I need help

I had a Medtronic pacemaker implanted one week ago.
The second day of operation, I woke up after midnight I had been hearing and feeling heavy, thudding heart beats on my left front chest just under the implanted pacemaker, the rate was around 62 per minute. That made me hard to fall into sleep, when I got up the beating becomes undetectable.
The third daytime I experienced the same beatings during a nap and a walking. I thought I had to get used to it, some day it would go away. However during the night, my situation was getting worse, I couldn’t go to sleep. When I laid down that horrible heart beating started without any other symptoms. The only thing I could do was to get up, that could help me. Finally I leant on three pillows and got a few hours peace.
The fourth day early morning I went to emergency room, the doctor found my ECG and chest x-ray were fine; the pacemaker worked normal. My operation doctor came and tested my pacemaker. He said that horrible feeling happened while my pacemaker working. He said the lead moved. He reprogrammed my pacemaker and shut off the lower chamber’s lead as a temporally solution. But I have to go to operation room again for relocating the lead (and something I don’t quite understand). I have got relief so far.
The fifth day I had a Holter monitor test. Now I’m waiting my next appointment. See what it could be.
I suppose the heart beating may be the pacemaker detects the low heart rhythm then send electrical signal to my heart, it likes the doctor said. But after learning the information on website, I know the electrical signals are undetectable, and then what is the cause of my problem. Should I really need another operation or just set my pacemaker to a lower voltage?
I passed out once in August last year, and I was diagnosed bradycardia, Sinus/ atrial block with occasional 2:1 rating. My question is that Dual-chamber pacemaker is suitable for me. I read an article says:
“Dual-chamber pacing is recommended for the management of symptomatic bradycardia due to sick sinus syndrome, atrioventricular block, or a combination of sick sinus syndrome and atrioventricular block, except: in the management of sick sinus syndrome in patients in whom, after full evaluation, there is no evidence of impaired atrioventricular conduction; in this situation, single-chamber atrial pacing is appropriate.”
Sorry about the long post but I don’t know where to turn. I am sure I will get some advice. Thanks a lot.

2 Comments

I can translate the verbiage

by pacemaker writer - 2010-01-16 01:01:01

I can help with the manual verbiage--I used to write manuals for pacemakers.

Your heart has upper chambers (atria) and lower chambers (ventricles). If upper and lower "talk" to each other but the upper chambers are too slow or erratic, you have what doctors call "sinus node dysfunction" (upper chambers too slow/erratic) with "intact atrioventricular conduction." In that case, a person can get an atrial pacemaker that just paces the upper chambers and the beat will conduct down to the ventricles.

People with any kind of impaired atrioventricular conduction (like you) have upper chambers and lower chambers that do not talk to each other well (they either don't communicate at all or communicate unreliably). Then you need a dual-chamber pacemaker so that the pacemaker paces the upper and lower chambers in sync.

From what you said, a dual-chamber pacemaker is the right one for you.

As for repositioning the lead, I don't really know why that happens, but it does occasionally. It often takes a new surgery to get the lead securely in place. I'm sorry you have to go through that, but it is not unheard of. Once it is properly repositioned, that should fix the problem.

Lead moved

by ElectricFrank - 2010-01-16 02:01:47

This sort of thing is common when the pacemaker can't handle synchronizing the chambers of your heart properly. There is only one effective solution: have the lead repositioned properly so it can be used. The only reason the docs try to program around it is to avoid having to fix it properly. Often the repositioning is a "warranty job" as far as insurance companies are concerned.

frank

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Member Quotes

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.