Pacemaker - Tachycardia question

[DanteTila]

Hi All,

A brief history of myself. I am a 24 year old male who was recently diagnosed with Celiac and I take Florinef for low BP. I had a pacemaker installed 2 years ago for two reasons. Firstly, my resting heart rate was around 30-40 and sleeping heart rate was around 20...but mostly because I had malignant neurocardiogenic syncope (severe fainting) which stopped my heart on numerous occasions causing head injuries. Finally it stopped my heart twice in the hospital and they put a pacemaker in.

Currently I had another black out after 2 years of success. The pacemaker clinic said my heart was going up and down too quickly for the algorithm set on the pacemaker and decided to basically set the threshhold so high that I pace at 90 almost all day.

My heart tends to be able to jump up to 100 and back down to 40 in a very quick time. They were unsure as to why this was, but they said the aggressive setting should keep me from blacking out. Now the cardiologist said I have quite a few rates of a 180+ tachycardia events recorded, with the highest being 210. He said they appear to be sinus tachycardia and I'm youing, so he is not too concerned but wants a loop monitor to check if it something more serious.

My question is, if the reason I got the pacemaker was for severe bradycardia and heart pauses, isn't it odd that I'm having HR's that high even sometimes? When I did a stress test 2 years ago, they had to stop the test because I could not reach a HR over 175. Now if I try to exercise, I am that high within 10 minutes. I feel like if i even go up the stairs, my chest is pounding and I feel weak. I have not worked out much lately due to this. Does this sound normal and am I just being paranoid? Also the person who evaluated my pacemaker said I tend to jump up and down, yet the cardiologist just shrugged me off. Is this typical as well?

I ask these questions because I have to wait 3 weeks for a loop monitor appointment.

Thanks.

[overactor2004]

hi dante, i totally understand bcuz im having very similar experiences ..i have a duel chamber pacemaker which is controlling my slow/brady heartrates but my fast/tachy 1s r getting worse (a-fib & some v-tach) causing me 2 faint alot again & get short of breath & exhausted easily with my heart thumping out of my chest.  my cardiologist & ep drs have both said yes its dangerous but nothings wrong (what??? u cant have it both ways!!!) & the ep dr is refusing 2 c me further stating she doesnt know what 2 do.  ive seen multiple ep drs in ny with no help, but i recommend u at least try 2 c some urself.  i know its tough but try 2 hang in there!

[PikaPika88]

Ksig is right.  He has those experience.  

My cardio told me my pacemaker has a build in holter monitor.  This pacer is not implanted recently, it's implanted in 2002.  At that time, most pacemaker already have a build in holter monitor.  You're sure your EP knows a lot of your pacemaker?  Have you try on internet to check what functions that your pacemaker have?  Are you on 2 leads or 1 lead?  Get your pacemaker interrogation report has a look.  Make sure the one that you have is turned "on".  Although my pacer has many many functions but most of them he turned "off".  Why I said that because the doctor has too many patients.  He can be mixed up and forgot who has what.  Especially if your doctor is near pension!

[DanteTila]

Thanks for the comments. He is an electrophysiologist. He seemed to think my high rates were not likely anything serious and that it is normal for a heart to go up and down like that. But on the other hand he ordered a 2 week loop monitor and told me the possibility of surgery or medicaition. Who knows, but the pacemaker lab seemed more concerned than him. Better that way then to have the specialist concerned!

Thanks again.

[ksig]

I am so sorry that you are experiencing the rapid highs and lows.  I agree with stevie_wonder in going to see an electrophysiologist for your rhythm problem.  I have had a pacer for three years and two weeks ago I had it replaced because the algorithm was not detecting my P waves when I was in AFib and could not pace me out of it.  My new pacer is working beyond my expectations.  I have had considerable work done on my heart and at times was on a boatload of meds. In a month, I will be med free and skipping down the street.  So if your pacer is not doing the trick, an EP can analyize your situation.  Good luck to you.  I know what it is like to have a pacer that does not function to meet my needs.
ksig

[stevie_wonder]

Sorry I can't help much with your concerns. Is your cardiologist an Electrophysiologist (heart rhythm specialist)? If not, it might be a good idea to try and see one. They are much better at diagnosing and treating heart rhythm problems.
Good luck and hopefully someone here will have some advice for you.
Take care,