PVC’s /Palpitations.?

I have been scheduled for CRT-P on August 22nd.  I have mentioned in previous post that I was concerned about palpitations and questioned whether I should have the CRT-D instead.   I did see on screen during ECG the rapid increase in HR while feeling palpitations.  Unfortunately, there was no one in room to capture it, I had not learned that part of job yet.  I did get the doctor in ER to order me a Holter, and increase my Beta Blocker prescription which GP had not followed through on.  That was almost 3 weeks ago, handed in the Holter yesterday after 24 hours in which there were some palpitations but, of course, not as bad as before.  What I have noticed now with the change in meds is with less palpitations I am having a lot more PVC’s again.  Does this make sense?

Last week I went for Venogram and also managed to get appointment with Cardiologist the same day, which is great since that hospital is a 5 hour drive from home.  I just wanted to talk, but of course everyone gets an ECG before seeing doctor, which just caught a quick rise and fall, back to 60.

Conversation with Cardiologist was good.  He said that my EP was very good and I needed CRT, and would feel much better after procedure, defibrillators could sometimes cause more issues, and I am in good hands.  I did feel a lot more confident when I left, but still concerned.  When I got home I contacted Pacemaker Clinic to see if could come in and check history, she is very nice but said I would have to get my GP to refer.  Yesterday she called me to let me know that the Cardiologist I had seen requested it be done before I go for new device.  Of course, now I am concerned that they will find an issue and I will have to get CRT-D, no pleasing me, hey?

Venogram showed narrowing of vein where there are already two lines, two more lines might be pushing it.  

I wish that 20 months ago, when I got my Pacemaker, everyone could have just taken a few days to do more tests and find out what was really needed.  My heart      is weaker now, three leads in beginning would have prevented damage done since.

This is when dozens of people respond and tell me the same thing happened to them and they are doing just fine 10years later.  Feeling a little discouraged.

OK now, the storm clouds have lifted and the sun is shining, I will go out and weed the garden while the soil is wet. Have a nice day,

Chapter 🌹

 


5 Comments

Clarification

by Gotrhythm - 2019-07-18 13:46:37

When you say "palpitations" do you mean A-fib episodes that you can feel?

I really get how frustrating it would be to have to travel 5 hours to see a cardio. Try as I will, all the questions I have, never occur to me during the appointment.

CRT-P or CRT-D

by AgentX86 - 2019-07-18 15:36:10

I don't see anywhere you talk about the cause of your palpitations. Palpitations are a symptom, and a very generic one, at that. In any case, no pacemaker is going to fix palpitations. It's not their function. Their purpose is to make your heart beat when it wouldn't by itself. As we say here, it's an accelerator not a brake. There is absolutely no difference between a CRT-P (pacemaker) and a CRT-D (implantable cardiac defibrillator), in this way. A CRT-D would be of use if your problem were a dangerous ventricular arrhythmia .(e.g. V-tach, or V-fib). My guess is that you have PVCs,  or something similar).

 

Palpitations ?? or Tractor in my chest.?

by Chapter - 2019-07-19 01:57:37

I initially got Pacemaker for Bradycardia Nov 2017.  I was at hospital for elective surgery which did not proceed because my heart rate was down to 30, and BP over the top.  I had not been feeling well for a couple of months before hand but had put it down to my Lupus.  Within a couple of days I had a new Pacemaker, and a couple of days later I started having very strong PVC’s.  Wasn’t long before was told that Pacemaker was now pacing 100% and I have complete heart block.  By the summer of ‘18, I was told my EF had gone from 55 at time of getting Pacemaker to 32-35,  and meds were started.  

All tests have confirmed I am otherwise healthy but heart is not.  This past Spring I have done all the tests and now I need a CRT because LV is not keeping up to RV pacing. The PVC’s continue I feel them on my left side and they are very visible.  I have what I call palpitations - which is a rapid increase in heart rate from a resting 60 to 120+.  I can feel it in the centre of my chest and pulse verifies.  Lasts for 2 or 3 or 5 mins and then drops back to resting, happens several times a day.  Makes me feel dizzy and nauseous.  I do know the difference between a Pacemaker and a Defibrillator, and Afib or Ventricle Arrhythmia.

Since I do have an Arrhythmia, my concern is that I want to know for sure what is going on before procedure in August.  If it is Afib I deal with it, if it is ventricle then I would like something to “Brake” as you say, AgentX86. I have Pacemaker to keep my heart beating and meds to stop it from beating to hard or fast.  I was hoping that Cardiologists would be able to tell me for sure what is going on so that we don’t have to try again next year.  They tell me I should have got CRT-P in the beginning but that did not happen so now I worry a bit about what we are not doing this time.

Thank You for your replies,

Chapter 🌹

Tractor pull

by AgentX86 - 2019-07-20 00:22:03

Your "cardiologist" should have some clue about your condition.  I hope you're seeing an EP and not just a general cardiologist.  This should be a relatively easy case because it happens daily.  A 24-48hr Holter should be able to nail it without any problem.  In fact, you should be able to capture it with your PM. 

You didn't get a CRT from the outset because they don't implant them for mere Bradycardia, unless the patient develops pacemaker induced crdiomyopathy (there are standards for these things that insuranc companies enforce).  You now won the sweepstakes so get a shiny new box.

Communication

by Gotrhythm - 2019-07-20 15:35:34

I want to narrow things down, so that I can, hopefully, get to the essence of your question. 

I can certainly understand why you don't want to find out a year from now that you need a defibrillator. How frustrating that would be! When, if you had only known, you could have had one at the time the CRT was installed. I can understand that you feel like something similar has already happened and you don't want it to happen again. Who wouldn't feel that way?

I understand that you have palpitation episodes (something different from PVCs) that are concerning to you. I do relate. I once found myself in a similar position, with palpitations that no doctor seemed to take seriously.

Here's what I don't know:

I can't tell from what you have written if the palpitation episodes are the same as the heart racing episodes or something different. And I wonder if you are saying you think the heart racing episodes are some kind of A-fib? --or am I missing the point?

You say you know the difference between a pacemaker and a defibillator. You clearly are up on your medical terminoloty and I believe you do. What I can't quite understand from what you have written is what condition are you afraid you have, or might have in the future, that would make a defibrillator neccessary.

What do you think would be different, better, if you got a defibrillator at this time?

Ulttimately, I don't know if you're afraid you have a problem that isn't being addressed, or, having been disappointed once by a pacemaker, if you are looking for reassurance (which would be totally understandable given what has happened.)

Please be patient with me. I do want to understand and help if I can. I hope we can sort this out so that you get from the group the actual help that you are asking for.

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