I'm new to this forum and am amazed at the knowledge out there. I had my pacemaker (Medtronic ADDRL1) implanted in 2007 for third degree heart block. Been feeling better BUT I am plagued by some Atrial fibs and Dr. now wants to treat with Beta blockers. I'm already on Exforge and don't want to add anymore drugs to my routine.

I never had Atrial fibs before and wonder if this is common after a pacemaker implant and can it be controlled by adjusting the rate. I'm pacing at 60 but was never told upper limits.

Thanks for any information....!

 

 

I had my Pacemaker put in last year . I had Atrial Fibrillation before my pacer was put in because my heart would go really fast and then because of the drug they put on to keep me from going into Atrial Fib it caused my heart to be too low. It depends on what your case of Atrial Fib is as to how they control it with the pacer. They can also have a defibrillator kick in to give your heart a little shock to put in back to where in should be. My settings are set so that if they heart starts to go below 80 bpm the pacer will pace my heart but if it goes above 120 bpm it does nothing. I have a defibrillator on my pacer but I'm not using it right now since I'm not going to Atrial Fib all time that I have the Pacemaker.
Have they talked at all about putting on a Anti-Arrythmic drug to control the A-fib.
I'm not sure how much they can control the A-Fib with the pacer without using a medication to keep you out of Atrial Fib.
I hope this helps.

 

Hello Magster,

Welcome to the pM Club.

I can relate to what you are saying very easily. I have a Medtronic PM (implanted in 2000) and from time to time I have episodes of afib. I did not have afib before I got my PM, but I'll not say it did or did not cause mine. The following a quote from a cardiologist "Pacemakers don't help atrial fib, but have no bad effect on afib or the heart."

Now I will add a little about the roll of a PM and afib, the good doctor did not mention. I understand some of the newer model PM can help prevent or maybe I should say stop an afib attack. However, in my case my PM is supposed to help me with afib in a different way. It is my understanding that when a "bad" afib attack ends our heart can go from being what a mounts to a runaway train to beating very slow. Possibly too slow to sustain life, but even if we are nor victims of that catastrophe we are likely to pass out due to an extremely slow heart rate. This is where our PM steps in and maintains a heart rate of at least the low setting on our PM. Another problem that can follow afib when the person does not have a PM is the extremely low heart rate can allow blood to "Pool" in the atrium and we then run the risk of blood clots forming, which have been known to be fatal. Sometimes blood thinners such as coumadin are prescribed for afib victims.

Also, I see you have been taking a calcium channel blocker, Exforge. I too was on a calcium channel blocker, diltiazem, and my cardiologist took me off of it when he prescribed a beta blocker. His reason was that the CCB could contribute to an irregular heart beat, like afib. I don't like beta blockers because they make me feel as if I have the flu, but I read all the literature I could find on CCB and irregular heart beats are one of the seldom mentioned side effects. I found that hard to believe since I had been taking diltiazem for 23 years when I was told to stop it. I mention the flu like feeling from a beta blocker because it is a sneaky side effect. It comes on slowly and in my case, I just knew I felt bad all the time without any specific symptoms, I found it hard to get treatment for my problem because all I could tell primary care physician was "I just feel bad all over." Routine blood tests and other tests did not show anything wrong.

Now I want to point out that not everyone has the feeling bad side effect from beta blockers. I hope you are one of those people.

As for your PM low setting of 60 that is a very common low set point. I have had a 60 to 100 setting and right now I have a 70 to 110 setting. I have not idea why the change was made. Sometime I think they change the setting to be able to show they did something.

I wish you the best,

Smitty

 

Hi magster....I, also, have a medtronic pm done in Aug 2007. It was first implanted and then the av node ablation which resulted in a 3rd degree heart block. My afib had been, is, and will be constant, but because of my pm I feel it very little. Because my pacemaker check showed episodes of ventricle tachyardia, my cardiologist ran several tests...stress, echo of heart, etc to be sure there wasn't a structural problem with the heart. My EP and cardiologist both agreed I should be taken off Coumadin
(because I have a history of falling, etc.) and if tests were to turn out o.k. I would be put on a beta blocker. I really did not want to go on one, but I was put on Coreg Cr which is suppose to help both blood pressure and heart
rythmn . It is a combination of a beta and alpha med and so far has helped the blood pressure and I will find out at my next check about the rest. I feel much better on it than any of the other meds I have taken. I was also taken off diltiazem... so hopefully, Coreg Cr will be my "magic" pill! Good luck with your new med..aldeer

 

Few years ago, my cardio told me that my PM recorded I got some A-Fib. I also felt some vibrations on my chest. He started me with some combo meds. From other forum, he told me that his EP adjusted his PM then his A-Fib has gone and he is no longer needed any medication. I told this to my EP. He adjusted mine one. Now my PM didn't record any A-Fib and I'm off the flecainide and verapamil.

 

Thanks everyone for your comments and trying to help. It's very possible that the calcium channel blocker is causing irregular heartbeat or my pacer is, but Dr insists not. But in all my years of dealing with Doctors I realize that most of them are not too smart on side effects of drugs. They listen to the drug detailer which is not a good thing since obviously they'll push their drug and convince Dr that side effects are minor. My group I go to has a habit of pushing the latest drug and use new drugs instead of the old tried and true. When nurse opened the draw where samples are kept, it was filled with the latest new BP medication Tekturna which is new to market and is still in trial by FDA..yikes..would not take that.

I too went through more testing to figure out what is causing AF's and even wore Cardionet monitor for l0 days (oh that was a joy, ha,ha,) Then just had an echo stress test chemically induced and with the contrast material Definity which I read later can cause atrial fibs during testing and is very dangerous. Oh another joy. Have a follow up appointment with Dr end of month for all test results and will have a conversation with him on my feeling of less drugs is better and can pacemaker be adjusted to help lower AF's. According to Medtronic's site my particular model is supposed to be paced so there are fewer AF's.

Thanks again all.....Magster

 

Thanks again to all for your very HELPFUL comments and for listening to my venting in my last e-mail. I'm sorry I vented although I still feel the same about drugs. However, I wasn't having a good day, could you tell? ha.ha.. I think all will agree that having a pacemaker takes a great amount of adjustment and we all have good and bad days but lately the good days are more so than the bad ones.

Smitty your long e-mail was most helpful and so full of some good information. Thank you.

I changed Dr's for my followup visit and that made a huge difference. He has a wonderful bedside manner and listened to my feelings on drugs, etc. He made the comment that he would love all his patients not to have to take drugs but unfortunately that's not real life so we'll go easy on drugs. All my tests were within normal limits and we were both pleased. He said that my atrial fibs have settled down in the last 6 months since the pacer insert which is not uncommon in pacer patients but he still wants me on a very low dose of beta blocker. He said don't think as you take the pill that you're going to get side effects because every symptom you'll say ah ha it's the pill. How true it can be that our minds rule our physical feelings. So I will work with this Dr and hopefully continually to feel better.

I would be interested to hear from other pacer wearers if you had a big adjustment period wearing a pacer.

Thanks all - Magster