Pulsating pain

The message below was posted about 6 weeks after PM implant.  I am now about 7 mos out and for the most part doing very well.  Still have the pulsating pains a few times through the day and night that are from very mild to mid range pain lasting 30 seconds to a minute.  Seem to feel it more when laying  on my right side.   I am no longer on a beta blocker.  It made me feel very bad and sluggish.    Lower hr is set at 45.   EP thinks I feel pain and pacing when I have a pvc.   I do not have a fib.    Wondering if anyone else experiences this.   Any suggestions.

(Posted 6 months ago)

I got my PM because I was having pauses that were 2 to 4 seconds and on the verge of passing out.  I am not in serious heartblock but they felt I would get worse and didn't want me to pass out. My original PM setting was 60 but I was having very hard thumps or spasms in my left diaphragm that started when my heart rate was in the low 60's.  It was keeping me up at night and very uncomfortable.   My EP lowered it to 50 and that stopped the problem but I started having the pulsating light pain lasting 30 seconds or so on and off.   I thought I Was feeling pacing but my heart rate was in the 70's or more.    Went to EP 3 days ago and had PM checked.  He thinks I may be feeling PVC's and so that's why he gave me low dosage metoprolol success er 25 and he lowered my setting to 45 so pacing wouldn't be kicking in with a lower heart rate.    I will be taking my third beta blocker this evening.   So I have only been on this med for not quite 3 days.  My average resting heart rate today is 60 and was 62 yesterday.   My Fitbit shows my daily resting heart rate from 72 to 64 over last two weeks.   I'm going to monitor things and continue this med until I see the cardiologist on Aug.  17.    I don't like taking a beta blocker and last night I still had the mild  pain sensations.  I was wondering I Was feeling the leads in the arteries because it is in that area and seems to start when on my right side.   Good news is I have not had long pauses since My PM put in 2 months ago.

 

2 Comments

Get Another Opinion

by Grateful Heart - 2017-02-10 19:06:02

You've been dealing with this for 6 months and your doctor's answer is to keep lowering your lower limit from 60 to 50 to 45.  A setting of 45 is low.  The pacemaker is there to assist your heart with needed beats when your heart rate dips too low. 

The pain and spasms in your diaphragm is known as "diaphragmatic pacing"....the lead is pacing your diaphragm.  Sometimes adjustments are made in the voltage in an effort to ease the discomfort but again, 45 bpm is pretty low unless you are a well trained athlete.  A "normal" heart beats anywhere from 60-100 bpm.  

It is possible the lead has dislodged.  If that is the case, it is not an emergency but it should be corrected.

I would seek another opinion...6 months is too long to not have a definitive answer.        

What she said

by Gotrhythm - 2017-02-13 11:51:42

I'm with Grateful Heart. It's time for a second opinion. Set at 45, your pacemaker is not really doing for you all that it can to improve the quality of your life.

 If there's any way you can, go to a doctor outside your area. Doctors in your town likely all went to the same three or four medical schools and learned the same ways of approaching diseases and conditions. Someone with the same background is likely to give you the same answers. Plus, doctors within a given specialty likely all know each other. It will be harder for them to disagree with what a colleague has told you.

What to do? Go to a teaching hospital associated with a university. Two reasons (1) it will be easier for them to suggest another treatment plan without callling your doctor wrong. (2) Whatever is going on, you obviously don't have a common, easily recognized and treated problem. Big teaching hospitals see more rare conditions, plus the doctors there like to solve diagnostic mysteries. For physicians in private practice a patient who keeps coming back and back and they can't diagnose and help is a pain-in-the-A. (No judgement. They are only human and nobody likes to feel helpless or incompetent.)

I'm convinced getting a second opinion saved my life. And once my pacemaker was doing what it should, and no doing what it shouldn't, I found out what a wonderful thing a pacemaker really is.

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