New pacemaker and svt

I received a surprise dual lead pacemaker on February 20, 2023 for complete heart block.  I had no idea I had a problem until one day my fit bit told me my heart rate was way too low.  It's been scary trying to adjust. The testing done in the hospital showed my heart is otherwise pretty normal and healthy.  I have had some sensations of a squeezing feeling in my chest that come and go, and apparently I am also having SVT. I came home on lopressor 25 mg a day, but I was told to discontinue it through my chart messages with the physician assistant because I was having low blood pressure. I ended up having a frightening tachycardia episode and went to the ER after finding out my new transmission box wasn't working. I have an appointment to see my Dr in three weeks in response to this. I haven't seen him since the surgery. I am so worried and upset about finding out there is an additional issue. I was told to resume the medication and that I would be ok. But I don't know or understand much about either of these issues. Has anyone else had a similar condition?


8 Comments

SVT

by AgentX86 - 2023-05-18 00:10:48

Hi KMTD,

Welcome to the group.  Wish you weren't here but here we are.

SVTs aren't uncommon and it's possible that your heart block was covering it up all along. I had sorta the opposite thing.  My atrial tachycardia was so symptomatic (uncomfortable) that they installed a heart block. ๐Ÿ˜†

The fact is that a pacemaker can't do anything for any tachycardia.  A pacemaker can only make the heart go faster.  As we say, it's an accelerator.  It is not a brake.

"SVT" is a catch-all for an arrhythmia originating in the atria (Supra Ventricular Tachycardia, or above the ventricles tachycardia). Fortunately, these events aren't often dangerous in themselves.  There are serious side-effects but they can  be (mostly) handled.  You did the right thing, though, going to the ER.  Anytime something scary happens, let them sort it out.

Lopressor is the brand name for metoprolol, a beta blocker.  It's job is to slow conduction times in nerves.  This slows the heart and relaxes blood vessels (It also reduces the shakes so it's used by snipers but that's a different issue). Because it relaxes blood vessels, it does reduce blood pressure. Your doctors are telling you that it's more important to slow the heart down than the lowered blood pressure.  Your cardiologist will likely tune this.

Just as a point of reference, I would bet that 80% of us are on a beta blocker and 80% of those are on metoprolol (Lopressor).  You're not alone. I've been on it since January '07.

You've described the additional problem, SVT.  Why do you have SVTs?  You'll likely never know.  It can be as simple as diet and/or an electrolyte (sodium/potassium/magnesium) deficiency, in which the solution is simple. There aren't a lot of studies into what causes it but it seems that endurance sports are a biggie. The enlarged heart from the abnormal training causes fibrosis that will cause arrhythmias.  

SVTs may be a PITA for you but there are treatments. The first thing they'll do is protect against the side-effects (tachycardia and blood clots), then deal with the symptoms.  If you are asymptomatic or can deal with the symptoms, heart rate control and anticoagulation are all that may be needed.

While waiting for your appointment it might help to record the time, duration, and how you were feeling during these events. They may be able to track the events down in your pacemaker's records for more information. The above information will give them a clue where to look.

In the mean time, don't borrow trouble.  You'll be fine.  You're certainly not alone here.  Most of us have been in your shoes.

Fitbit

by zawodniak2 - 2023-05-18 10:11:44

My FITBIT is my friend as it shows my heart rate never below 60 and displays higher rates with exercise๐Ÿ‘๐Ÿ‘

           Rodger

 

Record keeping

by piglet22 - 2023-05-18 10:16:41

Knowledgeable comments from both AgentX86 and Angry Sparrow.

I'm surprised at the extent of users insight into the complex world of cardiology. I have one relative now with a PM, but other than something is fitted to control longish, 20-second, total blackouts, I'm not sure if they know what the condition is.

This highlights the difference between the US and UK health systems. I get the impression that in US, you are far more open about medical matters and your system is more transparent.

From personal experience, some of the things you can get done, are unheard of here in the UK.

It might be just my cardiac centre, but there is a huge gulf between the clinicians and support staff, and the patient. The consultants rule the roost, top dogs. Almost medical Royals.

As I've said on here a few times, I've had worrying ectopic periods, but from starting in January 2023, I've had one visit to the physiology lab, no explanation from the technicians, just "PM working fine" and now waiting until end of June for a 15-minute phone call from someone.

Even my GP can't do anything about it and has to write to consultants like a Dickens character asking for a wage rise.

I'm pleased to hear that you both support record taking. Of course, it's the obvious thing to do, but can be looked down on here by medics as somehow patients interfering.

The best thing you can do is keep your own records, get equipment like BP monitors and oximeters, preferably ones you can download.

I used blood glucose results going back 12 years to good effect to show that although I was hyperglycemic, it wasn't type 2 diabetes. It was diagnosed as non-diabetic hyperglycemia, thus saving me from yet more medication.

Fitbit

by piglet22 - 2023-05-18 10:26:38

I wonder if there is ant clinical evidence that devices like Fitbits can cope with complications like ectopics or premature contractions.

I can say with some certainty that my oximeter (ChoiceMed, as used by GP), does not fare well with irregular rhythms. It does show a mini ECG that show the pauses. but that doesn;t translate into the palpable heart rate.

The BP monitor is much better for arrhythmia.It either gives the right result or gives up when it can;t cope.Either way, it's telling you something isn't right.

Welcome aboard ๐ŸŒบ๐ŸŒบ

by Lavender - 2023-05-18 11:41:56

So sorry to hear of your surprise pacemaker. Lots of us get them as an unpleasant surprise. Mine was two years ago-Boston Sci CRT-P. 
I am not on any meds. I do have complete heart block. My pressure tends to run low-normal. 

In time you will adjust both physically and mentally. Your life can be normal. You will learn to trust your body again. Your medical team will help. If they were concerned, they would have put you in the hospital. They know you're ok and can hold up three weeks while you see how the meds do. 
 

It is going to be ok. Breathe. Be good to yourself as you recover from this frightening episode.  ๐Ÿ’—

Thank you

by Kmtd - 2023-05-18 12:21:16

Thank you so much for the information and support. I started to gain a little trust in my body, and then got hit with the tachycardia. Right back to being afraid to move. I am grateful to have an opportunity to discuss how I'm doing with the doctor eventually in a three weeks.  And even though I was given a faulty monitor and I need to wait another week for its replacement, I'll be grateful to eventually have this tool. Medical support has been pretty minimal and there have been few opportunities for me to have a professional explain my condition to me or let me know what to expect. That's why I'm particularly grateful for everyone who has taken the time to help fill in the gap. It's a tremendous help. Thank you โค

Monitors

by Lavender - 2023-05-18 15:11:33

Not everyone has a monitor. I have one but it acts up from time to time and I have to call to be talked through resetting it.  I was told if I am going away, not to even take it along unless I am gone more than a month. 

Strange but true

by Gotrhythm - 2023-05-19 15:42:24

It really is possible to have a heart that is both fundamentally healthy and yet subject to arrythmias. Apparently, you are one of us  who have had to wrap our heads around that apparent contradiction. Welcome to the club. [wry smile]

Understanding starts with knowing the heart has two systems. What we jokingly call the plumbing--your plumbing appears to be fine--that's what they mean by healthy. The other system is the heart's electrical system. Yours is not so dependable.

Luckily for you, there's a workaround for some faulty electrical circuits. It's called a pacemaker, and you have one. So the danger that you could have heart block and faint or go into cardiac arrest, has been taken away. Pacemakers are incredibly dependable and there are lots of failsafes. It really is safe to trust your pacemaker to deal with the heart block.

That said, as you are finding out, the pacemaker doesn't replace your heart's electrical system. It's just a workaround for certain faulty areas. It's possible to have more than one arrythmia. In your case, that's SVT.

There's lots to learn about arrythmias, but here's what you need to know about SVT right now. It's not dangerous unless it goes really fast for hours. Most of the time it is self-limiting. The pacemaker can't stop it, but the very instant it stops on it's own, the pacemaker will return you heart to a normal rythm. SVT is not a warning sign that your heart is in danger of stopping.

Your doctor knows this. That's probably the reason he seems unconcerned. If you did't have a  pacemaker, he might be worried, but you do, so he's not.

I have SVT. A number of us at Pacemaker Club do. It is very unpleasant, uncomfortable. Upsetting. But, unpleasant as it is, it is not something you have to live in fear of.

Use the search icon--it's the circle with a tail in the top right corner, next to Logout. Look for posts about SVT. There are lots of them. Knowledge is power. And there is huge comfort in knowing who else is dealing with the same problem.

You're going to get through this. You're going to look back in a few months at all you have learned about arrythmias (that you never before wanted to know) with a new confidence in your self and a desire to live life more fully than ever before. And the knowledge that you can, now that you have a pacemaker

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