PVC, PMT, PSVT, RNRVAS--UPDATE

Over the years in Pacemaker Club, I've been helped and learned as much by reading other people's posts as from getting specific answers to my posts. So I hope there will be some value in sharing what I have learned with the group.

I have a history of PVC induced PMT. You may recall a year or maybe two years ago when I posted about a new diagnosis of PSVT questioning if it was being triggered by PVCs because that's what it felt like was happening.

Then, in October of last year after I got a replacement pacemaker. I repeatedly questioned if my settings were the same because I was feeling something like more PSVT or maybe PMT, and I was definitely having more PVCs. I was repeatedly assured that the settings were the same and PMT was "impossible." Nevertheless, the problem--whatever its name was--got worse, more frequent, more intense, longer lasting. I felt terrible pretty much all the time.

Fortunately for me, Penguin posted about RNRVAS, and I was able to ask the pacemaker tech about it. His face registered surprise, then intense concentration, and then he said, "There is no algorhythm to test for it, but it can be observed." When he looked for it, he found it.

The mode was changed from DDDR to AAIR and there have been no episodes since. Over about a week PVCs decreased sharply, and I have felt no,none, zero, PSVT.

HIndsight, as they say, is 20/20 and I can't prove it, but now I think the RNRVAS problem started even before the generator change and was called PSVT.

Today I am doing well. The pacemaker generates a nice steady, dependable heartrate with no interfence from my wonky heart. I feel good.

 

10 Comments

so glad to hear

by new to pace.... - 2023-05-02 14:47:35

It is said that we learn from others and you have congrats.

new to pace

This is a massive Success Story

by Gemita - 2023-05-02 15:10:28

Dear Gotrhythm, this is not a Checkups & Settings story but a complete Success Story and I am absolutely delighted for you that you have at last found relief from your difficult symptoms.  

You have worked hard to understand your settings, pacemaker and rhythm disturbances over many years and provided such caring advice to other members.  It was high time you received some answers yourself too, but the outcome couldn’t have been predicted and has certainly been a great success in all respects.  We have all benefited from your experience and will be all the stronger for it.

I hope you continue to feel good and that your heart remains quiet.  It is so deserved x

🎉

by Lavender - 2023-05-02 16:28:48

I've been reading your posts since long before I joined up. I'm so happy that you're so improved. Good for you for learning then prompting the tech to correct your settings!

Inspiring

by Persephone - 2023-05-02 19:09:44

Thank you for sharing your success story and sharing your knowledge. So great to hear you're feeling well.

- Long-time fan

So Happy For You

by benedeni - 2023-05-02 20:24:54

I feel the same as the other posters.  It's your turn to feel really good again!  Am so happy for you.  Personally I thank you for helping me understand my PMT.  You have a way of explaining things so we can all understand.  My very best.

I have also learnt a lot here!!

by Rch - 2023-05-02 22:11:36

Hi

I am glad you were able to dogde off your unpleasant arrhythmias, whether PSVT, PMT or RNRVAS, with a mode change from DDDR to VVIR based on some tips and ideas posted on this forum. Interestingly, it also reduced your PVC burden perhaps by some automatic reprogramming of AV delay, I'm guessing! To echo your feelings, I have also benifitted a lot from this forum. Ever since my Boston Scientific Accolade L331 Ingevity MRI implant in July 2022 for high grade Mobitz type 2 block, with any wide left arm movements sideways, such as trying to wear a jacket, raising my shoulder to change light bulb or any swimming or rowing motion of the left shoulder, my HR would race up to MSR (130) within 15 secs and when I stop, it settled down to basal rate within 30 secs! It was a S.Tach with Vs rhythm based on the narrow QRS complex on Kardia. When I first told my device tech of this, she turned the Accelerometer to passive but that didn't seem to solve the problem! Then I looked for answers in this forum by digging deep into posts as far back as 4 years ago, and long behold, found posts on this exact same topic with BS Accolades. It was posted under the keyword 'swimming and oversensing' ( July 2020). I sent private messages to those members to find out how they got around those issues, and they advised that tweaking RightRate pace on the MV sensor and SAM either solved or dampened the HR induction. So, I told my EPs and device tech that I might have a faulty MV sensor or some lead integrity issue, they dismissed outright stating that they had never seen that before in the 20 years of their practice!!! Nonetheless, they tried to turn off my MV sensor and accelerator and watched the electrograms on the Programmer Recorder Monitor as I swung my shoulders, and to their great surprise found no tachycardia!! Fortunately I have no CI, so I'm fine with the DDD mode only! So, now I can swing my left arm as wide as I can or change as many light bulbs as I want without driving my HR into 130s!😀 The impedence measurements and all the other parameters including battery life were all within range! While I am still at a loss as to why this new BS Accolade L 331 Ingevity with all its bells and whistles, failed in my case, I’m at least glad that my issue is solved and for that I'm very grateful to the members in this club.

great news

by Selwyn - 2023-05-03 14:31:12

Hi GOTRHYTHM,

So good to hear you are feeling better, I am pleased for you.  This club site offers wonderful support for people. Thanks to all that contribute, and that includes yourself.  As a network of people, we are more than just individuals. It is important to know that there is support for our health. Long may you continue to help others, and long may this site continue to help those in need.

"Your pacemaker is working fine."

by Gotrhythm - 2023-05-03 15:54:54

Thanks to New to pace, Gemita, Lavender, Persephone for the kind comments.

Benedeni: The credit for any ability to explain PVCs has to go to Pacemaker Club member, DonR. He had the most marvelous gift for translating technical concepts into something I could grasp. If I could pass on a bit of what I learned from him, I feel honored to step into his shoes.

Rch: glad a search through the archives yielded the information you needed. When I first got my first pacemaker I accepted that what I had been told (practicaly nothing) was all I needed to know. For some people, maybe most, that's true. They get a pacemaker and just get on with their lives.

For some of us though, learn we can't just go away with the assurance that "your pacemaker is working fine."  It turns out that we will need to be a lot more proactive, ask more questions, and learn more than we ever wanted to know, if we are to have a pacemaker that can do the marvelous job it's really designed to do.

Interesting that in your case, for once, the pacemaker wasn't working fine! But you learned enough here to ask the experts to look for something they never would have thought to question. Now that is a Pacemaker Club success story.

About PVCs. I don't know whether my experience is typical or not, but something about my heart easily gets into a feedback loop between PVCs and my pacemaker. For me, an increase  above what I think of as background PVCs is the first symptom I feel that tells me my heart isn't playing nice with the pacemaker anymore. Over time it gets steadily worse until the PVCs are severe enough to cause collapse.

So glad!

by Aberdeen - 2023-05-03 22:32:19

It's a bit technical for me but I am very glad you feel better now! I know how that feels like after having 3 pacemaker operations in 3 years!

Sharing Learning - A Precious Gift

by SeenBetterDays - 2023-05-04 10:25:20

Thank you GotRhythm for sharing your experience. I always really appreciate your posts as they are always measured, articulate and calm. I feel as though you bring a lot of wisdom to this forum. I am so pleased that you have found a clear answer to your problems and now dance to a steady beat. You have taught me the importance of being able to advocate for yourself and seek out knowledge rather than taking a passive approach. Thank you for being so inspirational.

You know you're wired when...

YouÂ’re a battery-operated lover.

Member Quotes

I, too, am feeling tons better since my implant.