Has any one had this happen
I got my PM in November of 2010. They made a change in the settings in December. After they changed it I started having this weird thing happen - after I start doing something like walking or bringing in the wood for the fireplace, my heart felt like it was racing and beating a little fast. When I checked it, it was like 110 112, then it would go away. I went back to see my Card Doc and the PM Tech came in and checked it out, he said everything was great and my Doc ask me what was going on in my life like stress. I just don’t think it is from stress.
The next day while at work, I went for a walk to employee health; when I got there it was fluttering and felt like it was racing, she check me out and it was 119bpm, so they put me in a wheelchair and took me down to the ER. They put a 5 lead EKG on and said everything was good. They called my Card Doc and I guess she told them I was crazy and they sent me back to work and I was to follow up with this Mental Doc. I’m not CRAZY, but I do wander if the PM is reacting with stress, what else can it be? Any clues? Can it be a spasm in my throat or what else?
15 Comments
YOur not crazy, but they are incompetent
by ElectricFrank - 2011-01-15 10:01:43
What you describe is a classic case of having Rate Response ON and set too sensitive. Rate response is intended for situations where the natural pacemaker isn't working properly. It senses your body movements and uses it to determine what your HR should be for the activity you are engaged in. There are settings that determine how it responds to various activity levels that need to be optimized to you.
If it is set too sensitive even an easy activity for you will send your HR soaring. In my case RR was turned ON unnecessarily and also set way to sensitive. Even the jets of my hot tub would send my HR up.
I see you are an electronic tech. My suggestion is to ask (firmly) for a copy of the most recent pre and post programming report. Also, a copy of your medical records concerning the diagnosis requiring a pacemaker. You may see something like Heart Block or Sick Sinus Syndrome (SSS). Unless you have SSS it is unlikely you even need rate response.
I'm an electronic engineer and finally built my own ECG so I could track what they were doing. Most cardiologists are good plumbers, poor electrical techs.
frank
You Ain't Crazy
by SMITTY - 2011-01-15 10:01:51
Hello Lane,
I do not think you are crazy, but I'll not say the same for your Dr. I can name two things that could cause what you are seeing and I'm sure others can name many more.
You indicate this rapid heart rate started in Dec after you had the first checkup. That being the case my first guess is if the rate response on your PM is or was turned it is supposed to increase your heart rate when you start physical activity. You say after hitting the high rate it goes away. Does it go away because you have stopped physical activity because of the discomfort. Regardless, if the problem is the rate response I would guess that the settings need to be adjusted or the rate response turned off it you do not need it.
My other guess is you have developed an arrhythmia that shows up with physical activity. I have this problem some times. Now my rate response is turned on, but when it kicks in from physical activity I have a very steady but fast heart rate. When it is arrhythmia caused by activity, it is a very erratic heart beat.
I'll stop now and see what others have to say, but not before I say you are caught in the same situation many of us have been. We have something unusual happen with our heart rate after we get a pacemaker and the Dr or tech says everything is fine and the problem is not caused by the PM. In my opinion they say that because they do not have a hint of what is going on. Many of these Dr are good surgeons and can implant a PM with absolute perfection. Yet when it comes to solving problems that involve the electronics of the PM they don't have any idea of what to do. Those Dr I figure have never mastered the use of their TV remote either.
So I'll say again you are not crazy. If you are you have lots of company among people that have a new PM.
I wish you the best,
Smitty
Thanks all
by lanew - 2011-01-15 11:01:25
I don't thank I'm crazy ether now, all of what you guys have said makes sence to me and sounds right on the money. the tech did say he decresed the RR time so it would take alittle longer to respond. he always leaves the room and talks to the doctor, I wish they would be in the room with me when they are trying something new. I.m about tired of them pushing the stress thing on me, I would not be stressed if this thing was not making me feel bad when it acts up. I have gotten some better. It.s when it runs wild when I feel bad. Frank maybe you should make some more ECGs to sell to us poor folks. I could repair them if you like. Thanks again guys.
Doctor and tech relationship
by ElectricFrank - 2011-01-16 02:01:01
That is part of medical politics. I had that early on with the cardio and Medtronic rep. He and I got along great what with both of us being engineers. The problem was the same as you have where he would leave the room and consult with the cardio. I sensed what was happening and firmly asked to see them both at the same time. I let them know I had no interest in medical protocol, that I respected both of their expertise, and that from now on all 3 of us would talk. It worked great and we get along fine now.
You wouldn't want one of these ECG's. It is something only an engineer could love. I plot only about 4 beats on a screen with the waves being half a screen high. I can put an arrow over a pacer pulse, hold down the mouse button, and scroll over to where the ventricle starts to contract and measure the time down to a millisecond. It's also handy to measure where between 2 normal beats a PVC falls. Some of my recent "PVC's" look like they are actually normal AV node beats that just beat the pacer to the punch a bit.
I think I posted a photo in the gallery of the display.
frank
just don't understand
by lanew - 2011-01-16 07:01:25
biker72, I just don't understand all of what is going on with the PM, but I sure am going to find out, when it was on was the PM pacing 100% or was it less? I just walk 3 miles and had no problem, they said it does respond to stress, if so maybe they need to turn that part off, I stay stressed. but I have alot of good reason to be stressed out. being crazy is not the problem.
Frustrating
by biker72 - 2011-01-16 09:01:25
It can be very frustrating when you KNOW you have a PM problem and can't seem to get through to the PM tech or EP.
My response rate was turned on for most of the year after the implant, Not good for bicycle riding. Once that was turned off everything got a lot better.
My PM tech actually called one of the Boston Scientific inventors for some advice. This particular scientist happened to be a bicycle racer that is very familiar with my PM problems.
This happened to me as well
by mama_w - 2011-01-16 09:01:57
After I had my pacemaker put in, I could feel my heart racing and I thought that I was actually feeling my pacemaker pacing. I called my cardiologist and had the pacemaker interrogated. It wasn't the pacemaker that I was feeling, it was my heart rate picking up that I was feeling. When my heart rate would drop below 50 bpm, the pacer would kick in and pace my heart at 100 bpm. After they found out that I could feel the heart beats at 100 bpm, they lowered it to 80 bpm. I can still feel it occasionally, but not nearly as bad as when it was 100bpm. It felt like it was in my throat and took my breath away! Good luck!
That is to cool
by lanew - 2011-01-16 10:01:20
HI Frank is that a E Scope,or Pulse Gen? That is to cool. biker72 could you tell right away after it was turned off? or does the heart have to adjust a few days? I think my Tech said that I was only paceing 2% of the time, Now that may be the lower chamber. Frank I try and look at this thing as a Mini PLC, we can control how fast we want somthing to respond, like I have work with alot of HVAC controllers that temp and humitiy had to be just right. so in the room we have a Hum sensor and a RTD, we want the condition to stay steady so we make adjustments to the controller to make things like steam valves, chill water vales, dampers, respond ether quicker or slower by way of Prop Bands and Inter gains to keep the room at a steady condition. Now Frank is this thing working in the same way?
lanew
by ElectricFrank - 2011-01-16 11:01:45
You have it right! There are multiple inputs that would normally affect HR and the pacemaker has to try to simulate them. The response rates vary a lot so they need to be able to set smoothing and lead functions.
As for the photos in my gallery, one is my ECG which shows several beats including a PVC. It doesn't look like a normal ECG because I use different electrode placements to pick up both the pacer pulse, atrial contraction, and ventricle contraction.
The other photo where you see an oscilloscope with the pacer hooked up to it is my measurements on the one they removed a year ago. I hooked some leads up to it so I could look at the waveform. Poor thing is still pulsing away here on my desk trying to keep me alive.
I have a web site that I haven't had time to finish where I have been planning on posting more such information than there is room for here. Hopefully, I can get back to it this spring.
frank
Right Away
by biker72 - 2011-01-16 11:01:58
I could tell right away that there was a significant change in the pacing after the response rate was turned off.
I'm being paced almost 100% of the time.
Thanks Guys
by lanew - 2011-01-17 11:01:48
Thank all of you on your help in understanding some of the problems I have been having, It has made me feel much better in knowing I'm not crazy as they would like me to be. Fruit First Thank you for your post, the next time I see the Tech I will be gitting the readout so I can tell if and they changed. Frank can't wait until you get that web site up, I love seeing what makes something tick. Mama_w that is what I felt like, Like is was in my throat, but they said it was my nerves and gave me some pills, I didn't take them. last thing I need is more pills. Frank is there something like a reed switch in this thing? Is that why they don't want you around magnets?
Heart going to the races
by Fruit First - 2011-01-17 12:01:49
I had the same problem in 2006 when I first had my EnRhythm installed it took getting the 3rd tec to correct my problem and it was simple Rate Response ON and set too sensitive he reduced the sensitivity and rate has been fine since.
Just tell them you think your rate is set to sensitive also always as for the same readou they give to your Dr. and then you will know if something has changed.
Not Crazy Only The Doctor!
by martinb - 2011-01-21 10:01:13
After I had my PM in for about a week I was sitting in a chair and started getting every anxious, actually started crying and it was almost midnight. I called the doctor's service and not my doctor, but another one called back and I explained what I was feeling and I thought my PM wasn't working. I have a dual lead and I'm 100% dependent on it. She immediate said it was working, but obviously needed to be tweaked a little, don't worry I would calm down in a little while, but if I was really worried come into the hospital right then and she would be there and adjust it. That was a shocker that she would even suggest going out of her way! My regular cardio guy was a jerk. I kept him for 5 years and dumped him just about a month ago, but that's another story. When I had it put in a specialist came in to do the final check before I went home and she said when I go in to get this checked they are going to shut it down. I was scared to death! She said they will tell you they need to do that so they can see how long it takes for your heart to come back on its own. She said this is why they lose patients, it scares them so much they won't go back for their normal checkups so don't know when the battery is getting low and end up in an emergency situation when it quits. Where I can't go without it she said to tell them to do what they need to, but don't shut it down completely. I worked it out with the tech and she said I need to be lying down completely and they put the sides up on the table and they do shut it down for a few seconds and I start feeling like I'm going to pass out and then she gets her numbers and cranks it back up again.
But you are not crazy they can adjust it, mine was set not to go higher than 60 bpm, when I went in my bpm was running at 30 and dropping fast. They since changed it so it can go as high as I make it, but can not go lower than 60. If I exercise, which is very little as I have final stages of arthritis in most joints among other problems, it does go up. So 5 years later, I'm still beating and not crazy. Your doctor should never have used that word or dismissed your concerns, that's why I dumped my last one.
Good Luck, Dale
Thanks Dale
by lanew - 2011-01-23 01:01:15
They did change the response time, and I do feel better, but it took a day or two for me to see that. because it would go up only when I walk for a certain distance or was carring wood in. But I am conceduring seeing a new Doc.
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what Frank said!
by Tracey_E - 2011-01-15 10:01:17
Might be time to shop for a new doc... it really sounds like they turned on rate response and it's too sensitive. Frank explained it beautifully. It's normal to take a few tries to get rr adjusted correctly, so that it goes up when you need it but doesn't shoot up every time you sneeze. Or as Frank said, it may be on when you don't even need it and it's competing with your natural hr.