New Pacemaker

Hello it's the new guy Ralph again. As I stated in my first post I had a Medtronic biventricular pacemaker installed on Wed April 25th and after some trouble getting the PM programmed( was pulsating my phrenic nerve and or diaphram) they seemed to have got it right and I went home Thursday afternoon the 26th. I seemed to do ok Friday but Saturday morning had me back in the ER. I awoke went to the bathroom and was standing by my bed when I felt this pounding in my chest. I tried to stay calm. I called the cardiologist on duty but he didn't call back soon enough. I checked my heart rate and it was at 100. It doesn't sound high but I normally pace at around 75 unless exercising. And it felt like the heart was going to thump.out of my chest. I became dizzy and that made me call 911. I had extensive testing and everything looked good other than an elevated heart rate they said was probably due to my anxiety. The Medtronic rep came.to the ER and tested everything( no leaking signal from the av node so it was ablated successfully) but what worries me is they could find no evidence of any event when checking the pacemaker history. So the ER,cardiologist or Medtronic rep could not give me any answers and to me I not having answers is worrisome to say the least. I want to start walking more but am scared to leave the house. I see my EP three weeks from now surprised after my latest to ER they don't want to see me sooner. I know what happened and did not imagine it and the ER told me since the av node was successfully ablated even if the atria were beating rapidly I should not feel dizzy. I am wondering does anyone think one of the leads could have set off my phrenic nerve/diaphram again or might have some other possible answer. Has anyone ever had an event that the pacemaker history did not show. Thank you in advance for your feedback.

3 Comments

Yes, frequently!

by donr - 2018-04-29 11:38:55

Ralph:  NUMBER ONE- You are not crazy.  Anxiety is a very powerful tool.  You do NOT even know it is working on you.  If they did a complete workup on you in the ER & the medtronic rep examined you & your PM thoroughly, they are probably correct that anxiety did it to you.  100 BPM is NOT a high rate.  The resting rate (75?) is exactly that - RESTING.  Stick a monitor on you & watch a horror movie & your HR will probably exceed that.  Stand up off the couch & walk to get a sandwich & a Coke & it can exceed that.  Normal HR is advertised as 60 - 100.  From reading your first post, it is obvious that your anxiety is working overtime, so I am not surprised at this happening.  Anxiety is a self-fulfilling prophesy - it can & does feed on itself & it takes nothing sensible to your conscious mind to trigger it.

I will try to seaqrch through my 10 yr archives & find a small monograph I wrote on this way back in the day.  It will (hopefully) give you a chuckle, but some insight into how anxietty affects us.  I have nearly 40 yrs experience with it, courtesy of Viet Nam generated PTSD.

Donr

Other possibilities for dizziness etc

by LondonAndy - 2018-04-29 12:07:06

As I don't suffer from anxiety issues I can't add to what Donr has said.  The only other point I can contribute is to ask what your blood pressure was when you felt the dizziness?  I went to my local ER a few months after heart surgery with feelings of dizziness as you describe (along with feeling sick), and after many tests the verdict was: dehydration!  I had had a busy day at work and not drunk much.  Its important to drink plenty of fluids - here in the UK the recommendation is about 2 litres (about 4 US pints) per day, and if you are not properly hydrated it can lead to low blood pressure and therefore dizziness. 

Events

by Jimmy Dinfla - 2018-04-29 23:23:06

Yes, I had an event recently - wasn't bad but I felt it.   I called my arrhythmia clinic to see if my ICD's home monitor data download history showed it.  Nope.  They directed me to the manufacturer.  I was told my device has a programmable feature.  If below a number, it does not record or report.  If above a number, it stores the data and transmits it on the next day's download.  The next time your device gets interrogated, ask about its settings.  Your EP may have insights.  Best of luck!

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