I'm new to this....

I just received my 1st pace maker 2 weeks ago tomorrow. Every time I get up and move around, I fell little electric shocks in my chest area....as soon I am sitting still, they calm right down. I said something to my doctor about this at my last check up and he said something about my heart & pace maker not working together. He has given me a RX of Diltiazem CD ER to control heart/pacemaker rhythms. It is not helping, that I can tell. This constant "flicking" feeling in my chest is driving me bats-it almost hurts sometimes. Has anybody else experienced this? If so, how did it work itself out? Any suggestions will be much appreciated.
Thanx, Stevers

7 Comments

Shocks From PM

by SMITTY - 2008-10-13 01:10:16


Hello Stevers,

I wish I could say I agree with Frank, but I can't. Not that I think he is wrong, but his knowledge of pacemakers and their operation is so much greater than mine that I am unable to follow all that he is trying to tell us. But, I'll put my money on him being right again.

I will try to add a little to the discussion. First let me say I've lived with something very much like what you describe for the 8 years I've this thing. Actually I got a 2+ year reprieve when I had it turned off. Then a couple of year later it had to be restarted and here come the shocks again. This time I had the nerve that was being affected by the electrical impulses from the PM deadened and the electrical shocks stopped.

From your description of when the shocks start I wonder if the rate response on your PM is on. My reason for asking is that to me it sounds as if your pacemaker is not needed when you are quiet physiucally and just goes along for the ride until you start some physical activity. When that happens the rate response starts the PM to helping your heart maintain a steady rhythm and with that come the shocks. Then you sit down, your physical activity decreases and the rate response goes back into its wait and see if it is needed mode. I should add, I'm just kind of thinking out loud here and not trying to make a statement of fact.

Be all that as it may, I think Frank told you what you need to do to get a solution to your problem. As many of us have learned it sometimes takes several settings adjustments to get the one best for a particular person.

One other thing, if you ever find out why the doctor gave you diltiazem I hope you will let us know. I've been taking diltiazem for almost 25 years and while it is a wonderful medicine for me to control hypertension and eliminating some minor, but continuous, angina I know of no other benefit I get from it not that I need anymore.

Good luck,

Smitty

Reasons for the "shocks"

by maryanne - 2008-10-13 08:10:04

Hey Stever.....

Well Frank and Smitty have both given you some valuable information.

The mono polar pacing is a valid comment as is the rate control....which like they both said requires investigation with the pacemaker clinic...if you are having concerns then you have them review the data have them make adjustments if necessary.

Having a new PM takes time...you are new with this...you are only 2 weeks into having your PM it still is healing and with healing people often get twitches or what I call flutters....regardless if this is new it should be investigated.

As for the Diltiazem shame on the doctor for prescribing that without further investigation. To answer Smitty's question, Diltiazem is a Calcium channel blocker...this drug not only helps with hypertension but it is one of the drugs used for rate control in atrial fib. I shouldn't assume but something tells me the doctor thought that your "shock" like feelings could be indicating you were in atrial fib and hence wanted to get you on a rate control drug. Did he by any chance do an ECG on you at that time to confirm his supsicions?

Welcome to the club and best of luck to you!

Sometimes...

by heckboy - 2008-10-13 12:10:16

Hi,

I'm 48 and have been pacing for over 4 years. Sometimes when I get my PM checked, my site starts to twitch like crazy...and a couple of times it happened at the gym too. It's only happened a few times and I plan to mention it at my next checkup.

This doesn't sound like what's happening to you...if they feel like little pin pricks, it could be severed nerves. Some of them can be sharp and feel like shocks, but it goes away after time.

Good communication...

by dward - 2008-10-13 12:10:37

I was going to write something very close to Maryanne. I too had many strange flutters, little shocks, strange feelings that were hard to describe.
In addition, the PM seemed to increase my PVC events! (A pacemaker doesn't stop PVCs.)

What I would like to add to all you've read so far is: really try to describe what you feel, when, and where on your body. Write this information down and re-read it a couple of times. Don't wait until you are at your Doctor's or doing you PM check-up.

I know some of us on this site get very frustrated with doctors, but they call it "practicing" medicine for a reason.
But more importantly, Doctors are people and when it comes to how you feel,(in many cases) they can only go by how you describe what is going on.

Dull pain vs. sharp pain
Flutter vs. numb feeling
When I'm sitting vs. when I am walking.

They thought I had nerve damage or a lead was too close to my phenic nerve - because I had numbness and twitching in my diaphragm approx. three months after my PM, turns out it was still healing and it cleared up totally.

So Maryanne makes a good point that it may be that you need to heal a little more.

Also - if your medication isn't working at all, I would let your Doctor know. thai may help him zero in on the real problem. Again - communication.

Good luck with your journey...

D. Ward

Frank...

by heckboy - 2008-10-13 12:10:53

So that's what the twitching could be? At my phone check, the muscles around my site were dancing like crazy, but the person at the other end was clueless.

I wonder if there's another cause. I have my leads replaced by w well respected specialist and several checks since then were fine.

Went to the gym today and it didn't happen at all.

Typical response from doctor

by ElectricFrank - 2008-10-13 12:10:54

The first thing the doc does is throw a med at it since he/she doesn't understand the basis of a pacemaker and the hearts electrical system.

The first thing you need to do is get a followup programming session, preferably by a representative of the pacermaker manufacturer. Request a copy of the pre and post programming printout. Several of us here can help you understand the report and make suggestions.

The first thing I would suspect is that your pacemaker is operating in mono polar pacing mode. This means the the return current from the pacing electrode goes back to the pacemaker through your body rather that through the lead wire. It is delivering a small shock to the muscles of your chest and causing the twitching.

There are two reasons for this type of programming. The first is that is was set that way at implant out carelessness or lack of understanding. The second is that the lead is either defective or improperly installed in which case the pacemaker reverts to mono polar as as backup measure. In either case the solution is to fix the problem, not try to medicate around it.

good luck,

frank

Flickering feeling myself...

by sidgirl74 - 2011-03-09 03:03:21

Hello there,
I had my PM done on Fe. 16th and have also felt the flickering. It is not uncomfortable at all. I feel it at night time when I sleep on my left side (PM side) - so I adjust and it goes away. I've felt it a handful of times since I left the hospital. I've had 2 office visits and they say that if it gets uncomfortable to call them and go in; however, their opinion is that the wires are settling in the way they are supposed to. So being patient is one thing I am doing right now but as listed above in a lot of these comments if it's uncomfortable you need to speak up and not wait for a follow up appointment. I COMPLETELY agree with what someone wrote above... in regards to communicating accurately. "It feels weird" just doesn't cut it... it is the heart we're talking about after all - pretty serious stuff. So, thank you everyone for all your wonderful and honest feedback. I've learned 2 things since I joined a couple of weeks ago... #1 go at your own pace and don't compare yourself to anyone and #2 pay attention to what you feel and communicate that accurately.

Best Wishes.
CID

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I have had my pacer since 2005. At first it ruled my life. It took some time to calm down and make the mental adjustment. I had trouble sleeping and I worried a lot about pulling wires. Now I just live my life as I wish.