Sinus Tachycardia after Pacemaker

I'm a 31 year old woman who had a pacemaker fitted on 26th March this year (just over a week ago).

I had the pacemaker fitted on the advice of my cardiologist for intermittent second degree block, which was causing me some dizziness and palpitations, and tiredness because of it occuring especially during the night. I had a choice because my case was 'borderline', but my cardiologist thought I would be safer with the device.

The procedure seemed to go really well, apart from a slight difficulty placing the leads, and I was elated. One of the reasons for choosing to have the pacemaker was because my husband and I were hoping to start a family, and I felt that all my problems were over.

About 2 days after the procedure, however, I felt my heart continually racing, even when I was lying down. When I walked around I felt really breathless (I was relatively fit and active before this). Turns out my pulse was resting between 90 and 110, and rising to 140 when standing, 150 when walking gently. I initially put this down to the stress of the procedure but it just wouldn't resolve.

I ended up on the 31st in my local emergency department where I spent a really traumatic 24 hours before being transferred to the specialist hospital where I had the pacemaker implanted. My cardiologist has done all the obvious tests: infection, blood tests, chest x-ray, echo and these are all fine. But my ECG is showing first degree block that wasn't there before the procedure.

They finally got my pulse settled with bisoprolol and invabradine and have sent me home for outpatient follow up. But I am devasted. I feel continually anxious and panicky, and can't stop thinking about what has happened. What I thought was the solution seems to have ended me up in a worse place than where I started, with all my hopes further away than ever. I just don't how to cope.

I was hoping someone on the site might have some suggestions for coping when things don't go to plan. I've tried to talking to my husband and family, but I dont think they really understand so would appreciate any advice.

7 Comments

So Glad I'm Not Alone

by Genie - 2010-04-04 03:04:58

Just wanted to say thanks to everyone for posting.

Wendy: it's so comforting to know I am not alone. The first thing they did was check my thyroid. One of the doctors was certain it would be this, and I have a family history for this, but the tests came back fine.

It's so weird. One of my doctors suggested yesterday that resolving the block might uncover other problems. If I get any answers I'll definitely let you know. If it helps, the beta blocker has made me feel a lot better just in the last 48 hours. So I'd definitely say give this a try. But a proper answer would be nice...

Best Wishes,
Sara

For Genie

by Chrissie2116 - 2010-04-04 04:04:24

HI Genie,
You are mentioning you had a ECG but did you also have a cardiac echography ?

I had exactly the same symptoms as yours after my PM was implanted (28th of Jan this year). Felt breathless after 10 minutes walk, exhauted, and my heart was also racing. I had to have 4 calibrations of my PM to the clinic and was still opressed and breathless. My ECG was ok and they thought first of all that I was very tired and very shocked by the surgery etc ... They gave me some additional pills and beta bloquants and I still felt the same.
I was really "fed up" and asked for a cardiac echography where they found the reason : I had water all around my heart that gave me consequently difficulty to breath. I know each case is different but we are here to share our thoughts ... and just to let you know I also receive a treatment with aspirin to take out the water from my heart and it is a bit improving (for those who know me on the site I can know walk 13 minutes :-) ) . Genie , I am 44 years old, also used to be activ and dynamic and I have learned through this site that we need to be "patient".
Nobody, except all our lovely PM friends, can understand how we feel, outside and inside, and be sure you will find all the support on this site. Do not hesitate to ask all your questions. I am sure many of us will answer to you.
Wishing you a nice day or evening from Paris,
All the best and take care,
Chrissie

Every situation is different but...

by DC Pacer - 2010-04-04 05:04:50

Genie

I developed intermittent sinus tachycardia after being fitted for my pacemaker to correct 3rd degree heart block. My doctor, my pacer tech and I were able to "override" the tendency for me to fall into sinus tachycardia by adjusting one of the many PM settings called the P-VARP. I had a p-wave that was slipping through the PM sensing, and it caused the PM to think I had missed an atrial beat.
This occurrence of "atrial undersensing" leads to atrial OVERpacing, and the end result triggered the ST episodes I was having.
Lots of settings on these things - don't give up! It took me a year of asking questions to get this corrected, but I feel great today.

DC

It's me not the pacemaker!

by Genie - 2010-04-04 07:04:18

Thanks DC,

The encouragment is really useful. It's good to know other people have resolved their problems.

Unfortunately, my tachycardia is me, not the pacemaker: it's happening when I am in a normal rhythm and the pacemaker is doing nothing!!!

Genie

ME TOO

by wenditt - 2010-04-04 08:04:24

Genie,
I too now have inappropriate sinus tachycardia since my pacemaker implant in September 09. I was diagnosed with intermittent 3rd degree heart block. I would have "episodes" a few times per year.

The first thing they did was to check my thyroid. Traditionally I am hypothyroid but for some reason after the implant went to the low end of hyperthyroid with no med change.

That took care of the tachy for about a month because they lowered my thryoid meds.

However, a month later on the lower meds and I am hypothyroid once again and they want to up my dose and put me on a beta blocker.

My father died of a sudden heart (so we think...no autopsy) so I am extremely fearful that "something" is still going on that has not been addressed.

I have worn halter monitors that report the tachycardia but because my heart rate lowers on it's on, my cardiologist insists its normal. However the EP says I have episodes on inappropriate tachy and says something in my body is just running too fast. Hence-the beta blocker so my heart is protected either way.

But I am concerned because of than an EKG which only really takes a snapshot of that moment, and other simple tests...something is still not being detected.

I feel things now that I didn't feel before. And I know something is just not right. Somedays I just ride the hope train that they figure it out....and soon!

If you get any ideas..please share them with me. I have hit a road block as well!

Wishing you well...and some speedy info with results!
Wendy

Genie

by LS - 2010-04-04 10:04:40

I wish I had some answers for you.
I understand the anxious & panicky feelings.
Hopefully they can find a medicine in addition to the PM that will help you.
Wishing you a speedy recovery & many blessings in your future.
Liz

Thanks

by Genie - 2010-04-09 04:04:52

Thanks Chrissie,

Its good to know I'm not alone on this. Yes, I've had an echo, which is fine. A week on, and I'm ok on the beta blockers, but still adjusting. I really want to get off the drugs, but I've started walking again and coming to terms with things, hopefully. Its good to know things do get better, and to talk to someone whose been through the same thing.

So glad I found this site!

Genie

You know you're wired when...

Your heart beats like a teenager in love.

Member Quotes

I had a pacemaker when I was 11. I never once thought I wasn't a 'normal kid' nor was I ever treated differently because of it. I could do everything all my friends were doing; I just happened to have a battery attached to my heart to help it work.