Technical Question re: AV Delay

Hi all, I have a question regarding AV delay and I hope someone can explain it simply to me and how it might be impacting what I feel when the PM kicks in. (Sorry up front for the long post)

History:Medtronic Sensia Dual lead for 2nd Degree AV Block, old Dx of Inappropriate Sinus Tach, and sprinkling of PAC/PVC's. Pacing about 3% of the time. Low rate set at 50. Don't know enough to include what might be other pertinent info.

Saw the Doc and Pacer Tech, after wearing event monitor, I am told that every "event" I recorded was related to paced beats...with "a few PVC/PAC's not many". My AV Delay was too wide (it had been adjusted at least 3 times by the tech previously in hopes of decreasing the sensation). Wed was the first time I actually got to see the EP since surgery. He looked over everything and shortened the AV delay, as he felt I was actually experiencing a Pacemaker Type Syndrome d/t the AV Delay too wide. He, the Doc, says I may have to learn to live with this even though most people are not aware of it. He also said that if I absolutely could not stand this sensation, that he could go back in and reposition the leads to make the circuitry more like God intended, but he would really NOT want to do that for fear of infection and other complications (I agree don't want to do that). Anyway, I do feel some better, but I can still sense when the PM kicks in, then after a short while (maybe 1-2 minutes) my heart rate speeds up (around 105 with what I perceive to be some skipped beats too) and then slows back to the 60's -70's. I generally only pace when up and moving, especially with upper arm movements like hairwashing, etc.

So, I guess my question is : When the PM kicks in, I assume that means my HR has dipped below the 50 mark right?. But then why does the rate speed back up even faster, skip a few beats, and then return to normal. Does the AV Delay have anything to do with this or is it just me? Do you think extra beats are "tricking" the PM? Anyone else ever have a similar "problem? Any thoughts on this would be appreciated.
Thanks for all your support thru the last 2 1/2 months. Carol

2 Comments

Terry

by Terry - 2007-12-14 08:12:11

I like your Dr's. opinion that your heart should contract the way God designed it to work. To me, that means His-bundle pacing. But though there are hundreds of patients with His pacing in Italy, this country is a little slow and I only know a few EPs who do it.

PM skipping beats

by pak - 2007-12-15 09:12:38

My dad had PM inserted 12/6/07. His heart is healthy, but beating very slowly, at rest only 32 b/m.
PM set for 50 b/m. Feeling well.
Biggest complaint is the PM skips a beat OFTEN. Help! Is this normal? Dr. says this is nothing to worry about.
Has anyone experienced this? What was the resolution? Do you know any sites where I can research this issue?
thank you pak

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