Missed beats

Hi Guys , could someone pls reassure me 😉 I have had my latest PM for 18 months , for about 6 months IV been experiencing missed beats & a horrid thud feeling now & again , had pacemakers 10 years & never suffered from until now , went for my PM check a few weeks ago & told them , they said only 1 episode could be found & were not concerned, but I'm now having them loads more often , is this normal please? They are really scary . UK member & I'm 100% paced ♥️ Thankyou 


11 Comments

Hi there

by Lavender - 2023-05-13 16:18:06

I'm 100% paced too. At times I go through more frequent PVCs. It's a strong beat and a skipped feeling. Premature ventricular contractions (PVCs) are extra heartbeats that begin in one of the heart's two lower pumping chambers (ventricles). These extra beats disrupt the regular heart rhythm, sometimes causing a sensation of a fluttering or a skipped beat in the chest.
 

They're not harmful. If you've been checked out and no one is concerned-just try and rest, stay well hydrated 😁-drink more water than your usual. 

Skipped beats

by AgentX86 - 2023-05-13 16:22:47

Welcome to the PVC club.  Sucks, doesn't it?

Yes, this is perfectly normal, not dangerous, and pacemakers can't/won't record them because they're so common, even in perfectly healthy people that there isn't space to record every one.  I get them every day, just after exercising and sitting watching TV in the evenings.

A PVC (premature Ventricular Contraction) is, as the name implies, is just a beat that happens before it's supposed to.  This causes the pacemaker to reset its timer and "misses" a beat.  It's not really missed, rather two beats are isued close to each other and one doesn't fill completely so it feels week.

If you feel your pulse in the neck, you'll feel this extra pulse.

Thanks Guys

by katz - 2023-05-13 16:52:08

Lavender & Agent X , thankyou so much for your quick replies & reassurance, got myself all worked up as been having them most of the day today & just not used to it , I wonder why it's suddenly started this past 6 months 🤔 I'm going to try & get some rest now Thankyou ♥️ 

What causes pvc?

by Lavender - 2023-05-13 22:04:50

Premature ventricular contractions may be caused by:

Certain medications, including decongestants and antihistamines.

Alcohol or drug misuse.

Stimulants such as caffeine or tobacco.

Increased levels of adrenaline in the body due to exercise or anxiety.

...and sometimes they just happen.  No cause for concern. 
 

 

 

Missed beats

by piglet22 - 2023-05-14 07:11:05

I'm not so sure that it's something to put up with. It needs investigating and an explanation given.

I'm having them after 18 years of exemplary pacemaker performance and I'm having a hell of a job to get to the bottom of it.

Like Agent, I get them after exercise or when relaxing, which is exactly when you don't want them.

I get prolonged episodes that can go right through the night, and that irregular heartbeat plus a palpable pulse of half what the PM is set to (70 BPM), is disconcerting. Even last night, I was getting 40 to 50 BPM measured at my wrist and again, the blood pressure monitor wasn't having it, with errors coming up. It tries to take three readings and averages those. Every one of the readings was reported as arrhythmic.

If it's causing symptoms, and mine does, then it is a cause for concern. Rising out of a chair and feeling the blood drain from your head is not pleasant. My forehead tightens, I feel dizzy and have to stop moving until the sensation passes.

This has been going on since January 2023 and the assessment given to the GP from the cardiac consultant was ectopy. I hope he does better when I get to speak to him at the end of June 2023.

I still contend that where a PM is fitted for bradycardia caused by heart block, the PM should be correcting it.

ditto Piglet's sentiments

by Gemita - 2023-05-14 08:30:48

Katz, If ectopics are prolonged or frequent, they may need treating or investigating before they trigger other arrhythmias which has been my experience.  I also suffer from both atrial and ventricular ectopics and they can be debilitating.  I have premature beats originating from multiple sites and they are most definitely triggers for other arrhythmias. I also experience symptoms like Piglet.  

Without long term monitoring there is no way of knowing whether the symptoms are always caused by premature beats, or something else like another arrhythmia, more serious, which is why any symptomatic arrhythmia should never be ignored.

Look also for anaemia, thyroid + electrolytes + look at all meds you may be taking?  Setting the base rate higher can help some of us to outpace simple, occasional ectopics.  There are various other settings that can be used to help as well, so ask your EP about exploring this possibility with a technician.  The golden rule for me is if I am so symptomatic that I cannot carry out simple tasks or my symptoms cause concern, then however benign the arrhythmia might be, it needs monitoring/treating.  I hope for the very best for you

Thankyou

by katz - 2023-05-14 08:36:57

Thanks for all replys ♥️ I am going to phone the pacemaker dept in the morning when they are open and ask to be seen ♥️

fixed mine

by dwelch - 2023-05-14 21:05:33

In my case my PVCs only happened shortly into a new device, and a new to me brand, I think I have covered all the major brands now over the years.   Turns out the quality of and placement of my A lead (despite being decades old) was causing feedback and the pacer setting was not such to block it so was getting a double beat but the ventrical was not ready so PVC.  

Holter, doc said she literally spent the weekend going through every heart beat on the holter.  Called me down monday, tech from the pacer company, made the adjustment.   Problem solved. 

Not something that can be fixed for everyone, hopefully yours can.  This is my first biventrical, so I sometimes get the "belly bumps".  Pacer fires muscles in my belly.  I find it fun not a problem since it is so rare, if it were all the time that would be a huge problem.  

Some things can be tuned, some cant.  Keep trying to tune them though.

interesting post dwelch

by Gemita - 2023-05-15 02:40:43

Dwelch, your post certainly proves that there is usually a reason for an arrhythmia if the patient and doctor can find the culprit and fix the problem.  Your comments as follows were inspiring:-

Holter, doc said she literally spent the weekend going through every heart beat on the holter.  Called me down Monday, tech from the pacer company made the adjustment.   Problem solved.  Some things can be tuned, some cant.  Keep trying to tune them though.

Oh, if all our doctors could spend the weekend going through every heart beat to identify the potential source of our distress, it would be wonderful.  Thank you so much for reporting your caring doctor's findings.  

Many of us suffer from arrhythmias like PVCs, especially following placement of a new pacemaker and once healing has taken place, arrhythmias may settle.  If they do not, an appropriate pacemaker adjustment may just help.  In your case though the PVCs appear to be caused by the position of the atrial lead and perhaps the fact that it is an old lead, so I hope the adjustment they have made to your current device will be a long lasting fix and will not drain the battery.  Great news though 

dwelch

by piglet22 - 2023-05-15 06:38:21

Your experience and outcome is how things ought to be, someone who has the time and attitude to get to the nitty gritty devil in the detail possible cause of your problem.

What your experience does highlight is the difference between US care and UK care.

I've banged on before about this, but it does matter.

The UK NHS service is going through the worst crisis since its formation in 1948. Everything is stretched to the limit. Patients are suffering as a result.

I don't think you would tolerate it in the US and I'm surprised we do here. But it's the British style, put up with it, it could be worse, etc. etc.

The chances of getting that level of care in my health trust (the UK is divided up into regional health trusts), is about nil.

Interesting to hear about "belly bumps”. I wonder if there is some leakage route for pacing pulses to go walkabouts. When my PM went into end of life (failed), it started twitching my pectoral and arm muscles. Clearly, the pacing pulses were being misdirected or something radical like the pacing polarity had reversed, like putting a battery in the wrong way round.

It always fascinates me, strange I know, but sometimes you can scratch yourself somewhere like under your arm, and a very specific part of you, usually my knee, gets a sharp nerve reaction. It's rep[reducible. A sort of acupuncture?

Could belly bumps be similar?

PVCs in Plain English

by Gotrhythm - 2023-05-16 14:15:12

For a thorough, accurate, and easy to understand explanation of PVCs, go to a youtube video: PVCs in n plain English Dr Joshua Cooper.

He not only explains them in a simple, straightforward way, he explains why you feel the sensations you get in your neck sometimes.

It's completely normal to think, "OMG! Does this feeling mean my heart is about to stop?" and to find that thought very scary. Being told it's normal doesn't really help that much.

But knowing, not just that there is a name for it, but really understanding what's happening will go a long way toward calming your fears.

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