PM playing up....

Hi, I am new to this site and reasonably new to a PM... I have a question in relation to a complication and wondered if anyone else had suffered the same... a little back ground first! 

 

In 2015 I was diagnosed as having complete heart block, my pulse of 28 apparently wasn't good. I was fitted with a PM and life was wonderful, well for 4 months... I had to have a CT scan and during that a cannula became loose and was reinserted, not the best idea as I ended up with sepsis, stalphycoccolus which resulted in endocarditis, pneumonia etc etc. After 10 weeks of hospital treatment my device was removed and a 'leadless micra' inserted as a temporary measure as I'm dependent. 5 weeks later a new dual lead was put in but on the right side of my chest due to the previous infection... which then 6 months later was removed and another inserted back on the left. This was all good but over the last 4 months I've struggled... I'm a 38 year old female in a demanding job and so I train/exercise daily. Well no more... when running I started to get severe chest pain that went to my shoulder, neck, jaw and head... then went through times where I couldn't even take a breath in due to the pain. I went back to my cardiologist who ran tests and there is no heart disease which is a blessing but what they found was when the PM got above 160bpm it was cutting out and I was going back into a 3-1, apparently this is unheard of... I wondered if anyone else had gone through the same? 

I am having another device change later this week that will apparently solve the problem but I've had no answers as to why this happened and I have baffled the surgeons...

i look forward to your responses 

 

Thanks 

1 Comments

turn that off?

by Tracey_E - 2017-10-21 09:39:30

That sounds like a safety feature for afib. It senses a high rate and thinks it's doing us a favor by putting us into an artificial block to slow the heart rate down (afib causes racing but the heart is quivering more than beating). That's great if you're in afib, it's like hitting a wall if you are just exercising. I have no history of afib so for me they turned it off and the problem went away. Well, that part did. 

Sometimes that's only part of the problem. With heart block, our atria beats normally but the pacer can only make the ventricles keep up as high as the  upper limit. Ask what yours is, it sounds like 160. Most of them go up to 180, a few go to 220. If your upper lmit is 160, that means you'll want to stay under 150 when active so there's a cushion. When your atrial rate gets above the pacer's upper limit, the ventricles won't be keeping up so the heart is not in sync and it doesn't feel too good. For me this meant trying to keep my rate down when I worked out, eventually I spent half my workout bringing my rate down so I went on a low dose beta blocker to artificially keep it down. When I had a replacement last year, they gave me one that goes to 220 so I went off the meds and haven't been close to my upper limit since. 

It can take a LONG time to fully bounce back from endocarditis.

Have they done stress test to watch what the heart does on exertion real time? That's how they figured out my issues. I switched practices last year and my new doc says he can get 80% by taking to us and looking at the pacing report, he does a Holter to tell him the other 20%. 

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