Tachycardias

I am 26 yrs old and I just had a pacemaker put in on April1 due to total heart block. My heart was skipping 6 beats at a time, sometimes more, on a daily basis. Since I had the pacer put in, I have developed even more problems. I now have a fast heartrate (at rest it has been as high as 160+ beats per minute) and have been put on betablockers. Has anyone had anything similar happen to them? I am a little worried that I went in with one problem, had it fixed and now have another problem that I never had before. Any help, advise, support would be great. Thank you.
Nikki

8 Comments

Fast Heart Rate

by SMITTY - 2010-05-18 01:05:03


Hello Nikki,

Welcome to the Pacemaker Club.

Total heart block, which has probably been explained to you, means the signal or impulse from the hearts natural pacemaker is not completing its intended journey and results in your heart not beating as fast as it should. This can also result in skip beats, but more often it just means a very low or slow heart rate and that is where the manmade pacemaker comes in.

It is supposed to check and see if the heart's natural pacemaker is going to make the heart beat and if not then it will send the necessary impulse to give you a heart beat. However in your case, it is apparently working over time and giving you a much too high heart rate.

Before going further, let me say I'm not a doctor, nor am I a pacemaker expert. I've had a pacemaker for 10 years and some of that time was made very difficult by the pacemaker and some has been most enjoyable. Because of those difficult times I've asked my doctor a lot of questions and asked many questions here. In addition I have read many articles on the function of pacemakers. While all that makes me think I have a reasonable understanding of how a pacemaker is supposed to work, the fact remains I am not a pacemaker expert.

Now back to your problem. You don't say what your heart rate was
before you got the pacemaker, but with total heart block, I'm guessing it was very low and possibly there was some arrhythmia in addition the skip beats. In such cases what I have seen is a pacemaker is implanted to speed up the heart beat to a minimum of say 50 to 70, maybe more or maybe less depending on the patient's needs. It will also have an upper set point, usually in the 110 to the 140 range, but again it depends the patient's needs.

If your pacemaker is increasing your heart rate to 160, I can think of some possibilities for that. One, is you have an uncommon (at least uncommon to me) heart problem. Two, is whoever programmed the settings on your pacemaker made a mistake. Three, the rate response on your pacemaker is activated and the settings on that feature are sending your heart rate to the high level you are experiencing. You don't say if you have the high heart rate when you are inactive or if it occurs when you are exercising. If it occurs when you are exercising, then the rate response may be doing its job as it is supposed to increase the heart rate in accordance with the needs of the body. If you are at rest when the high heart happens, then the pacemaker settings are incorrect, or some of the medications you are taking are causing the high heart rate.


I see you are taking a beta blocker. While I never heard of a beta blocker increasing the heart rate (they are supposed to do the opposite) I guess anything is possible. I think of a beta blocker being prescribed to slow the heart rate to stop arrhythmia and then let the pacemaker bring it back to a desired lever.

I going to stop here as the possibilities are too many. If you can give us a little more information such what was your heart rate before you got the PM? Also is the rate response activated? Your doctor can tell you this if you do not already know. Also what are the upper and lower settings on your pacemaker? Last but not least, have you considered a second opinion, if that is possible.

I wish you the best,

Smitty

Welcome!

by tcrabtree85 - 2010-05-18 01:05:20

Welcome to the club. I don't have the exact same issue that you are talking about. I have had many problems with my pacers but overall its better than not being alive.
I also wanted to tell you don't feel alone. I am 24 and there are many younger people that come through on the site. It will get easier as time goes.
Thinking of you on your road to recovery.

Tammy

Hey!

by Loopy Lou - 2010-05-18 03:05:41

Hi Nikki! lovely to see you here.... this is just a quickie as I am off to work in a moment..... but rest assured the Pacer Chicks will soon round up and leave you messages....

Same happened to me..... I went from a 30bpm to a more civilised 70 -80bpm. Didn't feel better at all.... tachy ryhthm up to 220bpm for a few seconds at a time. The feeling that George Clooney had turned up at my door.... phew! Anyway, I kept going back to my clinic and seeing my cardiologist. At Easter my meds changed and I have calmed down a bit now.......

See what the other say.... it is a fab club here and you will get lots of advice! Take care.

Love & Hugs, Loopy Lou xxxxxxxxxxx

Yes - exactly!

by Genie - 2010-05-18 07:05:17

Welcome!

I had my pacemaker put in the week before you. I spent the next week with a resting pulse of 110, 140 when I stood up, more than this when I walked (when I could, as I was so dizzy and breathless). Ended up back in the hospital. I am 31, had my pacemaker put in for 2nd degree heart block (sound the same as what you had). I was put on beta blockers and ivabradine, which slowed things right down. I have been crying for weeks, anxious and feeling hopeless about it all.

But yesterday I turned a corner: had a really good pacing check which shows everything has settled down (I posted yesterday all about this). This is despite my stopping the ivabradine and reducing my beta blocker dose (with my doctor's supervision, of course).

It may be that your problem will be temporary too, and will start to get better. My cardiologist couldn't really explain this, but I think sometimes it takes our heart some time to adjust - they don't have to work hard to correct the block anymore, and they go into overdrive instead. This is stilll new, so you need to give your body a little more time.

Have you spoken to your cardiologist? If not, they should be able to help you. By reading the information stored in your pacemaker they can tell you exactly what's going on (what sort of tachycardia, for example). If, like mine, it's just sinus tachy then it is unpleasant, but not really dangerous (and much less dangerous than heart block). It's really important to get as much information as you can.

But I am sure you are feeling anxious - I still do despite seeing improvements. If you can try not to get stressed about it then that will help, because I'm sure you know that stress and anxiety make this worse. If you want to swap notes more do message me: I'll be happy to chat.

Best Wishes,
Genie

sort of!!

by Hot Heart - 2010-05-18 08:05:16

Hi there and welcome, you too genie.

I've been a bit busy last few weeks and not been on much.

I had third degree hb, and got afib after my pm was inserted, settled down nicely though after about 6 months.

I know I say this all the time, and people must be getting bored with me saying it, but.............everything settled down and I felt about 600% better after I got my rate response turned on.............and thats from someone who can't stand all these people who say I'm gonna give it 110%, you cant!!!!! 100% is the whole! lol

HH

Response

by Nikki - 2010-05-18 09:05:22

Smitty,
The dr put me on the beta blockers to slow my heart rate down, and it has been working, but not all the time. The other night I thought I was having a heart attack. I had extreme tightness in my chest, difficulty breathing and I almost passed out. Several minutes later, after I could finally move again, I took my pulse and it was only 101. It felt like it was beating faster than that, but maybe it had calmed down a bit since I had waited a few minutes to check it. Normally at rest my heartrate is in the 80s, but there are times (like I listed above) that it randomly goes up higher, even if I am not being active.

My heart rate before the PM was in the low 50's. I think the pm is set at 60, but not sure what the upper setting is. I'm actually not even sure about the 60 because that is what the nurse guessed it was set at. I still haven't seen my cardiologist since the surgery. I've been back in the office at least 7 times and they have always had me see a nurse, which I am not thrilled about. It seems that they don't know what they are talking about. They just keep putting me on different meds and tell me that it will take a while for my body to get used to everything. I am thinking of getting a 2nd opinion, I'm just doing research now to find a good doctor.

Thanks everyone for your responses. It's good to know that I am not alone.

Nikki

Heart Problems

by SMITTY - 2010-05-18 10:05:25


Hi Nikki,

I kind of thought you may be getting a runaround from your doctors based on what you said in your first message. There could be more than one reason for that, such the doctor is too busy, or he doesn't know enough about pacemakers to be of any help to you and knows that.

Unfortunately doctors are not required to have certified pacemaker training before they get into the pacemaker implanting business. I have seen some people here talk about the only training some cardiologists have is attending a one or two day pacemaker seminar presented by a pacemaker manufacture. Then when they get into the PM implanting business they learn that there is more to pacemaker implanting than just the surgery. While I will not say your doctor is one of the overnight wonders, what you have run into by not being able to see the doctor in seven trips to his office is what I would expect from such doctor.

I wish I had answers for you but your problems are complex enough that for me to make any guesses may be just adding to your existing problems, so I'll not make that mistake. I will say I hope you can get another opinion and if possible see an electrophysiologist. An EP will be a pacemaker specialist. And if your current doctor is an EP then by all means find another ASAP as it appears to me the fellow is too busy, or for whatever reason has lost interest in helping you.

By the way I see you are 26. We have a beautiful granddaughter named Nicole but goes by the name of Nikki. She is 30 and as I sat here trying to offer you some encouragement, I kept visualizing our Nikki as the person I was writing. I know, this is just useless prattle, but we don't come across many Nikkis.

I wish you the best,

Smitty

Get more advice

by tcrabtree85 - 2010-05-19 04:05:39

Smitty is amazing please listen to him. You need to for sure get another opinion. You poor thing are faced with so much and not being able to see your Dr is not going to help you at all.
I have only ever gone to a EP when I first started having my heart act up I went to a cardiologist who didn't do anything learned from a friend about a great EP and have never turned back to a cardiologist.
I wish you the best. It sounds like your settings need adjusted some have the nurses looked at that? Hopefully soon you will be able to be back to normal everyday living.

Tammy

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