Pacemaker Club: Needs advice

Needs advice

by daisy0388
2012-11-20 03:11:17
ICDs
1416 views
1 comments

I have posted on here off and on since I got my pacemaker after 3 ablations. I found out almost 2 months ago that I have accelerated junctional rhythm. It didn't bother me too much at first the the last 6 weeks have been really rough with the palpatations and dizziness. Almost 2 weeks ago my dr put me on multaq, I have been trying to give it time to work but I continue to feel worse every day. Its getting bad enough that whenever I am sitting or laying down and get up my heart starts racing. Yesterday at work it was beating so hard you could see my pulse moving in my neck and it was more than a little bit. After it calmed down some I was completely wiped out and was told I was white as a ghost, that I had no color in my face whats so ever. I called my dr but he won't be in til tomorrow. He told me that if this drug didn't work he might have to go in and ablate the av node and switch out my pacemaker to a dual chamber instead of a single. My dr is usually pretty good at listening to me but sometimes I don't think he realizes how bad I acutally feel on a daily basis. My question is how long should I give this drug to work, the longer I am on it the worse I seem to feel. I have tried many other drugs but couldn't handle the side effects. Also I would love to hear from anyone else who has had av node ablation to see if it helped and what the recovery time is.

1 Comments

Accelerated junctional rhythm

by golden_snitch - 2012-11-21 03:11:34

Hi!

Multaq didn't work that well and my accelerated junctional rhythm for me either. It slowed my AV-node down A LOT, so that my pacer had to pace my ventricles much more than before. If you don't have a dual-chamber pacer, yet, it could be that you are experiencing heart blocks while on Multaq. When did you have your latest holter monitor?

I'd still say give Flecainide or Propafenone probably in combination with a betablocker (Nebivolol is one that most patients tolerate very well) a try. That worked for me for about two years! Yes, I know, you tried different drugs before, but if I remember correctly, you did not try them in particular for accelerated junctional rhythm, but for sinus tachycardia. So, again, accelerated junctional rhythm differs from sinus tachycardia and also responds differently to drugs.

Maybe your doc realizes how bad you feel, but knows that the AV-node ablation should really be the last resort.
My EP professor knew that I'd most likely not tolerate Sotalol, that it would make me feel awful, but he said, before doing an AV-node ablation he wanted me to try every single drug available. He did the ablation when Sotalol failed, but this was also because I had different arrhythmias, not only accelerated junctional rhythm; I had to many to ablate one by one (and had already undergone seven ablations). AV-node ablation did the trick for me. I'm doing much better now, no more arrhythmias.

So, my suggestion still is that you try all the drugs you tried for sinus tachycardia again, give them all a chance, before you go for an AV-node ablation. And what also helped in my case for a while was to set the lower rate of the pacemaker a bit higher, so instead of 60bpm, have it at 70 or 80bpm, so that it's faster than the accelerated junctional rhythm.

Best
Inga