Ventricular Trachycardia

Hi Everyone.  I had my yearly checkup today and found out I had an attack of ventricular trachycardia two weeks ago.  Other than that, everything was good.  I felt the attack and thought it was a couple of missed heartbeats but, apparently, it was a 9 second attack with my heart beating at 230 beats per minute.  The cardiologist on call at the clinic prescribed a 5mg beta blocker and I am seeing my regular cardiologist tomorrow to, I suspect, begin a series of tests to find out what happened (or is happening).  Right now, I am feeling a little lightheaded but as I am really upset with this news, it could be anxiety.  My questions:  could this just be a one-off - anyone else had this?  and, as I understand beta blockers are for tachycardia and my dual pacemaker (July 2016) is for type 2 heart block and is set at 60 beats per minutes.  My resting heart rate is usually around 65 BPM and my blood pressure is around 120/70.  Sounds like a contradiction to me -pacemaker for low heart rate and beta blocker for high rate.  Any comments? 


Contradiction? Not Really

by Gotrhythm - 2019-02-21 14:04:27

I understand your confusion, but it's actually easily cleared up with a couple of facts about pacemakers.

Pacemakers can only make a heart go faster. They can't slow your heart down. (It's an accellerator, not a braking mechanism.)

Your heart can still go faster than the base rate set by your pacemaker, and the pacemaker can't control it.

To control the V-tac, you might need medication. The medication will make it go slower and the pacemaker will keep the heart from going too slow. 

By the way, where there is one arrythmia, it's not uncommon for another arrythmia to develop. I used to just have sick sinus. Now I have sick sinus and heart block. Getting upset is understandable, but it really won't help.

Beta Blockers & Pacemakers

by catthree - 2019-02-25 23:33:27

Based on my experience, not a contradiction. Due to almost 50 years of competitive endurance athletics (bicycle racing and distance running) my resting pulse was around 48, and I was told it sometimes dropped as low as 38 when sleeping. I developed v-tach around age 65, at which point I was given an Implanted Cardiac Defibulator (which also has a Pacemaker component)  and put on a beta  blocker as an anti-arrhythmic (i.e. to help prevent v-tach episodes). But  because beta blockers also slow down HR, the PM side of my ICD was set to keep my HR from dropping below 50. Exactly your case: beta blocker which slows the heart, but PM to make sure it doesn't get too slow.

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