

Take care, I hope the symptoms improve soon. 


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My pacemaker was installed in 1998 and I have not felt better. The mental part is the toughest.