Medication for PVCs - Diltiazem


Since my dual chamber PM was put in at the beginning of February for second degree heart block just at night, I have been having thousands of ectopic beats when I am resting - PVCs. My settings have been changed several times and now I am on a 'guardian angel' setting - back up VVI at 35 bpm. So I am only sensed and paced in the ventricle - nothing in the atrium. This has improved the situation but not got rid of it. When I asked if these extra beats could be dangerous, he said "well they probably won't kill you"! Very reassuring!

My EP thinks these ectopic beats can be suppressed with a calcium channel antagonist but this runs the risk of prolonging the AV delay and increasing my pacemaker requirements.

I have been taking amlodipine for many years for hypertension and he has recommended I convert from amolodipine to DILTIAZEM 120mg and he hopes this will suppress the ectopic beats without increasing my pacing requirements. I have heard bad reports about some of these drugs and I wondered if anyone is taking diltiazem? He has also mentioned ablations and I am feeling upset that my PM seems to have caused more problems than it has cured - these extra beats, tiredness, lethargy and some breathlessness. Some of these symptoms have got less now that the PM is hardly on!

Any help on Diltiazem would be appreciated.


Sue from London



by SMITTY - 2008-06-20 04:06:55

Hello Sue from London,

I've been taking diltiazem since 1983, although not continuously. I have had a few cardiologists that insist diltiazem is not the best medication for my irregular heart rhythm and changes me to a beta blocker. This has happened five or six times during the 25 year period mentioned but beta blockers are the devil's concoction so far as I'm concerned. When taking the beta blockers and I get to feeling life is no longer worth living, I say to hell with it and go back to my diltiazem even if it means I will have to get a new doctor that will agree to write diltiazem prescriptions for me. It is definitely the best medication for my hypertension and whatever else it does when I am taking the right amount.

What I mean by that last statement is that I have had prescribed as much as 360 mg/day and a little as 30 mg/day. I currently take 60 mg/day and have for several years. The reason I mention this is FOR ME too much diltiazem worsens my irregular rhythm and too little simple will not do the job. So, I would suggest that you be aware of any side effects that you have or in the event the medicine does not help as much as you think it should, talk to your doctor about changing the dosage. For me it actually took about 18 moths to finally figure out that 60 mg/day was what I needed.

To repeat, I have benefited more from diltiazem than any single medication I have ever taken. I have tried at least two other calcium channel blockers, Verapamil and Procardia without equal results. I hope diltiazem serves you as well as it has me.

Smitty from Texas


by peter - 2008-06-21 04:06:26

I am in the UK thankfully not near your hospital. Some people can be tactless. Fancy saying it probably wont kill you? Calcium channel drugs need very careful monitoring as you can react quickly to them and im my case sent be in a almost fatal downward spiral. They ought to be able to stop the PVCs. I often wonder in these cases whether the patient really has been given the right treatment and the right pacemaker. It might be worth talking to the rep from the manufacturers as they are often far more skilled and knowledgeable about how to set your pacemaker for best results. Cheers Peter

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