A-Fib after pacemaker insertion.

I had a Bos. Sci. PM installed 1/14/15. I had a-fib while still at hosp. They ran an ekg imm. after. the nurse said that I had had an a-fib event. Went home next day and recovered well. have felt great since. But last thursday afternoon while sitting i had another "event" that came on suddenly and lasted at least a minute with hard pumping and quivering pain and breathlessness. Took a nitro and it went away. felt weak for a while after that. Next day called Device lab and informed them but it didn't show up on my monitor, she said that that type of "event" would not show up on my monitor. She wanted me in next day as having the pain "go away" from taking the nitro concerned her but couldn't make it that day so will go in on Monday for sure, My question being to any one out there is "can one have events of A-Fib even after having PM installed"??

3 Comments

Yes, you can

by Theknotguy - 2015-03-07 08:03:46

I'll repeat my note to a person who previously posted and was asking about afib.

The best way I can describe afib is to tell you to jump up from your chair, run around the block as fast as you can, then come back in and sit down. Your heart will be pounding, you'll be gasping for air, and either slightly or really dizzy. The only problem is, with afib, the symptoms keep going on and on. They don't stop and sometimes get worse. If you go into afib with RVR your heart rate will go way up, you won't be able to get air, be very dizzy, and possibly black out. Afib with RVR, if it isn't medically treated, can kill you.

I'm one of the very fortunate people who can feel my afib, know when it starts, know when it stops. My wife, on the other hand, can only tell when she's in afib because she's short of breath and feels like she's has the flu.

There are several kinds of afib. There is also a-flutter. The doctor's haven't identified my afib type, and I probably have several kinds. Based upon the way my afib sessions feel, I can tell you they are different. Most of the time I get what I call a "benign" afib. I know I have it, but I also know it will go away. Afib with RVR is very dangerous. Actually all afib is dangerous because there is a chance blood will pool in the heart and form a clot. As soon as the heart resumes normal beating, it can pump the clot out which, in turn can cause a stroke or heart attack. Once you go into afib, the danger of having a clot pumped out lasts for up to 30 days. So even though your afib has stopped you can still be in danger of having a blood clot pumped out and having a stroke.

You'll need to be on a blood thinner for the rest of your life. Doctors still prescribe Warfarin/Coumadin. I call it rat poison and refuse to go on it. Pradaxa gives some people stomach problems. I'm on apixaban/Eliquis and like it - under the circumstances that is.

I have a procedure I'm supposed to go through if my afib goes into RVR. I also have a procedure to follow if I go into the "benign" afib. Most other people are supposed to go to the ER and get treated. I don't take afib lightly, I'm following doctor's orders in my treatment.

Usual treatment for afib is ablation. Results of ablation can be anywhere from total removal of afib to no changes. Worst case is to have ablation, have to get a PM, then find the afib is as bad as it was or worse. Some cases of afib can't be treated and the patient is left in afib - sometimes for years.

I also have a Medtronic PM, it has APP (Atrial Preference Pacing) which is a software program that helps mitigate the effects of afib. I had APP turned on five months after having my PM implanted. While it wasn't and overnight change, the APP did help reduce the number of afib sessions I had. I don't know if Biotronic has anything similar, but it is something to ask.

There are medications for afib. They call it chemical ablation. Success is anywhere from 100% to none. It just depends upon you and the type of afib.

For me, they tried rhythm control of afib with didn't work. So I can't talk about it. They're using rate control. They give me medication to slow my heart which reduces the number of afib sessions I have. The medications slow my heart to below what would keep me alive so they use the PM to bring my heart rate up to a normal rate. I still can get afib and do. But until the sessions increase in number or intensity my doctor has advised me not to go for an ablation.

It may take some time for the doctors to hit on a combination of medications that will regulate your afib. Sometimes they find out quickly, other times it can take months. You can also run into a situation where a medication works for a while and then doesn't. So you may be switched around.

You can live with afib, it isn't comfortable. I don't really have any suggestions other than to follow your doctor's orders.

I hope they can find a solution for you quickly.

Absolutely Yes

by NiceNiecey - 2015-03-07 10:03:18

Welcome to our exclusive club, C130. The Knot Guy gave a splendid and thorough explanation of aFib. The short answer to your question of whether one can have it after PM insertion, however, is a resounding YES.

My PM was placed in an emergency situation so I have no idea what I had going on prior. But after I got the PM, I began having episodes of aFib almost immediately. I also developed a blood clot very quickly. I've been taking a beta blocker since then. After the initial treatment phase for the clot, I've also been taking a baby aspirin each day.

For some reason, heat really bothers my heart. Last summer (it was in the low 70s F), I was working in our yard when an episode of aFib and total arrhythmia came on. Although I had what I call a "funky rhythm" for hours, my PM only showed an episode of aFib lasting 50 minutes. After that, I avoided any strenuous activities in heat. A couple other times I felt it start to come on again so I quickly stopped what I was doing, got inside air conditioning, drank cold water, and laid down, successfully averting another bad situation.

One of my friends (in her 40s) is in aFib ALL the time. She was on a med that made her feel lousy, and, ultimately, didn't work so they took her off that. She has also been ablated a few times.

Keep in mind that the PM is primarily there to keep your heart from beating too slowly. Unfortunately, additional problems often accompany PM insertion. I don't know whether it's the chicken or the egg. I'm just grateful God has given me another chance.

I hope this helps in your understanding of the new friend in your chest!

complications

by C130 - 2015-03-09 11:03:16

Thank you's to The Knot Guy and Nice Niecey for responding. I went to PA this a.m. and explained what happened on the evening of insertion of PM and this past Thursday afternoon and how I had come about to thinking that it could have been A-Fib. They checked my readings from the PM on both days at the pacer lab and found NO readings at all that it was A-Fib. They say that they are at a loss to know what those two "events" were (other than to say that it may have been angina) that had hit me. So they cut down on one of my med's and upped the dosage of another of my med's.
So I left the hospital with zero explanations to what it is that had happened and the worry of will it happen again and if it could be worse the next time round!
Thanks again for your concerned and helpful posts!

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