I'm Confused

Ok, I need some help! I am very confused as to what is going on with my heart, and I thought that maybe someone here could help me understand things a little better.

I had a sinus node ablation in November, which has left me completely dependant on my pacemaker.

I have never had problems with my ventricles or AV node...all of my problems stem from the atria and SA node. When I went in for a follow-up, my doctor found that I was having some episodes of non-sustained VT.

I know that the heart beat is initiated by the SA node, or in my case, the pacemaker to make the atria contract, and is then followed by the AV node to make the ventricles contract. So how is it that my heart rate will not go above 130 because of the pacemaker settings, but my ventricles are beating at 150-200 bmp at times?

I am really confused. I have done a lot of research, and learned alot about the heart's electrical system, but this one has me stumped. Someone help me understand!

Thanks,
Amanda

1 Comments

BillMFl

by BillMFl - 2009-02-03 11:02:36

There are at least three locations in the normal heart that can initiate a signal. The sinus node and av node are the primary ones. In addition, it is possible to have unintended signal pathways that can cause unwanted contractions. Feedback loops, etc. I have little confidence that even a good EP can sort out every electrical problem that some patients have. The good news is that brief PVCs are not considered medically significant. The bad news is that they still make us feel very uneasy. I don't pretend to know all the possible sources of your PVCs, but I have been told that a pm can induce them even tho its not supposed to. Read up on "pacer sydrome" and its various manifestations. I was told I had a mild version of pacer syndrome and to just get used to some SVTs and PVCs because they weren't bad enough to justify intervention. Lowering voltage to the leads can sometimes avoid the signal leakage via unwanted pathways. Sorry I don't have good answers, but in 7 years I never got real good answers from the techs or the docs. They see a very normal sinus rythm on my ECG and figure I'm exagerating I guess. But my interogation history records the events, so I know they happen. You can color me CONFUSED!Hang in there and keep pushing for answers. Good luck.

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