Much more frequent pvcs and pacs four weeks after implant

Since I had my pacemaker implanted four weeks ago I have had many more pvcs and pacs which are uncomfortable.  My Apple Watch picks them up and I have about 4-6 per 30 sec. ECG  and they are fairly constant.  I just want to know if this is common after implant and if experienced, when does it seem to calm down.  My first doctors appointment after implant isn't for another 4 weeks. I did have  checkup with the nurses in the clinic after 1 week and I did experience chest tightness and dizziness when the lead to the ventricle was paced which they said was very unusual.  Chest X-ray and echo were ordered and as far as I know were fine.  I have since reported the increase in ectopic beats and the nurses at the clinic seem unconcerned and act like I'm a bother so I have stopped reporting them. 


Frequent ectopics

by Gemita - 2024-03-09 12:59:23

Hello Cindy, PACs and PVCs disturb many of us and there can be many causes.  Yes I experienced more of these and more of my other arrhythmias too in the first three months following implant when my heart was still healing.  

Other causes could be electrolytes and thyroid abnormalities, and other health conditions like an infection or lifestyle changes (too much caffeine, stress, lack of sleep, alcohol).

I expect the nurse wasn’t too concerned because they ordered an echo and chest X-ray and these came back relatively normal.  But of course what counts is the patient, you, and if you are symptomatic with your ectopics and they are happening too often, you might need some help before you see your doctor in 4 weeks.  Do you have any medication prescribed by your doctor that you could take, like a low dose beta blocker?

Get plenty of rest and keep well hydrated.  Dehydration, lack of sleep, stress can all be triggers for ectopics.  They can be truly difficult to tolerate.  Most of us know them well and we do understand how uncomfortable they can feel.  Let us do everything we can to stop them


by Penguin - 2024-03-09 15:25:35

Yes, I agree with Gemita - although my own initial disturbances arising from the operation were quicker to settle.   I'm sure Gemita won't mind me saying that her arrhythmia are more frequent and serious than mine and therefore the timing probably relates to this in part.  Things should improve as your body settles back down. I would mention it at your follow up and see what the advice is, but its not unusual. 



by Lavender - 2024-03-09 18:45:06

I'm thinking this has to do with healing. It's early in the process still. I had a lot of PVCs after my implant but they calmed way down in time.

Your reaction to the lead testing is something that others have experienced.  I'm more concerned that you're feeling too intimidated to report things to your cardiac team. Please don't ever feel that you cannot call them with questions.  That's part of their job. 

Do you have a bedside monitor? If you utilize that or an app, it would catch anything amiss and report it.  


by USMC-Pacer - 2024-03-09 20:53:45

In agreement with everything above. Most of all... relax. Stress can, and always will cause increased anxiety, BP, and of course palpitations which cause more stress and anxiety. Like Gemita asked you, I'm hoping they put you on a beta-blocker which will help to calm things down. Go for walks or whatever helps you to relax... good luck


by piglet22 - 2024-03-10 06:12:18


Have you checked your pulse by another method?

Try radial pulse or BP/oximeter monitor.

PVCs can start any time during your pacemaker lifetime and can cause the same problems symptomatically as you might have had before the PM was fitted, such as dizziness

You can get a pulse rate well below the minimum set on the PM and still be told that the PM is working well.

My pacing consultant simply said PVCs come and go.

Yes they are treatable or suppressed by beta blockers but you can pay the price by being in a state of permanent physical fatigue.

I'm trying to wean myself off Bisoprolol by gradually dropping the dose from 10 mg to 5 mg daily.

On 10 mg, I can get around but any incline does me in.

It's the devil or the deep blue sea.

Ectopic beats

by Cindy1 - 2024-03-10 21:15:33

Thanks for all your comments.  I guess I was just asking if people had a major increase in ectopic beats and for how long after pacemaker implant.   I had a history of frequent ectopic  beats prior to implant  but after the implant they have increased significantly.  ( I'm currently four weeks post implant. ) I have been on 10 mg of bisoprolol  for a long time but never helped the ectopic beats.  I was on diltiazem as well for a long time which helped somewhat but my doctor too me off of that once I started getting frequent pauses.  He mentioned that might be a possibility again post implant.  
I actually am less nervous about my heart now that I assume the pauses will be controlled by the pacemaker.  Since the ectopic beats also are accompanied by some dizziness and fatigue and are fairly constant at this point I find it draining.  


by piglet22 - 2024-03-11 08:54:17

Mine took 18 years and two pacemakers to surface, 7 years after the last PM.

The pacemaker cannot control the ectopics and can make matters worse if it senses them and counts them in as real beats.

Bisoprolol doesn't a;ways work and can be a sledgehammer.

In the longer term, newer pacemakers might be able to distiguish between a "normal" beat and an ectopic. I don't understand why they don't already. Afterall, the clue is in the name, ectopic or out of place. If it doesn't fit the pattern, take it out.

You might think that extra beats would be a good thing, but if they don't pump effectively and introduce pauses into the PM generated timing, then it can introduce problems it's supposed to fix.

You know you're wired when...

You’re officially battery-operated.

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