AFib following PM surgery

I had a PM implanted in late December, 2014. In May, 2015 I experienced my first ever bout with AFib. Now I have had two more bouts in July. It seems to start at night when I roll over on my left side. I have felt something like a shock from the PM and the data on the PM shows that is exactly when I went into AFib. It seems to me that the PM is causing the AFib. My doctor says there is no correlation between the PM and the AFib, but I feel the "coincidence" is much too strong to ignore. Has anyone else every experienced this?

Jerrys111.

3 Comments

Actually it's the other way around

by Theknotguy - 2015-08-09 09:08:05

Actually it's the other way around, you're starting to go into afib, the heart acts funny, it wakes you up, the PM tries to compensate. You think it's the PM when actually the PM is trying to correct something and you feel it.

While the PM, in and of itself, can't help with afib, it can sense other things and try to compensate. Maybe your heart is stopping just before the afib session starts and the PM is catching that? Or it could be a whole bunch of other things. About the only way to find out is with a holter monitor. And maybe the holter monitor won't pick it up either.

Sorry I'm so flat about "that's not it", but I've been dealing with afib for quite a while. Have experienced the stuff you're going through now.

The good news is it sounds like you're another one of those rare individuals (like myself) who can feel their afib. The bad news is it sounds like you're another one of those individuals who can feel their afib. Great for knowing when you're going into afib. Bad for when they want to stick needles in your arm. You feel it when they miss the vein. After being in the hospital your arms feel like you're a living pincushion.

I did live through a period where my heart didn't like being "under the new management" of having a PM tell it what to do. But that was in the first 90 days of getting my PM. After that it settled down. You're well past the 90 day period so I don't feel it's a factor.

There are all sorts of triggers for afib. Discussions on the forum have indicated such things as chocolate and alcohol. And I think there is a correlation with the vagus nerve but can't prove it. Sounds like there is something with your physique that may trigger your sessions? But the doctors may tell you your afib sessions are randomly triggered. You can keep a log and see if you can spot a pattern.

While it may seem like you have quite a few sessions of afib, you're not up to the level of having the afib last for days, or have frequent sessions per day. Both of which would be a reason for an ablation.

Currently the only "cure" for afib is ablation. There are several different kinds of afib and each responds differently to ablation. Results range from having no afib to being worse off than you are. Physician skill comes into play too.

Another treatment for afib is chemical ablation via such drugs as Cardizem, Metoprolol, Sotolol, and Fleckanide. Chemical ablation has various success.

Some people have indicated an over the counter supplement of Magnesium helps too, but you have to be careful with dosages and to make sure the magnesium doesn't interfere with other medications you take. Since it's over the counter, there are no good scientific studies. Just word of mouth reports which are always glowing reports. Caveat emptor.

Some Medtronic PM's have a software program called APP (Atrial Preference Pacing). The software program can sense when you go into an afib session and the PM is instructed to go into a beat sequence that sometimes mitigates the afib. I had my APP turned on a five months with my PM. Over the course of a year and a half the APP did reduce the number and intensity of afib sessions. You can see it in the graphical printouts as well as the numerical reports from my PM. If your Medtronic PM has APP it may work for you. But that's a discussion between you and your EP.

I was told to have an ablation. But my EP has been reluctant to do the ablation because the type of afib I have doesn't respond well to ablation. Currently I'm using chemical ablation and the APP with my PM. I've had really good success and it's pushed the need for a medical ablation down the road. My EP has indicated I can yell "uncle" at any time, but since the number of afib sessions and the intensity of the sessions have continued to decrease, I've decided to hold off.

I know the afib sessions are a pain. But I suggest you do some research into your condition before jumping into doing something rash. A medical ablation can damage your heart and put you into a worse situation than you are. Going the chemical ablation route with the PM software may give you enough relief so you can continue with your life. You've only one heart so it's best to make sure you know your options.

Oh, and the only explanation I've gotten for the afib is that my grandparents swam in the wrong gene pool. i.e. it's genetic and I was going to get afib anyway. Fortunately (or unfortunately) I had the afib before the PM so I couldn't blame the PM.

Finally, you didn't mention if you have been tested for sleep apnea. I have sleep apnea and even with a CPAP will sometimes stop breathing. Even with the CPAP blowing air into my system, my brain will recognize I'm not breathing, dump a whole bunch of adrenaline into my system, kick off my heart, and sometimes send me into afib. If you haven't been tested for sleep apnea, that would be another reason for an afib session to be kicked off. If you haven't been tested, I would schedule a sleep study. Not to alarm you, but problems with your heart being kicked off by sleeping positions can also indicate other heart problems that may not have been diagnosed yet.

Sorry I'm so long winded, but I've been living with this afib for quite a while. The PM just added another layer of complexity.

I hope you can get some help for your afib sessions.

Afib with a pacemaker too

by azkaren - 2015-08-11 05:08:50

I just got out of the hospital after going into afib for the first time since my implant just over a year ago. I couldn't understand how it could happen, my insurance had dropped my cardiologist who I trusted with my life, ofcourse and I was scared. It took 2 days to get my insurance company to give in and tell my pcp the name of a cardiologist I could go to. When I got to the new dr I was sent to the hospital lickety split. I was in afib a total of 4 days. I had been on motoprolol and it was no longer working. I didn't respond to anything except my bp kept getting lower and lower. Eventually I was electro shocked and did convert. I was kept in the hospital one more day for my bp to return to normal, which is pretty low anyway.
I had awakened to the knowledge that I was in afib. I cannot imagine having my heart jumping around inside my chest and not feeling it! It is a miserable feeling and I feel badly for anyone who has to go thru this. The Knot Guy sure makes things clearer tho, doesn't he?

AFib following PM surgery

by jerrys111 - 2015-08-11 12:08:23

Well, I certainly appreciate the information you shared. I can tell you a few answers to the questions you posed. I do have sleep apnea (moderate) and use a CPAP. Interestingly enough, the first time I experienced afib, I was just talking to my wife when we first layed down in bed (had not put on the CPAP yet). As I mentioned, I rolled over onto my left side and felt shocks - then went into afib. The second time was in the middle of the night. I had awoken and rolled over onto my left side, felt shocks again, and went into afib. My doctor and the technicians assure me that the PM does not cause it - just as you stated. But "Wow", wouldn't you be suspicious? I'm afraid to roll onto my left side now!

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