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Pacemaker & Gallup Rhythm

Dear Doctor,
You have helped in the past and I appreciate your on-line opinion.  I have a Medtronic Dual Chamber Sensia PM.  Implanted 10/07 for Symptomatic 2nd Degree AV block.  I have had a normal Echo post PM implant, worn an Event monitor, worn 24hr Holter, and had Nuclear Stress Test that I was told showed no "Blood Flow Problems"...although I did exhibit Bigeminy that made me feel sob- I requested to stop the treadmill ( d/t being frightened) and proceeded with Persantine stress.    
PMH- 55 yo post-menopausal.  IST, HTN,IBS, Anxiety/Panic attacks 30+ yrs ago.
I will meet with my EP Doc on 1/15 to discuss formally the Holter and Stress results but I was told by his Pacer Clinic nurse via telephone that the "arrythmias" I am experiencing during activity and that coincide with my symptoms are actually Pacing episodes, and that I am one of the minority that can feel it kick in.
What I have been experiencing is an increase in heart rate to about 100-110 with position change (but sometimes happens at rest or wakes me up) I get a couple of heavy beats then HR slows down (I think this is when pacer kicks in) but it feels VERY uncomfortable , like my heart will pound out of my chest and throat-I can feel it near my Rt clavicle too.  I feel like I have to sit down to rest.  
My question/concern- I had a co-worker (former cardiac nurse) listen to my heart during one of these episodes-she said I had a "gallup" that sounded like "Tennessee".  When the episode settled down the "gallup" disappeared.  She scared me with talk of "stiff ventricle". Never heard this before PM, could that be causing it since its only heard when PM kicks in? I will mention it to my EP but value your opinion as well.  Thankyou
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Avatar universal
Thanks for your thoughts on my situation.  
***Would you know of any EP doctors in Florida who might enjoy a challenge such as myself?  I live in South West Florida, but would be willing to travel within the state for a second opinion.  Or,  since I am originally from NE Ohio,  I may be able to make a trip home for consultation....if so, which Dr at CCF would be most interested in pacemaker challenges???  By the way, CCF is an awesome institution, I received my E.T. Nursing certification there and hold it in the highest regard....sorry I digress.
Thankyou Doctor,    Sincerely, Carol
Helpful - 0
230125 tn?1193365857
MEDICAL PROFESSIONAL
Diastolic dysfunction (aka stiff ventricle) is usually apparent on the echocardiogram.  There are specific Doppler maneuvers to tease this out.  It is more like that you are symptomatic with your pacing.  This can be the pacing itself (the act of pacing the right ventricle) or could be what is called pacemaker syndrome.  Pacemaker syndrome usually makes people feel lightheaded, more fatigued, or pulsing in their neck. Sometimes this can be improved by changing the interval between atrial sensing or pacing and ventricular pacing to minimize ventricular pacing.  Unless they didn't see it on the  echo, I doubt this is a stiff ventricle.  He may have heard the Tricuspid valve closing before the mitral valve as that also may happen with RV pacing.

I hope this helps and that you feel better soon.
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