Tachycardia with pacer

svt

by Tracey_E - 2018-01-26 15:06:26

If it doesn't happen often and corrects with a dose of metoprolol, isn't dangerously high, is regular beats (as opposed to afib), I would not be in any hurry to ablate. Most people have to take it daily rather than as needed.  If it doesn't happen often, they may not be able to reproduce it to know what to ablate. 

Some of those episodes of 120 could have been normal activity. Do you know what time they were?

Have you kept a food log to see if you can figure out a trigger? My svt us usually set off by caffeine or exercise induced. It might happen once a month or so for no reason, but usually it's because I adore coffee. 

I've never heard of a minute of a fast rate. Why not just let it add beats so you don't go under 50? Is there a purpose to the fast rate?

Wondering

by Gotrhythm - 2018-01-26 16:29:33

I don't have anything like Tracey's expertise, but I also wondered why your pacemaker isn't set to function in the ordinary way. Most just add beats as often as needed to keep your heart rate steady at rest, and speed it up only when called for by exertion. 

Programmed that way, most people don't feel it pacing at all.

Rate Drop

by JaqsDad - 2018-01-27 03:00:32

I'm paced mainly to prevent asystole. It's not uncommon for me to go from 70bpm to 0 in a matter of seconds (not just bradycardia but asystole). Because of this, my pacer is set to Rate Drop Mode. I am only paced when my rate drops 20 beats or more in 15 seconds or less AND I go below 50bpm (a drop from 90bpm to 60 won't trigger it). The therapy for this is a set rate for a set time since there is no activity detected and therefore no beats to "fill in". After the minute, my pacer slows and hopefully my heart is going again.

One thing the ER noticed on Monday and my device tech and cardiologist noted today is that my rate seems to be rather erratic. When I'm not paced (which is now 24%) my rate jumps around between 60 and 120. Cardiologist definately wants electrophysiolgist to take a look and see why it is so erratic. My rate jumps around even while I'm sleeping with a 30 second SVT episode of 200bpm in the middle of the night.

SVT

by Beattie - 2018-01-27 03:07:51

I have had a pacemaker inserted for Bradycardia in August 2017..... i have almost daily episodes of SVT. I have tried 4 Radiofrequency Ablations which were'nt sucessful and still have episodes of my heart rate going up to 180-200bpm. My pacemaker is set curretly at 50bpm and i dont feel it pacing at all either. 

I currently am prescribed  Ivabradine, Diltazem and Amiodarone to control my SVT this is not perfect but after last  12 years trying many different combinations it seems to work the best for me.  (I cant take Beta Blockers as when i tried they promptly triggered an Asthma attack)

some people find  EPS +/- RFA works for them so might be worth while going over it with your Electrophysiologist... Good luck and keep us posted.

talk to the ep

by Tracey_E - 2018-01-27 19:57:25

Regular cardiologists are basically plumbers. Ep's are electricians and much better at handling your type of problem. 

If the racing happens regularly,  perhaps taking a low dose metoprolol will  keep you more even. 

If a pacer is set for a minimum rate of 60 ( using that for example because the math is easiest), it isn't actually set aat 60 bpm, but one beat per second. Every time the heart goes a second without a beat, it will kick in with pacing. I'm no doctor so I'm probably missing something, but I still don't see why this type of pacing won't work for you, it would be a lot easier to live with a steady rate than sudden racing every time it kicks in. 

Write down your questions/concerns and have an appointment with the ep. They will have mch more experience at this than the cardio