EF and CRT-D

PVCs (premature ventricular contractions)

by Gemita - 2023-08-13 19:08:13

Debs, I don’t know what is going on either but can I make a few suggestions.  You say you have 7 months left on your pacemaker before you are due a replacement.  Is it possible that the battery is fading fast and triggering your abundance of PVCs?  You could ask?   Maybe getting a new device with up to date features sooner could help to control your rhythm disturbances.  

Also have they checked your electrolytes, thyroid and looked for other conditions that could be causing your PVCs?   I expect they have but worth asking again.  

In my experience pushing more meds at PVCs doesn’t always work, especially beta blockers and anti arrhythmic meds, but it is very individual, what works for one may not work for another.  I find slowing my heart rate (and blood pressure) too much will trigger more PVCs.  

I see they tried increasing your base rate to 70 bpm/80 bpm.  A base rate of 70 bpm is helping me, but clearly it hasn’t worked for you.  You have my sympathy.  I know how awful ectopic beats can make us feel.  Make sure you stay well hydrated (water) and avoid caffeine and alcohol if these make your ectopic beats worse.  For your major heartburn, your doctor might try a short course of a PPI (proton pump inhibitor) med because heartburn can worsen arrhythmias because of the proximity of the oesophagus to the heart.  Worth asking about a med to calm your heartburn.

I know you hate taking so many meds.  I do too, but if they can bring your ejection fraction back up it would help with the PVCs.  My sister had an EF of 16% and it is now up to 49% after 18th months with heart failure medication alone.  She doesn’t have a pacemaker/defibrillator.  The last resort for you would be an ablation but you would need a very experienced EP since an ablation in the ventricles could be risky.

I am sure they will carry out many investigations prior to an invasive procedure like an ablation.  In the meantime, please try to stay calm to give yourself every chance of controlling those pests.  Good luck and please let us know how things go.

808 PVCs per hour

by AgentX86 - 2023-08-13 21:25:07

That's 13/min, or about every fifth beat.  Yikes! I'm that bad at times but certainly not all day, every day.

Shortly after my PM implant, I had bigeminal (every other) PVCs. Raising my HR to 80bpm made it a lot better and adding magnesium did the rest.  In the last six months, or so, it's come back.  It's still a major PTA.  My cardiologist added 25mg metoprolol (3x 25mg/day) and dropped the amplodipine in half (as you mentioned, to take care of the BP). That seems to have helped but not enough.

He also put me on a PPI to see if some tightness in my chest for a short period while walking was caused by a GI issue.  I didn't get far enough down that road.  The side-effects were just too much to risk going further.

That many meds? Let's see, amlodipine, atorvastatin, metoprolol, febuxostat, Lumigan, Eliquis, ferrous sulfate, and lamotrigine.  Then add another six, give or take, supplements and vitamins (all prescribed). Getting old isn't for sissies.