Increase in atrial pacing

Hello, I had a 6 month pacemaker check back on October 5th. My atrial pacing had gone from 12% to 25% in that 6 month. However my bigger concern is the check I had today showed an increase from 25% to 48% in just under 2 months. I have not had any change in settings. I do have increased shortness of breath and tiredness. I plan on talking with my cardiologist soon but wanted to ask if anyone has experienced anything like this and what might have caused it. I feel like something isn't right and that I am only getting worse. Anyways, thank you all for reading. Have a great day. 
Laura

2 Comments

Increase in Atrial Pacing

by Gemita - 2023-12-01 04:44:13

Laura, yes I have experienced symptoms similar to those you describe and we all go through the fear of what increased pacing percentages might mean for us but really it is more about “how we feel” that matters.  If we need to be paced more to feel well, then so be it.  No harm will come to us.  I am paced 100% in the top right chamber (right atrium) with minimal ventricular pacing.  Some members are paced 100% in both upper and lower chambers, and lead active, happy lives.

So I am not worried about your pacing percentages, but I am concerned to hear that you have increased shortness of breath, fatigue and do not feel well.  Shortness of breath can have many causes, but it needs to be investigated if it is a new symptom and it goes without saying that you should see a doctor immediately if you are concerned about your symptoms.  Perhaps a visit to your General Doctor first for some checks?

From your Bio, I see that you have a number of different arrhythmias and these could well be causing your symptoms.  I can get short of breath from my rhythm disturbances and with the irregularity of rhythm from an intermittent arrhythmia like AFib, I can completely understand why you might be feeling breathless and tired.

I would speak to your cardiologist or a doctor as soon as possible about your symptoms who will no doubt check for signs of worsening arrhythmias.  When my rhythm disturbances increase, these and my medication can affect my pacing percentages, when my pacemaker settings or medication may need some adjustments.  

Hopefully your doctor will be able to control your symptoms and help you to feel better quickly.  Arrhythmias need to be controlled when they get out of hand but they can be tamed with the right treatments.  

What's your pacing mode?

by crustyg - 2023-12-01 08:20:15

It seems likely that your sick-sinus problem is getting worse.  If you don't already have Rate Response enabled, it's probably time for it - or have it adjusted to give you a higher HR when active.

Many of us have progressive conditions, so it's to be expected that our PMs may need to be adjusted as time goes by.  For example, at implantation my resting HR was 42BPM.  10months later it was 28BPM (we turned my PM off during an MRI scan).  So my A-pacing went from something like 50% to 99%.

Gemita provides excellent advice as usual: time to call on your EP-team.

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