Bigemieny

by craig1075
2009-02-26 04:02:45
Complications
2273 views
9 comments

Hi,

I received a biventricular pacemaker 12/01/08. Shortly thereafter I had my medication regimen changed in an effort to suppress my episodes of afib and thus avoid having an A/V ablation.

The medications I was put on to achieve this goal are bystolic 5 mg at hours of sleep, cartia XT 240 mg daily, digoxin 0.250 mg daily, and lotensin 20 mg daily for blood pressure. In addition I was and still am taking vytorin 10/20 at hours of sleep, coumadin 5 mg at hours of sleep, advair twice daily, singulair 10 mg at hours of sleep, and combivent inhaler as needed for shortness of breath.

Then above meds did in fact reduce both the frequency and duration of my episodes of afib. However, about one week ago I began experiencing high frequency PVCs causing fatigue, low energy, shortness of breath when engaged in normal physical activity such as climbing a flight of stairs, and uncomftable chest palpations.

On Tuesday the 24th of February my symptoms became severe enough for me to seek medical consultation at the E.D. at the hospital I work at (I'm an RN and work as a hospital supervisor). My EKG showed that I was in bigemieny (every other heat beat is a PVC). I was admitted into the hospital and met with my EP doc and cardiolgist.

I had my pacemaker interrogated in the E.D., and the following morning had my settings changed as per my EPs order. Also, I was put on Rythmol SR 225 mg twice a day, and my bystolic was increased from 5 mg to 10 mg once a day. A 2D echo cardiogram was also done to evaluate my EF (ejection fraction). Prior to this echo my EF was estimated to be 44% (I have cardiomyopathy, which is why I have a biventricular pacemake). The tech who did my echo said my EF has decreased, though she would not say by how much. I will have to wait until I see my doc to get that answer.

Right now I'm pacing at 100%, and between my new pacer settings and meds I'm in normal sinus rhythm. How long this will last remains to be seen.

I have a question: Has anyone reading this post had a similar experience, and if so, is your pacemaker and meds still working to keep you free of high frequency PVCs?

Thanks for taking the time to read this post.

Steve

P.S. I hope your ablation was a success Debie.

9 Comments

Hoping you continue to feel better

by dairyprincess - 2009-02-27 01:02:47

Hi Steve,

I know you're not having much fun right now. I hope this works or at least your doctors find the right solution for you that gives you a normal, healthy lifestyle once again very soon.

My ablation has helped, although I'm still having some afib episodes today. My doctor did say I could have some episodes until the ablation heals...I'm hoping the healing goes fast!

Take care,

Debbie

Hoping you continue to feel better

by dairyprincess - 2009-02-27 01:02:47

Hoping you continue to feel better

by dairyprincess - 2009-02-27 01:02:48

Hoping you continue to feel better

by dairyprincess - 2009-02-27 01:02:48

Hoping you continue to feel better

by dairyprincess - 2009-02-27 01:02:54

Hoping you continue to feel better

by dairyprincess - 2009-02-27 01:02:54

AVOIDING AV NODE ABLATION

by pete - 2009-02-27 02:02:15

The majority of EP Doctors on planet earth would consider the job only half done if you have been given an Biventricular pacemaker but not had this followed up with an AV node ablation 6 to 8 weeks later (to allow for the leads to fixate). My opinion also is that it is not the right thing to do, not to have an AV node ablation. I am speaking from my own personal experience and from the experience of others. I even have a neighbour who has an AV node ablation. My prediction is that you will end up with one, and should be looking forward to it. The decision to have it done was in the end left to me. Its not as complex as other ablation proceedures. You will also benefit from not having to take so many drugs. I was getting vtach during the period between pacemaker implantation and AV node ablation. This was not picked up until 18 months later when the pacing technicians spotted it on the printout from the memory in the pacemaker. Good Luck Peter

Thank you

by craig1075 - 2009-02-27 10:02:33

Thanks to all who have responded to my post. I appreciate the insight and sharing.

Steve

Not fun!

by bobad - 2009-02-27 12:02:18

I know what you mean about the bigeminy. It's not fun.

The first and only time I went into bigeminy made me wind up the hospital for a pacemaker.

Up until then, I had mild PVC's, maybe 1000 per day and not too bad. Then I started helping a friend with a heavy-duty building project, and We worked in the hot sun a lot and I got myself dehydrated. I guess my Pot and K went low, and I went into bigeminy and bradycardia (diagnosed as SND) bad enough to warrant the pacemaker.

I don't tolerate bigeminy well. It made me gasp and hack, and I wanted to just reach in and pull my heart out of my chest. I absolutely hate it.

I hope it's not as bad for you as it was for me. Luckily, I haven't had any bigeminy episodes in about 8 months. During my episodes, keeping my heart rate low helped for a couple of weeks until I got my electrolytes in balance, after which a higher heart rate no longer triggers bigeminy.

Maybe keeping your HR lower could help you, maybe not. It may be worth a try. There was a study at Johns Hopkins (I think it was Hopkins) that showed fish oil reduces arrhythmias tremendously. It was a small study, but the results were overwhelming. Maybe the fish oil (2 grams daily) is helping me, and could help you.

Best of luck Craig, and keep us posted!

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It may be the first time we've felt a normal heart rhythm in a long time, so of course it seems too fast and too strong.