Junctional tachycardia treatment

Are there any pacemaker setting changes, or any therapy other than beta blockers or channel blockers for junctional tachycardia?


8 Comments

don't think so

by Tracey_E - 2019-05-08 09:20:09

The pacer is a gas pedal, not a brake, so if the heart goes faster on its own the pacer can only watch. Depending how fast it is, I've heard of them increasing the lower rate to pace out of it, but that would only work if the rate isn't too high. There's a limit to how high they want our resting rate. 

Junctional tachycardia treatment

by wantok - 2019-05-08 10:06:37

Thanks, Tracey.  Do you have any idea of how high the resting rate can be set?  I know I have some wiggle room as I am set at 50 at the moment.  Also, the weird thing is that a Medtronic techician who supposedly was trying to help with this brought my top rate down to 110 as I told him my tacchycardia usually put me at 120, saying he could "monitor" what was happening?

Resting heart rate

by AgentX86 - 2019-05-08 11:40:04

I would doubt that an EP would set a resting rate above 80ish (someone here was talking about 85). A resting rate of 100 is a sure path to cardiomyopathy.  My daytime rate is set to 80bpm to try to bury PVCs. I don't like it much but it's better than PVCs.

settings

by Tracey_E - 2019-05-08 12:40:18

An upper limit of 110 just means it can only pace you to 110. Your heart can go as fast as it wants on its own, the pacer will just watch. As Agent said, a resting rate over 80-85 is probably as high as they'd go so if your tachy episodes are 120's, you probably don't have much choice other than meds. If it's really bad they can sometimes ablate. 

Junctional tachycardia treatment

by wantok - 2019-05-08 22:33:12

Thanks!!  So why would the technician change the upper limit in regards to this issue?

I'm not quite sure if (Tracey) you are ruling out the raising of the rate to 60 or 70.  This would only work if my junctional tachycardia was in that range.  So with 120 (it is always over 100), it's meds period.  (This is so terrible since me and meds get along sooo poorly.)

settings

by Tracey_E - 2019-05-09 09:31:12

I don't know why the tech would change the upper limit for this, doesn't make sense to me but I'm also no professional. I would ask to see the doctor, not the tech, to get your questions answered. A resting rate of 120 is asking for trouble. Techs can make tweaks but any serious tinkering should be done by the doctor. 

I was saying they will usually be willing to raise the lower limit as high as 80, but if your tachy episodes are higher than that it may not do any good. 

Junctional tachycardia treatment

by wantok - 2019-05-09 22:03:26

Just got back from my EP.  He said they can do ablations for junctional tachycardia.  I can't explain it in technical terms, but they go in and see where the culprits are that are causing the arrythmia and if they can ablate without causing AV block, they go ahead.  If not, they pull out.  So I am almost sure I will be going ahead.

good plan

by Tracey_E - 2019-05-10 09:38:10

If they think they can get it with ablation, that's what I would choose. Drugs have side effects, a high rate not only feels bad but is hard on the heart. Zap it and be done with it! The worst risk of ablation ending up with a pacer. Been there, done that :)

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