PVCs/PACs - Settings

I've had a biotronik single chamber for bradycardia set to 60/50 am/pm since August 2015. Last May 20 it was changed 50bpm 24/7 without complications. In mid-June following an extremely painful and stressful dental health scare, I started to have what sound like PVCs or PACs, a heavy thump followed by what feels like a skipped beat. It was happening a few times a day, mostly a few at a time, sometimes up to about 10 in a row. But when I went for a walk a few days ago they were almost constant for more than hour, before subsiding to minor episodes for the next two days. Yesterday they nearly constant for 20-30 minutes when starting a walk, before mostly subsiding for the day. My blood pressure has generally been in the low 100's over upper 50's to low 60's, and mid-50s to mid-60s bpm. With no noticeable onset of anxiety, dizziness, brain fog, dehydration, etc. I'm wondering if anyone has experienced anything like this from a change of settings, and what the experts here might advise. I'm one of those set-it-and-try-to-forget-it type of pm recipients. But is great to have this forum to turn to when things get weird. Any comments would be appreciated. ~Rod  



by AgentX86 - 2019-08-28 08:38:46

Sure, a change in the rate setting can unmask PVCs that were already there. They increased my heart rate to 80bpm, daytime, just to bury them again.

You should see your EP about this to make sure that's what's happening. If possible, capture them on your remote monitor. Your PM may or may not capture them (mine didn't). In either case, once captured, these will be easy for your PM tech to identify and then your EP can figure out how to handle them. If they are PVCs, the chances are that they're completely benign, though perhaps uncomfortable as all get out.


by Bhamster - 2019-08-28 10:21:17

Thank you! Yes, uncomfortably weird. If you don't mind me asking, did you later drop back down from 80bpm? ~Rod


by AgentX86 - 2019-08-28 13:45:11

No, I'm still at 80bpm, daytime, likely permanently.

Because of a risk of SCA, they start AV ablation patients out at 80bpm, for a month or two. Then back to 70bpm for another month or two (if all goes well then to 60bpm). That's where my bigeminal PVCs showed up, so they put it back to 80 and left it there. I still get them but not as often or as long. My rate is set to 50bpm at night so I can sleep but the tradeoff is occasional PVCs.


by Bhamster - 2019-08-29 07:20:10

Thank you, this helps. I'm hoping to see an EP soon (not easy in France). My concern is the way what appears to be PVCs has worsened with exercise. So I'll be a little more careful until I can get checked out. ~Rod

PVCs and exercise

by AgentX86 - 2019-08-29 12:45:26

Make really sure that you're well hydrated. Dehydration is a sure path to PVCs. You might want to think about magnesium supplements, as well. Potassium and sodium are big, too, but we almost always get enough from out diets. Particularly sodium. BTW, one of the best sources of magnesium is dark chocolate. ;-)

Late pacing

by Pacedmyruns - 2019-08-29 20:42:55

Not sure why your paced but it could be pacing you late. I had that where the changed my settings to get my own heart to work on it’s own and in turn, I paced late. Felt like the thumping you describe and it was only when my HR Was 80-100 range. 

PVCs and exercise

by Bhamster - 2019-08-30 07:48:28

Thank you for the helpful reminders, AgentX86. Dehydration, magnesium, potassium, sodium could well be factors. It's been a hot summer in S. France. I'm gonna look at magnesium suppliments & dark chocolate ;-) Though I didn't have this problem when living in the Caribbean (Cozumel, MX) and set at 60/50bpm.   

Late pacing

by Bhamster - 2019-08-30 07:58:34

Thank you, Tiffsterty. I have an appointmen to see an EP next week and will bring that up. My HR was 60-70 range when the PVCs? kicked in almost non-stop for ~90 minutes. I had not felt any thumping like this before when exercising. And don't recall much of this going back to first nights after the pm implant in 2015.  

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