Arrhythmias after pacemaker implanted

My mother had a pacemaker put in 5 days ago. She's still in hospital and while I was visiting she became a bit weak with high BP but then everything settled down. A nurse told me that last night she had 2 arrhythmias which shouldn't happen after pacemaker surgery.

This morning a doctor asked if she felt strange during the night last night and Mom said she didn't feel anything because she was sleeping. The doctor said she might need an adjustment on her pacemaker.

Is it normal to have arrythmias with a pacemaker?

14 Comments

Arrythmia after pm

by musser75 - 2010-05-04 10:05:06

Hi,
arrythmiaz can occur after pm implantation. Indeed, there are a lot possibilites and different types of arrythmias. I assume that Your mother has atrial fibrilation during these episodes. Nevertheless, I can advise You to ask her nurse or doctor in a respectful way about the type of the arrythmia.
Best Wishes
musser75, MD

maybe

by Tracey_E - 2010-05-05 06:05:31

Ok, here goes! I'm going to be contrary this morning. :o) The nurse's statement that arrhythmias don't happen with a pm is inaccurate. What kind of irregular rhythm are they talking about? All a pm can do is speed up a slow rate and smooth out an irregular beat by adding beats. It can't control what the heart does on its own, all it can do is watch and record it as an event.

I disagree with musser's assumption that it's probably afib. There are many other things it could be. Just ask, much simpler than assuming based on your short description.

And I'm gonna disagree with Renee too. Some arrhythmias can be fixed with programming, it depends what type it is. Sometimes the pm can correct it, sometimes the pm can't fix it but it can be programmed so that we can't feel it as much, sometimes medications will help it, sometimes it's just there and not treated.

It's very common to need it adjusted. The standard settings it comes with aren't right for everyone. It's also a very easy thing to do, if you didn't yet know that. It is done by computer and only takes a few moments.

Two short episodes while she's sleeping are probably nothing to get worried about. It's possible it's something she's had for years and it's totally harmless but they're only catching it now that she's monitored more closely. Wishing your mom a speedy and uneventful recovery.

Renee

by SMITTY - 2010-05-05 08:05:06

Renee, when it comes to pacemakers you should learn to "separate the wheat from the chaff" before trying to correct some one with Tracey's experience and knowledge. And yes, the information you get from the likes of Mayo Clinic and the pacemaker manufacturers will be loaded with "chaff."

By your own admission you are new to this game so it would be to your advantage to at least learn the location of all the players before trying to get to deeply involved in the game.

P.I.T.

by sputnick - 2010-05-05 09:05:10

I had a pm implanted in Jan 09 cos my heart was stopping for up to 10 secs at a time. I seemed to have a lot of what I call "flippy- floppy" feelings with my heart which I found really uncomfortable and didn't like. At my last pm checkup about 6 weeks ago the tech said that I had been suffering from Pacemaker Induced Tachycardia and changed my settings, and although I still have odd irregular heartbeats the change is really quite noticable. Maybe like the others have said she just needs the settings altered!
Best wishes to her Jan

yes, Renee

by Tracey_E - 2010-05-05 11:05:33

Well, I was going to mention my personal experience having arrhythmia fixed when my pm settings were adjusted, but I'll just blow Smitty a kiss instead.

Renee, by definition an arrhythmia is any abnormal beat or electrical activity. Not all arrhythmia are EXTRA beats. Perhaps you're confusing the word with fibrillation or tachycardia, both of which are types of arrhythmia which have extra beats and a pm can't really help. It can, however, also be missing or slow beats, both of which can be fixed when a pm fills in beats and smooths things out.

Did you read the whole page on the link you included? Your quote comes from the pacemaker section of the list of treatment options on it's arrhythmia page. Perhaps that means Mayo also sees pacemakers as a treatment for arrhythmia? ;o)

thresp, I apologize for hijacking your question. I hope your mom is doing better and you have some answers by now.

Arrhythmia After PM

by SMITTY - 2010-05-05 11:05:33


Hello Thresp,

I'm in total agreement with Tracey. In fact I started to write something similar but the spirit wasn't there last night. But everyone should realize that there is nothing absolute about pacemakers and what they can or cannot do. My thought was the nurse had little idea what was happening and again it was a case where that person thought they had to give some answer. Unfortunately it is also entirely possible that they thought what they were saying was correct.

As for pacemakers not stopping arrhythmia, while one didn't stop mine completely, it reduced it by some 80 to 90% and all that was done was increase the lower set point from 70 to 80 BPM. That even had the cardiologist saying "it is amazing how a small adjustment like that can make such big difference."

As for answering your question, "Is it normal to have arrhythmia with a pacemaker?" the answer is yes, but it is not confined to just getting a pacemaker. It has been my experience any time some procedure involving the heart, from bypass surgery, to having stents implanted to getting a pacemaker, there will be an increase in arrhythmia. I have always accepted it as the hearts payback for being disturbed. Or more likely, it is just the result of the trauma the heart experienced during and after the procedure.

Pacemakers. The only thing consistent about them is their inconsistency. When you start giving answers about them or pacemaker related problems, you best leave yourself an opening to retreat through.

Smitty

Doctor Patient Liason Available?

by heartu - 2010-05-06 03:05:01

You want to understand what is going on with your mom so that you can trust the doctor and his recommendations for your mom's speedy recovery.

The body is much more complex than a car engine. Everything has to work in a certain synchronization in order for us to not only to stay alive, but to function as a healthy disease free organism.When something fails to work properly in the body we have great people called doctors who can seem to work miracles. I believe that a truly great doctor may not be the one with all the answers, but one who doesn't give up until he finds an answer.

Unfortunately, there is no manual that can give us easy answers to all our questions or dilemmas. To help your mom. ask detailed questions and write down the answers.Make them explain what you do not understand. If the hospital has one, see if they have a patient- doctor liason. Sometimes it is hard to get answers directly and this is the job of the liason. They will explain in simple layman terms what is going on and what treatment is recommended.They will stay on top of your mother's treatment.

Using the internet is great if you can understand all the scientific terminology. People on this forum can provide you with a firsthand account of their own experiences, however, their experiences may not be analogous to what is going on with your mom. Just know that there are a number of electrical problems that can occur in the heart. Some can be easy fixes, other more complex. An "artificial" pacemaker is one that takes over the function of our own natural pacemaker when our own is failing or faltering. One size does not fit all. It takes some fine tuning to get it just right, possibly along with some meds. Don't give up and don't be frustrated and come back here and let us know how your mom is doing!

P.S.

by Ashregan - 2010-05-06 12:05:34

Also googled "pacemaker arrhythmias and cleveland clinic" and went to "how are arrhythmias treated at the cleveland clinic" and this is one of the options I found:

" Permanent pacemaker
A device that sends small electrical impulses to the heart muscle to maintain a normal heart rate. The pacemaker has a pulse generator (which houses a batter and a tiny computer) and leads (wires) that send impulses from the pulse generator to the heart muscle, as well as sense the heart's electrical activity. Pacemakers are mostly used to prevent the heart from beating too slowly. Newer pacemakers have many sophisticated features that are designed to help with the management of arrhythmias, optimize heart-rate-related functions and improve synchronization."

So in reference to this last statement,we should all keep in mind that management of heart rhythm problems is a work-in-progress---consequently wouldn't it make sense to be grateful and open when others bring up new or unfamiliar/even surprising facts/information--often the explanation of differing opinions is going somewhere in the middle, not a black or white static kind of situation.

Have It Your Way

by SMITTY - 2010-05-06 12:05:58

Renee,

Have it your way, or more accurately believe anything you wish. I will say you have definitely mastered the art of taking things out of context or applying your interpretations to whatever is stated.

No where did I say Tracey, or anyone here (I will make you the exception) knows more about pacemakers than those experts you quote. What I said was separate the wheat from the chaff, or in more simple terms, separate the B.S. from facts learned from experience. Just don't try to tell those of us that have lived with these electronic gadgets for some number of years that everything will be as the experts (including those at Mayo Clinic) tell us. The results may be better than stated, they may be worse, or they may be exactly as we are told to expect. When you learn to accept those facts fewer of your comments here will be challenged.

Smitty

the devil in the details

by Ashregan - 2010-05-06 12:05:59

I was interested in this question of whether pacemakers help with arrhythmias since I've had a general impression of hearing differing ideas about this here and there.

So I googled "Mayo Clinic and arrhythmias" and found the topic/link "Arrhythmias-Diagnosis and Treatment Options at the Mayo Clinic".

Here is one of the Mayo statements that I found at this Mayo site:

"Depending on the cause of the abnormal rhythm, arrhythmias can be treated at Mayo Clinic with:

Surgery
Medical devices, such as pacemakers
Nonsurgical procedures
Medications"..

So it does seems as if this Mayo Clinic posting is saying that some arrhythmias can be treated with a pacemaker.

Confirming of course the complexity of the cardiovascular literature, the need for knowing quite precisely what you are referring to in terms of conditions and terms when investigating this literature.

And IMHO the futility of getting into simplistic "Is NOT! Is TOO!" types of arguments when considering such a broad and changing scientific field of reference.

Thank you!

by thresp - 2010-05-07 09:05:06

WOW! What an animated group! (Obviously those pacemakers are working pretty well!) I read the comments during the week but was too tired to reply before now - Mom's been in the hospital for almost 2 weeks and this is my first night non-visitation this week.

Thanks for all of your comments.This pacemaker business is pretty much new to me and I wanted a first-hand account from people who have experience with them. Since the PM surgery, Mom has still had weak spells and that's when I was told she was having arythmias - I think she had them before. To make matters worse, she went into delirium with hallucinations for a few days. This has cleared up and the doctor figures it was caused by the stress of being in ICU - she's now in rehab where it's much quieter.

At least she's not fainting like in the past and hitting her head on the floor. It's heartbreaking to see your parent so badly bruised from a fall over and over again. Mom is 85 but still sharp as a whip She was driving last year at 84 but decided to quit when she started having fainting spells. She moved into a retirement home where she's made many friends. Although she's 85, she looks and acts younger than the 70-year olds there and I know if she gets over this she's still got a lot of good years ahead of her which she deserves. That's why when the doctor told us she needed a pacemaker we were happy thinking this would stop the fainting and Mom could go back to a normal life - there's nothing else wrong with her whatsoever besides the heart problem.

Mom has atrial fibrillation (it's in the family - Dad died at 42 so I'll be getting it from both sides - one of these day's I'll be typing firsthand too!). She's in rehab but still weak, although she just called me as I was typing this and sounds much better. I'm hoping this weakness thing will go away and hope to talk to the doctors/nurses although you pretty much need to be there when they show up because they don't have schedules.

Thanks for all of your comments - I thought perhaps the pacemaker wasn't working like it was supposed to but I now understand that what she's experiencing might not be related to the PM but the PM will likely help. I've learned a lot just from reading your posts.

Christine

wuw!!!

by Hot Heart - 2010-05-07 10:05:38

Almost lost the will to live by the time i got half way through these comments! lol.

I got pm for total hb, think i was probably getting afib before i got pm but thought it was menapause related (not knowing at that time that i'd got a heart irregularity).

Apparently in first 6 months post pacing had thousands of afib episodes, then the next 6 months almost none.

Had rr switched on 6 months ago, dont feel like ive had any afib,but will let you know when i have next interrogation.

I was fitter during the second 6 months, when I had less episodes, and I also started drinking alcohol again during the second 6 months, having been tee total for 8 years previously.

Sooo, what stopped the afib? who knows? Was it brought on because I was nervous, did it go because I became fitter and occasionally tipsy??? I suppose no one can answer those questions.

Glad You Found Help

by SMITTY - 2010-05-11 03:05:40

Hello Christine,

Glad you got some help from all the comments. I have often thought that getting help here is at times like walking across a cow lot that is holding lots of cows. There will be stuff you want no part of that you will have to walk around or step over to get to what you wanted. But be patient and careful and if you are lucky the reward will be the worth the trip.

Before anyone says anything, yes I am aware that I'm one of those that spreads some of the unwanted stuff. If I didn't many of the trips would be awfully dull.

Smitty

Pacemaker mediated arrithymias

by tarsha - 2014-12-28 07:12:59

I was just diagnosed with arrythemias caused by my pacemaker (not caused by my heart). I went to the University of Michigan because I wanted a second opinion. They did 2 hours of various tests. I was shocked when they said that the pacemaker was causing my problem. This is serious.

Anyone who is having arrythemias - after getting a pacemaker - needs to be checked for this. Medications won't correct it. It's called PMT.

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