Pacemaker and tachycardia

  I am a 35 y.o female who has Lown-Ganong-Levine Syndrome. Had 2 ablations about 6 years ago, with good result, however have continued to have another form of tachycardia since, not so fast, around 180-200 beats per minute. This happens regularly, nearly every day, and I feel other thumpings etc a lot. Last week I had a holter monitor and it showed lots of abnormalities, including tachycardia, 1st and 2nd degree heart block. The Dr put me in hospital and I had EPS, and a permanent pacemaker (2 chamber) was put in. After that I developed ventricular ectopics, in runs, which made me pass out. This lasted for days, as well as adrenaline surging all the time. Back on Tenormin, ectopics stopped, and home I go. Back to hospital 5 days later with more problems with arrythmias. Now I am home again, I am still having my usual morning tachycardia and lots of what feel like single ventricular ectopics, (dozens and dozens per day). My ventricle is pacing all the time according to the data on the pacemaker. Is this going to be an problem always I wonder? I realise the heart block is fixed and that was serious, but I still don't feel great and wonder whether there is any more that can be done to help? My doctor says I have a very complexly abnormal conduction system. I would appreciate your view.
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Dear Helen:
Your problem is indeed very complex.  It is not clear to me whether, in addition to your atrial arrhythmias, you also have ventricular arrhythmias.  You state that you passed out from what sounds like a ventricular arrhythmia.  If this is true, then the approach to treating you may require different medications and therapies.  An EPS study, if it were a complete study, might have been able to detect ventricular arrhythmias, which can be quite serious.
It may also be that the paced beats are uncomfortable for you.  While the Tenormin may decrease the ectopics, it may also make the heart block worse, causing your heart to utilize the pacemaker more often.  Again, a different medication may be more appropriate.
If you wish to be evaluated here at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist who specializes in heart rhythm problems at desk F15.  Information provided in the Heart Forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your doctor.

[BobbiSalgado]

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