IRHB with pacemaker dependence

I had AV node ablation and I am pacemaker dependent. My pacemaker is dual chamber. I have prolonged periods of irregular heatbeat. I understand that my atrial  tachycardia persists, but I thought the pacemaker was supposed to keep my heartbeat regular. Any insights?


5 Comments

Some confusion here

by AgentX86 - 2019-06-05 12:09:56

When you say that you have a "dual chamber" pacemaker, I'm assuming that you mean a "biventricular" or "CRT" pacemaker. A "dual chamber" pacemaker commonly means an atrial lead and one ventricle lead.

A pacemaker can only add beats. It cannot stop beats started somewhere else in the heart. Since you have had an AV ablation, there won't be any atrial activity causing arrhythmias (assuming the above is correct) but you're still open to PVCs, which can be as bad (worse, IMO). They should feel different (worse) than what you had before.

I have the same situation. My EP had my PM turned up to 80bpm to try to minimize these PVCs (bigeminy, in my case). It sorta works, at the cost of a more uncomfortable heart rate, all the time.

Thankful Reply

by BRK - 2019-06-05 12:25:38

Thanks. Yes, my pacemaker is Bi-V, sorry for the confusion. I am able to feel my tachycardia even though my HB is usually normal. The periods of contiuous irregular heatbeat can last for several hours. This does feel similar to how I felt prior to the AV node ablation. Can PVCs be continuous like that? I used to get PVCs before I had persistent arrhythmia. They were usually momentary even when they repeated frequently.

AV node ablation and irregular heart beat

by Selwyn - 2019-06-05 17:49:43

It is possible to have more than one conducting AV node! Hopefully, not in your case. [He says, having had two ablations for atrial fibrillation- sometimes things get missed). 

( further reading is at 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3893335/  ) 

The ventricular arrhythmia situation, given your symptoms, should be diagnosed. You need to catch your palpitation symptoms on a ECG ( EKG), perhaps with a monitor.  Best to seek advice early as some of the ventricular things can be dangerous. 

 

Certainly get things checked out

by AgentX86 - 2019-06-05 21:03:28

No doubt.  You want to get to the bottom of this, sooner than later. I assume you have a remote monitor device.  If not, forget the rest of this paragraph.  When I started having bigeminal PVCs (didn't know what they were) I did a remote transmission to my clinic.  I didn't catch the bigeminy and they could tell nothing from the transmission (I had wrongly assumed that my pacemaker recorded everything "unusual" - they don't).  About a week later I managed to catch it, so they could identify the issue.  This is a sure way to catch your arrhythmia.

An alternative would be to invest in a Kardia Mobile.  Depending on the model you can perform a one or six-lead EKG, using a cell phone.  You can then email the results to your EP for analysis.  The device can be had for between $90 (one lead) and $150 (six lead EKG).  I carry the one-lead (bought it before the six-lead model came out) version around with me.

Thanks everyone

by BRK - 2019-06-06 09:20:33

Thanks to each of you for the info. I have an appointment with my cardiologist/electrophysiologist next week.

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