Irregular after Pacemaker

I had a pacemaker and an AV node ablation four years ago and have had a lovely trouble free time ever since..... until a couple of weeks ago, when I suddenly felt faint, my legs went jelly and I just made it back to the car where I was short of breath and had some chest pains.  Both my husband and self felt an irregular pulse - not fast but stopping and double beat starting type.  This lasted a couple of hours before normality.  I previously had a few years of trouble with atrial fibrillation to know that this felt the same with all the old former symptoms and feelings.  

So I went to the Pacing Clinic where they did a printout showing that period and - NOTHING!  However they did do my blood pressure and found it to be extremely high and gave emergency medication and that is also now normal.  I am now very confused as I am convinced that the attack wasn't from hypertension but was a cardiac event.  Is it possible the pacemaker printout missed it or must I accept it was hypertension (my two medically trained children say that raised BP doesn't produce those symptoms).  


Welcome to the wonderful world

by Theknotguy - 2019-01-21 12:22:34

Welcome to the wonderful world of "undetermined heart event(s)".  Doctor's may not be able to tell you what happened.  They don't know, you don't know.  No one gives you an answer.  Not a happy place to be.  

Question in my mind is if you went into afib with RVR and your heart rate went above the top level of your pacemaker.  Mine is set to 120.  So if my  heart rate goes to 125-130 the pacemaker with just sit there and do nothing.  Not sure what it records during that time though.  

I had a similar situation where the ventricle side of my pacemaker kicked in.  But it only lasted a couple of minutes.  No where near what happened to you.  I don't think that is what happened to you but I agree it's a strange feeling.  

I'd still go back to your cardiologist/EP and ask what would be possible causes of the event you had.  Then see if they can come up with a plan of action in case the event(s) happen again.  Do you go to the ER?  Do you note the time?  Any course of action those around you can take?  Do you call the EMT squad?  What?  Having an idea of what to do may give you a feeling of some control over the situation.  

Otherwise, I hope everything else goes well for you.  

Irregular pulse ? Missed by pacemaker interrogation

by Selwyn - 2019-01-21 12:22:46

I am unsure as to what your print out showed.

My PM whould account for a period of atrial fibrillation ( AF) on the print out under the AMS ( atrial mode switching). I believe although AMS will detect  AF, if may miss irregular extra beats ( from atrial origin if there are not sufficient to reach the programe dection threshold, and ventricular origin beats are not accounted for ).

It is quite difficult to distinguish between extra beats and AF. Clinically, the pulse with extra beats is described as irregular, and with AF as irregularly irregular !!! 

I would expect some extra beats with severe hypertension. 

If the problem remains you will need a proper ( Holter) monitoring over 24- 48 hours or more.

Irregular after Pacemaker

by JoMarie - 2019-01-22 06:11:12

My printout was shown to my cardiologist who said he was satisfied that no electrical impulses were leaking through from the atrial to the paced ventricles - so I have had to accept that, although I was astounded nothing showed as the event felt quite severe.  I know it took ages to get AFib caught during an episode and then diagnosed, and think I will purchase one of those pocket ECG machines for the future, the ones which can connect to the computer and print out.   Of course, I am hoping this will not happen again as it has affected my confidence in a continuing trouble free future...

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