The twitch when pacing, what is it?

twitching

by Tracey_E - 2023-07-20 08:16:34

The signal that the pacer puts out is very very small, mimicking what the heart should be doing on its own. In other words, nothing we should feel. I would go talk to your consultant. It's possible the lead isn't in a good position and they may be able to adjust the settings so you don't feel it. It's also possible it's not the pacer at all but something like pvc's, which are annoying but generally harmless. 

"Twitch in the chest area",

by Joshua417 - 2023-07-20 10:00:15

As Tracey_E shared, spot on.  Given how you described "Twitch in the chest area", a less common possibility is that the pacemaker is recruiting/stimulating the chest wall, near where your lead tip is.  As the pacemaker provides a stimulus to cause the heart to beat, it also captures the muscle near it.  The assessment and correction is still exactly what Tracey_E said- Talk with your device doc.  Could be something as easy as a quick programming correction. 

The plot thickens

by John_Locke - 2023-07-20 14:19:48

So here is what I know.

1. This is for sure a new sensation. It's not painful but it is weird and freaked me out quite a bit the first time I felt it after the pacemaker had been inserted.

2. The sensation coincides with heartbeats. It also doesn't feel like PVCs which I also get. It's also following the pattern of my AV block as captured on 7 day ECG, more likely to occur in the evening at rest.

3. When my pacemaker was tested after insertion and was running my heart at a higher rate, I did _not_ feel this sensation. However, a few days later I had it checked out again at a different hospital when travelling and just as they disconnected the reader, I felt it clearly like three heart beats.

4. I've been told it's common to have the pacemaker set at a high voltage in the bedding in period to ensure capture while things settle.

5. I've also been told that the pacemaker runs a self check where it finds the lowest voltage that will give a response by starting with a high one and stepping down. I was told this was "once a day" though not sure if that means exactly 24h. I imagine it's possible that the clock starts again once the disconnect the programmer for this?

My hypothesis then based on all of your answers is that the pacemaker is set to a voltage higher than is necessary and that this is indeed recruiting some muscle. I wish I could capture this on video so that I could see what if anything actually moves on the outside but these don't happen often for me.

Does this make sense to you all?

Twitching

by piglet22 - 2023-07-21 05:23:56

I experienced this 7 years ago in 2016.

It started in my pectoral muscle above the pacemaker then extended down my left arm until it was moving in time with the heartbeat.

To cut a long story short, the battery had gone past its change by date and the pacemaker had "changed mode".

I was in A&E by then and the on-call physiologist temporarily raised my threshold to eliminate the twitching.

The pacemaker was replaced a few hours later.

A senior paramedic, before diagnosis, dismissed the twitching as being not pacemaker associated, in his words, not enough voltage to make muscle twitch. If a pacemaker isn't twitching heart muscle, then what is it doing?

Mr Galvani knew this centuries ago.

I'm still curious what the exact mechanism is that causes the electrical signal from the pacemaker to suddenly turn its attention to the neighbouring muscles.

settings

by Tracey_E - 2023-07-21 10:06:11

They often start it turned up then turn it down once we heal, 4-6 weeks later. Talk to them, the fix is likely in the settings.