paxil and IST

[KAD]

Hi, thanks for the opportunity this forum provides people with.  I was wondering if you had heard of prescribing paxil to help with IST?  My doctor wanted me to try it for tachycardic episodes with IST.  I tried it but all it seems to be doing is making me exhausted and very nauseated.  I thought these drugs were just for depression, which I do not have?  Do you have any success stories with this drug and ist?  Also my AAIR pacer at my last pacer check is pacing my atrium 98% of the time.  Is their any harm with pacing this much?  It seems like a lot?  How long do you think my battery will last with pacing this often?  It is a guidant pacer and I just had it put in this past Nov.  I'm 27, do you think in my lifetime I will have to have the leads changed?  Also, my pacer settings concern me a little.  My doc put my lower setting at 75.  Do you think that is to high?  It paces me at 75 while sleeping, is that ok?  How often do you recommend routine pacer checks?  Is every 6 months sufficient enough?  I still have very short tachy episodes show up of the interrogations.  They are as high as 220, but very short lived.  Since they are so short, I am not taking meds for them.  Do you think that is ok?  Thanks for all your time.  I sure do appreciate it!

[CCF-M.D.-MJM]

Hi KAD,

Paxil is occassionally used for inappropriate sinus tachycardia if the possible cause is anxiety or anxiety attacks.  This is a reasonable thing to try, but if it is causing more symptoms than it is helping, I would consider stopping it.

Is their any harm with pacing this much?

No

How long do you think my battery will last with pacing this often?

Depends on the threshold of your pacer (how much energy is needed to pace) and the pulse duration (how long the pacer maintains the pacing current).  The more you pace, the shorter the battery will last.

do you think in my lifetime I will have to have the leads changed?

I hope not, but it is possible.  If you ever have an infection, they will need to come out. If one fractures or breaks, it is possible to put in a new lead without extracting the others.

Do you think that is to high? It paces me at 75 while sleeping, is that ok?

If it is a rate responsive pacemaker, you  can always set the device to a slower basal rate knowing it will increase if you need it (exercise).  Most devices have a function that slows down the rate during sleep hours.  you can ask your doctor if your device has this.

How often do you recommend routine pacer checks?

For a new device, every 3-6 months should be ok.

Do you think that is ok to not take meds for short bursts?

If you aren't having symptoms, that should be ok.

Hope this helps.

[Lyn2]

KAD,
My pacemaker is programmed in AAIR as well.  I pace in the atrium 100%, and my low rate is set at 80bpm.  My nighttime rate is 75.  I have paroxsymal atrial fibrillation, and my EP doc. explained that the rate is set high because my atrial arrythmias are often triggered when my rate goes down.  It really has helped reduce episodes.  When my rate goes up into the 200s I know I am no longer in a sinus rhythm.  My own rhythm barely goes above 50bpm. Your situation sounds alot like mine.  My problems started with my first pregnancy.  I am in my 30's now, and continue to take multiple meds. to control arrythmias.  
Good luck!

[cryingheart]

You're only in your 30's and you have a pacemaker. you should post on compassions question. This person needs to know what could happen after a pregnancy when she already has PSVT. If you knew you'd end up with a pacemaker after having a kid, would you have done it? Sorry, I just feel some people are giving that person false reassurance about pregnancy. Can you go swimming with a pacemaker?

[DottyCece]

I have a pacemaker and can go swimming, exercise and do everything I want to except take direct hits on the pacemaker site.  I am not handicaped in any way.   There is no reason my a pacemaker alone would make it unsafe to be pregnant and deliver a baby.  The real problem is why is the pacemeaker necessary?  If there is a cardiomyopathy of some sort then that may be a risky situation.

[Lyn2]

I agree with DottyCeCe.  The problem is not the pacemaker, it is the underlying problem.  People with pacemakers generally can do whatever they want, provided the underlying problem is treated.  Often all that is needed to treat the problem is the pacemaker.  Other times, arrythmias exist or various levels of heart disease.  Pregnancy is a special issue, but should be treated on an individual basis.  I was a little bit brief with my explanation about how I got the pacemaker.  I started with problems during my pregnancy, due to complications, then I had three ablations which resulted in the need for a pacemaker.  I am going to read the post from compassion and see if I can help.  I certainly don't want to alarm someone, if their situation is entirely different.