Can I combine a beta blocker with my AV heart block pacemaker

Hi, I am Alan, age 76, In 2011 I was pronuced clinally dead due to total AV heart bock resulting in a permanent heart pace maker to keep my heart beating at above 60 pulses a minute

Hi although I have a heart pacemaker installed in my chest wall during 2011 and the battery still has five and a half years left before it runs out, I have been having problems with irrugular heart beats or palpulations that are some times scary.

It is scary because this is exactly the same way I felt before my life and death episide in 2011. 

Yesterday I got the pacemaker checked by a young lady from the company who supplies these devices in my country of South Africa. She said one of the leads had moved and was interfering with the other lead, so she disconnected it and only left one active lead from the pacemaker box.

 Since then on getting home the irregular heart beats have increased and I really do not feel comfortable and unlike previously, I am now aware of ever beat  and every misbeat my heart is making.

I phoned her and she told me my heart would not stop and the pacemaker does not correct irrecular heart beats or paplutation. 

So I have arranged for her to reconnect the lead she disconnected, because proir to this I was OK.

It seems to me she fixed something that was not broken!

So my question to the wise men of the forum is.

Can I use a beta blocker for the irregular heart beats, even though the pacemaker is doing its work by keeping my heart beats at 60 or obove per minute?

Do any of you folk with heart pacemakers use beta blockers?

Please help

Blessings Alan McDougall 


5 Comments

2 chamber PM

by BillH - 2016-11-18 00:33:39

It sounds like you have a two chamber PM with one lead in the right  atrial and on in the right ventrical chamber. 

Normally the sinus node causes the atrial to beat. Then the signal flows through the AV node and triggers the ventricals.

In your case the signal is blocked in AV node and thus the ventricals does not beat.

There are a number of modes that the pacemaker can be set to. In your case it probably monitors the atrial and when it senses a pulse it looks to see of the ventrical pulses. If not the PM pulses the ventrical. Basically the PM just bridges the defective AV node.

This is the most efficient mode with the heart beating in sequence. And if the sinus node is working properly it will speed up when needed for more activity

However, if the atrial lead is not working properly the PM can be setup to independenly pace the ventricals. However, other setting need to be made to activate the rate response feature so it increase the ventrical.

But there are lots of setting involved then just "turning off" the lead.

As too your question about beta blockers. In addition to reducing PVC's it can it can slow does the AV node conduction, but that is not a problem in your case as the AV node is not working.

It can also slow the sinus node and if it is too low to start with that can be a problem, but again you have a PM that can take care of that.

But you really need to be seen by an EP to determine if their real is a lead problem and how bad it is. In some case if can be made functional by settings. Or with the appropriate PM setting that it can be made to reasonable function without it. Or he may think that the best thing is to replace it.

 

Can I combine a beta blocker with my AV heart block pacemaker

by Alan McDougall - 2016-11-18 01:37:38

Wise men only of course not, wise woman also!

"Of course not, not only men are wise, my mistake I should have said wise people"!. 

'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''

I do have a two chamber model, namely below

Medtronic ADDR 5076 leads===implant date 18/06/11

Thanks for the information although I do not really understand it I will discuss it with the tester lady today and let you know.

Why the below has also suddenly happended since the pacemaker test lady adjusted my pacemaker two days ago? 

1) Last night I felt really realy bad only slept one hour and for some reason my well controlled blood pressure has gone sky high== 160 over 95= (When for the past year it has consistantly been approximately 120 over 75) === (Without meds) 

2) As well as my glycose levels which has consistantly been approx 5 to 6.5  (Without meds) ======  (Now 13 to 15?)

This really baffles me because for the last year I did not need to take any blood pressure medication or antidiabetic drugs.

Regards

Alan

 

Doctor

by BillH - 2016-11-18 09:48:24

You really need to see a doctor.

It is very likely that those symptoms are caused by some unrelated problem such as thyoid. And if it is the thyroid it can also cause the palpitations.

I would start with your GP.

what Bill said

by Tracey_E - 2016-11-18 15:21:17

when we have CHB, all the pacer does is make sure the ventricles beat when the atria does. It has no direct effect on either bp or glucose.

Yes, many of us end up on beta blockers with CHB for various reasons. If the CHB was untreated then bb's would be a bad idea, but as long as we are paced the pacer won't let our rate drop dangerously low. 

Can I combine a beta blocker with my AV heart block pacemaker

by Alan McDougall - 2016-11-18 15:33:24

Thank you Tracy, and the other commenter

I saw the pacemaker lady who changed my setting by disconning one of the leads that she said had moved. But that really made me feel much worse.

So I asked her to set it back to what it was and I am feeling hugly better

Using a beta blocker seems to make me feel much worse so I will leacve them for now

I have made an appiontment to see a cardilogist in March 2017, because my wife and I are going to vist my daughter and family in Switzeraland Geneva in December..

I hope to see the large hadron colidder because I am an amatuer scientist and engineer

Thanks for all the encouraging comments.

Best wishes over the holiday season

Alan McDougall 76 South Africa

You know you're wired when...

You have a maintenance schedule just like your car.

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