100bpm thobbing heart + cold limbs 3 wks after pacemaker

hi, my Mom is 69 and had bradycardia set in, so had a 2 lead-wire PM installed 3+ wks ago.   Today she was about to tell me she was finally feeling more like herself after being somewhat weak for these 3 weeks,  but today she had two 5 minute episodes of her heartrate rising to about 102, while lying down.  Legs & arms were very weak and shivering cold.   Also the heartbeats were very strong.  It went away and came back 10 minutes later but not as strong,  lasting more than 5 minutes, mainly feeling shiveringly cold for the 5 minutes.   (It's a 30C day today but she has AC)    

Her resting heart rate is now about 96-100, but according to her, not "throbbingly strong" as it was during the "attacks" about 1 hr ago.  (2:30pm on Mon.Aug1 2011) However, the pulse in her wrist feels quite strong to me now,  much easier to detect compared to other times I've taken her pulse.

I will monitor her overnite and we'll call her doctors tomorrow.  (Today is a national holiday)   we'd appreciate any info in the meantime, thanks.
Steve

P.S. 3 hrs after the attacks her HR has dropped to 90bpm resting,  but it used to be 74bpm during the 3 wks following PM install...

[ksig]

My suggestion is for you to take your mom to the doc.  When they implanted the pacer, the tech and doc programmed the pacer to what they thought would suit your mom.  Apparently her pacer needs to be adjusted.  It took me several trips to the pacer clinic to find the settings that best suited me when first I had my pacer implanted.  I am on my second pacer and again I had to go in for a couple adjustments at the beginning.   It is probably the rate response switch that needs a bit of a tweak.  Not to worry as this is an easy fix.  Make it an outing and go out to lunch, too.
ksig

[swon001]

Thanks for your reply,  
we did go to the pacemaker clinic yesterday, and the nurse/specialist did another pacemaker computer scan like before, and didn't find anything out of the ordinary.
However the PM only records certain types of episodes. She says at least the PM didn't malfunction in any way, but there could have been some other kind of reaction and maybe she would need her medications (such as bloodpressure pills) adjusted. So we've also made an appointment on Friday with the cardiologist from the ER as well--he might tweak her meds, or have some other insights.
We're not bothering with her regular family doctor though.

The nurse/specialist did adjust one inconsequential setting for us, but it's not going to change much, she admitted. (This setting was for the upper BPM that the PM would go to, lowered from 130 to 120BPM. She said she wouldn't do this for a younger active person, and that this change was neither here nor there, and could be changed back if we wanted.)
Oh, also she adjusted so that the PM would record incidents when pulse was above 150, instead of above 180bpm.

She had also mentioned that sometimes vessels dilate, which causes the blood pressure to drop and for people to feel cold. I suggested we might get a home BP tester cuff. She said that if this happened again in the near future, that we wouldn't necessarily have to come in again...
Hopefully the cardiac doc will have further advice when we see him friday.

having thought more overnite,  about something the nurse did yesterday:
She has lowered the maximum rate of the pacemaker from 130beats down to 120beats.
Well she mentioned that next time the heart tries to go above 120bpm, (say 140),  only the upper part of the heart will pump at 140, the lower part, will only go up to 120 maximum,  the lower heart is controlled by pacemaker (because of the "stage 2 electrical signal block" ), and so the heart would be out of step,  upper at 140, lower at 120.   This may be exactly what happened during the attacks on Monday--fast throbbing heart rate, but little blood flow (feeling freezing cold & weak).  
Maybe.  
So I think it could be exactly opposite to what she should have done,  maybe she should have raised the pacemaker maximum setting upwards, to 150bpm,  so that if the heart wants to go 150, both the upper and Lower parts will go 150 together and still pump well.  If the upper is 150 and the lower only 120, then maybe that's when the heart feels really throbbing and it doesn't pump efficiently because the upper and lower heart and fighting each other pumping back and forth 150 vs 120....   I'll try to call the clinic and ask today...

Steve