Palpitations

Hello everyone,

I've had my pacemaker implanted on October 12 2022.  I was diagnosed with SSS (sick sinus syndrome) with symptomatic bradycardia which caused my heart to pause for 12-seconds.  Trying to cope with this life changing event along with palpitations, anxiety and fatigue. Some days the palpitations are not as frequent as other days and some days I feel fatigue and other days not so much.

I have always had palpitations once in awhile but ever since the pm was implanted it's doubled the frequency which causes heightened anxiety.  I feel like my mind is in a fog and fear what's next is going to happen.  Are the palpitations all in my head or are they real? Does anyone feel similar?

Thank you 

Joe


6 Comments

Palpitations are real, not imagined

by Gemita - 2023-02-23 16:40:09

Joe, no the palpitations are certainly not all in your head and they are very real.  I had a similar problem immediately following my pacemaker when my palpitations increased and I started to question whether I had made a bad decision to get the pacemaker.  Fortunately over a few months my palpitations eased and I hope it will be the same for you too.

You clearly say your palpitations are not always so frequent, so you are slowly beginning to heal from the pacemaker procedure which may take longer for some of us.  Not only are we dealing with having to be paced for the first time in our lives, but we are also having to deal with any heart rhythm disturbances that may either appear for the first time from pacing itself or that are already present. 

Heart rhythm disturbances from whatever source can usually be helped by settings adjustments, by medication or something like this if you ask your doctor.  Also palpitations can occur because of another health condition, so if you are really concerned, I would pop along to see your GP.  They might check your electrolytes.  

Are you drinking enough water.  Dehydration can trigger palpitations for me as can sleep problems.  I hope you feel better soon and don't be afraid to return to ask lots of reassuring questions

Palpitations

by _Claire_ - 2023-02-23 18:22:39

Hi Joe

I had new palpitations after my pacemaker (PM) implant too and there was definitely more activity in the first few months. I have sinus node dysfunction (some have called it sick sinus syndrome) and my long pause I believe was from a vasovagal episode. Mine was 13 seconds so v similar to you. I don't know how much your PM paces you? Mine is barely at all. But I have been able to feel very short periods of pacing at times (although rare that I'm paced) and this feels like palpitations so for me it can be difficult to differentiate between the two at times.
 

I know I can feel pacing because of my PM checks when they make the PM pace my heart, and from some automatic threshold test that the PM used to do every hour, all day long, which I was aware of. I wonder if you could bear this in mind as a possibility? I don't know the percentage of people that can feel pacing (I think it's the minority). I wasn't sure what was happening at first and it caused me a lot of confusion in the early days. To be honest, I still can't always differentiate between tiny periods of pacing and an ectopic beat or two. 
 

The anxiety loop is very real and I suffered significantly with this. If they are palpitations (likely) and not you feeling periods of pacing (quite unlikely) then I think anxiety can make them worse. I think the anxiety will improve as you heal and get used to living with a PM. From an anxiety perspective, for me, the more I can understand, the calmer I feel about it all. At the beginning I had no idea what was going on and knew nothing at all about PMs. For others, it's better to understand the minimum and this helps with their anxiety.  

Hope you get to the bottom of the palpitations in time and in all likelihood after healing as Gemita said, the palpitations will reduce. 
 

I wish you all the best 

Palpitations

by Jmonastero - 2023-02-23 22:08:42

@_Claire_
@Gemita

Thank you so much to both of you for sharing your thoughts and experiences! It's very helpful mentally that I'm not alone.  I know this has been hard on both of you too.  Like I’ve said previously Its been very difficult on me having to deal with this  happening to me (hard to believe or except).  At the same time I'm very grateful and lucky to be alive after my heart stopping ( pause) for 12 seconds and then the next day having a pacemaker implanted. Hearing other people's stories are helpful and therapeutic.  Thank you sooo much again.

Without writing a book about my heart issues.  About 10 years ago I was diagnosed with RBBB (right bundle branch block) which is a problem with your right bundle branch that keeps your heart’s electrical signal from moving at the same time as the left bundle branch. Instead of moving together on the left and right sides, the signal on the right side is running behind. Causing my heart to occasionally palpitate.  Unknowingly I’ve had this for awhile and dealt with this electrical issue with my heart which initiated anxiety attacks. Now Fast forward to today after having the pm implanted the palpitations are a lot more frequent causing my anxiety to heightened. I’ve been exercising and pushing it hard to get back in shape.  This has helped me mentally, physically and with my anxiety which of course makes me feel "normal".

My pacemaker performs a test at midnight everyday which I can physically feel (if I’m awake). This test feels exactly like a heart palpitation so to your point I would like to know also if these palpitations are from pacing or from RBBB or something else. I was told I pace at 6%

My pacemaker technician is supposed to call me at some point so I can have her look at my recent data collected and ask her questions that I need answers too

Hopefully this will be all behind us with time and we’ll get used to the pm and forget that it’s even there.  

Sincerely ♥️

Joe

Listen to your body

by Gemita - 2023-02-24 07:12:23

Jmonastero, you could ask for the testing at night to be changed to another time if the tests disturb you?  This would be one way of seeing whether your palpitations are caused by this test at that specific time.  Alternatively have them stop the nightly test completely which is what some patients do, particularly if they don’t have any significant arrhythmias or other indication for nightly monitoring? 

Both my husband and I have pacemakers and we do not require nightly monitoring of our devices, only periodic home monitoring and of course we receive full in hospital monitoring at least every 6 months or so.

As to whether your palpitations are from pacing or RBBB or something else, if you keep a record of the precise time (like midnight?) you always get these palpitations and the date of any significant symptoms, your doctors can have a look at your records at that given time and date and possibly confirm the arrhythmia present.  I say possibly because certain parameters, set by your doctors, have to be met for the recording and storage of an arrhythmia on your pacemaker.  RBBB patterns can usually be seen on any pacemaker's internal ECG, although pacing itself may cause unusual patterns on ECGs but your doctors will be able to confirm the arrhythmia present. 

Sometimes however, we may still need external monitoring (like an event Holter monitor) to perform 24/7 recordings over a longer period (say up to 7+ days) to give your doctors all the information they require.  I had an implant monitor (for 3+ years) to detect my “intermittent” arrhythmias causing syncope before my pacemaker implant.  Monitoring in its many forms is the key to getting a proper diagnosis but can be a slow process, although you already have the protection of your pacemaker to keep you safe so you can relax.

However this is still early days for you and there is every chance that your palpitations will settle.  It sounds as though you are already living a fairly normal life and exercising well.  I wouldn’t push too hard though, or push through palpitations if they increase during exercise and you become "symptomatic".  Listen to your body and you won't go wrong

Hi Joe!

by Lavender - 2023-02-25 19:16:04

Joe,

I was diagnosed with left bundle block in 2010. I never had any idea of that and it was accidentally discovered on an ekg while in the hospital for something else. I was told that it came and went and wasn't a problem. 
 

Eleven years later, I ended up with a pacemaker. I had a thirty three second pause. Dropped on my livingroom floor like a doll with the battery pack removed. No pain. Just dropped. My guy who knows no CPR, thought my death rattle was me choking. He punched my back hard which started my heart. 
 

I got post traumatic stress from it. Each night at 10 pm, the time of my drop attack, I got anxiety and my blood pressure raised. My pcp wanted me to try medical marijuana but I declined. Instead, I turned to prayer, meditation and being outdoors as much as possible. 
 

That was two years ago. I used to have lots of PVCs. I would lie awake feeling my body-which I no longer trusted. I do have PVCs but not every day. Stress can make more of them. Your device is doing it's job. You will learn to trust that you are okay. I was afraid to leave the house for awhile. I didn't want to be alone. 
 

Your brain will settle down and stop thinking you're in danger. Retrain it. 
 

All will be well. (((Hugs)))

Hi Lavender

by Jmonastero - 2023-02-25 20:39:40

Thanks you for sharing your traumatic experience and glad to hear your ok.

I push myself to go anywhere fearing that something would happen again. The palpitations make me think there's more going on which causes my anxiety to heighten.... like you said I just don't trust my body yet I have good days and bad days.  Hopefully I'll get to the point where the palpitations aren't as frequent and mentally and physically get over this.

 

Thank you ♥️

Joe

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