Palpitations & unwell

Dear all, I want to share my current situation as I would appreciate your comments. I am 24 days post op a CRT-D and things were going well for a couple of weeks as I put in a previous post. Then I started suffering from high heart rates of 85-90 with palpitations which made me feel unwell. On the advice of my cardiologist by email, I went to my GP and she advised that I increase my bisoprolol to 7.5mg (and 8.75mg if the HR didn't drop). I stayed the same for a couple of days and this is where it gets interesting. 
 

At 3am today (unable to sleep due to feeling stressed and unwell) as I lay in bed I felt a small kick in the middle of my chest. I lay there wondering what had happened as I hadn't felt any activity from the device since the implant. Anyway, I noticed that my heart rate had dropped into the 50s and the palpitations had stopped. I fell asleep and today I have been well with a HR of 55 which is the setting for the CRT-D. I have been very careful all day not to do anything strenuous but this evening just after my evening meal, I had a palpitation and my HR is now 83 and I am feeling bad again.

I plan to phone the heart clinic in the morning to see if they can look at the data and see if my device needs adjusting. I will also visit the GP again.

If you have any similar experiences, I would appreciate your comments.

Thank you.

Graham 

6 Comments

Palpitations

by Gemita - 2023-10-08 18:48:59

Hello Graham, I am sorry to hear that you have been experiencing some unpleasant symptoms.

From your description of feeling unwell at 3 am today, unable to sleep, feeling stressed and then noticing a small kick in the middle of your chest, it sounds as though your device gave a little shock to the heart to restore you to a normal heart rhythm.  I am sorry you have a slightly raised heart rate tonight after a meal.   What did you eat Graham?  Was it a heavy meal?

What I would like to say is that a heart rate between 60-100 bpm is actually a normal heart rate, with anything below 60 bpm being bradycardia and anything above 100 bpm being tachycardia.  However in the presence of any heart condition, a difficult arrhythmia, or any other health problem, you might struggle with heart rates above 80 bpm which could make you feel extremely uncomfortable.

I note you have poorly tolerated Atrial Fibrillation (AF), like me, Graham.  The irregularity of rhythm during AF can be so difficult to tolerate but I hope that your CRT will soon improve your ejection fraction and therefore help with your heart condition and all your symptoms.

I feel it is wise to speak to your doctors tomorrow to see what happened in the early hours of this morning, which arrhythmia was detected and whether it was an "appropriate shock" you received  You could ask what pacing therapy was given to stop the disturbance?  I hope this is just your heart settling down to pacing which should improve, but your doctors will be able to give you an answer and let you know whether your medication or CRT-D settings are appropriate for you?

I hope you sleep better tonight Graham.  Try not to worry and remember to keep well hydrated

You have my sympathy

by piglet22 - 2023-10-09 05:44:17

As Gemita says, you are in the normal range of BPM, but if the raised rate doesn't feel right for you, then get some advice. I know that's easy to say when the NHS seems to be stressed as it is now.

I usually run at 70 BPM give or take one or two below and say five above, but if I got into the 80's, that would not be normal for me.

I'm currently suffering from the scourge of ectopics that are sending things haywire from bradycardia in the 40's and as I write, palpitations (fluttering sensation) in the 80's.

Fortunately, I'm due to see a cardiologist tomorrow which obviously helps, but I can fully understand how you might feel.

If you do get really worried, don't hesitate to get to A&E or have an urgent chat with a GP.

Update

by Graham Harry - 2023-10-09 14:54:10

Thank you so much for your comments. I went to Derriford Hospital in Plymouth today and they checked the ICD in the cardiology department. I was told the device is working well and it has not shocked me since it was installed. At least I know that. I also was able to ask questions about the device which was helpful, for example my LV lead is in place but not switched on. Apparently I don't need it at present but it's there for the future. 
I was told a heart rate in the 80s is acceptable. Also my pm is working correctly when needed at 55bpm. I have a planned checked up later this month and I have booked an appointment with my private cardiologist for the end of the month. 
I must say A&E was very efficient seeing how busy it was. I got my ECG in just over half an hour and then went to cardiology. Well done to the NHS!

so reassuring

by Gemita - 2023-10-09 15:35:12

Graham, well done to you too for seeking help.  I am so reassured to hear the news that the ICD has stayed quiet and that no shocks were received.  Perhaps the kick in the chest was an ectopic beat.  Hopefully now you will be calmer when your heart rate goes in the 80s bpm range which is quite normal.

I was surprised to hear your LV lead is in place but not switched on.  I would want to ask more about that because a CRT pacemaker is given so that the left and right heart chambers can work in synchrony and if you have a low ejection fraction, you will want all the help you can get I would imagine.  I am assuming you have a right atrial, right ventricle lead set up at the moment.

Ejection fraction

by Graham Harry - 2023-10-09 15:43:29

Yes you are correct about the set up. Btw my EF is 51%. 

That is a very good EF

by Gemita - 2023-10-09 16:15:34

Graham, perhaps they are waiting to see how well your arrhythmias settle on Amiodarone and other meds or whether you might need a further ablation, followed by CRT pacing.  A good question for your private cardiologist?   First time I have heard of a CRT being implanted without signs of heart failure or a low EF, less than 35%, although you do have other indications.  It is all looking good so far.  I hope you stay well and symptom free.

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