hate this feeling

So as I have posted the last couple weeks I have had some complications post AV node ablation (particulary pericarditis). I spent 2 hours in the cardiology office last week and ended up coming out with a new mode of pacing. I feel absolutely terrible with this new mode. I cant find any way to descibe it other than it feels like my two ventricles are complelely out of sync. I know that is rare, but possible. Maybe my atria and ventricle is out of sync. I dont know. I know that they switched me to this new mode that is DDDIR. I have a lot of atrial tachycardia. I am set right now 90 to 130. Even at 90-100 I feel like something is thumping in my chest. Something feels totally off. Has anyone had experience with this mode before? I dont known if it is just mode switching when I get up and active or what. My previous mode was just DDDR until just last week, which felt better until I got to higher heart rates (about 130 my atria was competing with the pacemaker and screwing it up). Any thoughts?

6 Comments

??

by pete - 2009-08-18 02:08:01

Your lower 90 rate set seems far to high to me. Should be in the region of 70. If you have had an av node ablation your atria will be permanently out of sync with your ventricles. I would ask them if there is any reason why they cant put it back as it was before as the pupose of medicine is to make you better not worse. Cheers Peter

Feeling Abnormal Beat

by bobad - 2009-08-18 02:08:12


The doc wanted to try a certain mode on me that was supposedly a little more efficient. When the tech switched it, all I could do is hold my chest and say "Ak! Ak!..." The tech looked at my doc and said "He doesn't tolerate that too well". And he was right. It felt awful. So yea, some patients can easily detect an abnormal beat.

DDDIR

by sam78 - 2009-08-18 03:08:01

The best way I can describe what this mode would be that it is the same as DDDR but when I have atrial tach it switches to a non atrial sensed mode to ignore the atrial tach.

They are suppose to lower my rate but they said that because it is new they had to set it at 90 and then will lower it monthly. I personally dont understand why they have to do that.

The thing that I dont understand is why did I feel ok with the DDDR mode (except when I went fast which then it skipped and raced and got all confused)? I didnt feel like my heart was beating out of sync then. I could understand if I felt this way when my heart rate would be in the upper limit because my atria could be beating faster and be put in the block, but I feel this way all the time even when my heart rate is in the 90-100 range. Doesnt make any sense.

um

by Tracey_E - 2009-08-18 04:08:38

If it turns off atrial sensing, what is setting your ventricular rate when it goes into that mode? The ablation probably left you completely dependent on the pm for ventricular pacing. Does it leave you at a flat 90 bpm when it senses tachy?

weird

by Tracey_E - 2009-08-18 08:08:56

If the new settings don't feel good, call and ask to be seen again. My first thought is you have a lot going on and it's going to take a few tries to get your settings right so you may need to have some patience with them. I had similar problems more than once over the years, it has taken as many as 7 or 8 trips back to get it right. But it did get right in the end! :o)

Do you know what DDDIR stands for? I haven't heard of that one. Maybe Frank or Smitty will know. Did you get a copy of the report?

I agree with Pete, 90 is a very high low setting. Do you know why they put it so high?

I don't know that you'd feel it if your ventricles are out of sync. You'd feel symptoms, probably tired and dizzy, but not the actual beating. Your atria and ventricle probably ARE out of sync, the pm is doing that on purpose every time you have tachy. If your atria rate jumps to 200, the pm is only going to let you get as high as 130. Two things are probably happening. The pm makes your ventricle to beat when the atria does, until it gets to 130. When your atrial rate gets above 130, the pm will keep you at 130 unless it senses you are in tachy, then it is probably programmed to put you in a 2:1 block, which means if your atrial rate is 200, it'll pace you at 100. It will take some tweaking to get this just right so you do not feel the transition.

I can see that DDDR (rate response) would not make you feel good because it artificially raises your atrial rate when it senses exercise. If you already have atrial tachy and your sinus node goes up on its own anyway, rate response would compete with your own atrial rate and make you feel lousy. Rate response is best for people with atrial rates that drop off, not atrial tachy or ventricular problems.

I just went throught that

by CharlyB - 2009-08-24 01:08:22

New Doc came in and Swtiched me to DDDIR due to the Significant amount of Tachys I was having Fel horrible also, Like I could be laying down watching tV and my heart would beat HARDER, I went back and My current EP was there she Was Upset and switched me back , she stated that In DDDIR I don't Synch kinda like pacemaker syndrome, so I am Now back to DDDR I feel my usual Fast HB but not that other crap I was feeling.. So I know How you feel, DEMAND they switch you back...

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