Because a few people asked just a quick explanation of why I was persuaded to have a PM.
After my Atrial tachycardia ablation in 2019 my heart rate sat around 100 bpm so I was prescribed nebivolol 2.5mg twice a day. At this level my HR dropped below 60 at which point the 2nd degree block cut in and I started getting pauses which resulted in a few presyncope events which caused some concern. By only taking 1.25mg once a day for the last two years or more I have kept my HR around 85with no presyncope but JC at Royal Brompton persuaded me that a PM would be a safety net to allow me to increase the beta blocker without any risk.
The setting is 60bpm and no I have not seen any difference in how I feel other than a few ectopics likely the result of being poked about and lack of sleep. After a good seven hours last night I now only feel knackered so we shall see how things progress. PM check in 6 weeks or so.
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BobD
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Thanks for the update Bob. As you know, I'm on the list for one but a " one up, end of the road one"!. Just trying to glean any info from all sources, even just about the pacemaker on it's own. Have a restful day, onwards and upwards.
So glad to hear you had a good result Bob. You must be happy to have that part behind you. It’s interesting because PM is what people always think I need when I tell them. Have an arrhythmia.. but it’s good to know that it’s an option should ablations etc fail .. also considering mini maze of I do get a recurrence after ablation.
Curious to know if that would have been an option for you. In this case or would PM be the only viable solution?
I also had the right BBB which made me feel like passing out and terrible!
The diltiazem seems to control all of that well for me…still waiting for ablation.. hopefully in Toronto….
You’ve got this… keep on doing well .. we will be waiting to hear more about your progress…
I hope this sorts things out for you - you are so helpful to everyone else
I hope you don’t mind if I ask if you know anything about arrhythmias other than AF ?
After six years trouble free following a PVI cryoablation ( following paroxysmal Fast AF that became persistent then permanent) my heart has suddenly gone haywire again .
On instructions of My GP ( whilst waiting for a 72 hour monitor to become available) I have been doing regular Kardia 6L checks during the day if I feel strange palpitations and also first thing in the morning and last thing at night
I’ve had a few short periods of AF mainly during the heat wave but I now have regular episodes of Premature ventricular contractions ( with sinus rhythm and heart rate c 80 ) interspersed with supraventricular ectopy and very occasionally normal sinus rhythm
It feels awful
I have also had a couple of near syncopes when standing up
Also I have just discovered that at night according to my apple Watch my heart sometimes jumps To 140 plus for a short while or Drops to 40 and my
o2 levels drop well below 90 - in fact my Average O2 during the day is less than 95
I feel v tired most of the time .
My normal resting heart rate is 65 ( 49/50 pre ablation)
My GP says I need blood thinners but she says she can’t prescribe them Without cardiologist input because I have Mitral and aortic valve defects so She has referred me urgently but I was told today by the hospital that there is a long wait for a monitor and even longer for an appointment with the cardiologist
Given that I seem to be in sinus rhythm
Albeit with all these strange palpitations do you think I should Just wait and see .
Or I should try to get a private appointment ( I am A pensioner and have no Insurance but I do have some savings ) . I am nervous about my heart as I nearly died during the ablation last time around .
On the Kardia guide it says that occasional PVCs and SVE are not usually serious unless they become frequent which mine are - multiple times a day especially after eating or even a little exercise .
Also Do you know where I could find more info about these strange types of arrhythmias
Sorry if this is a bit of a download - any tips from your long experience or that of others would be v much appreciated
Thanks, Bob. I know your dislike of ECG devices is almost equal to how you feel about PPI tablets! Wide QRS caused by the bundle branch blocks is different from other kinds (i /2 /3 degree...), I have been told. My experience of it is that it isn't as symptomless as much internet information tells, and that it causes runs of ectopic beats, mild tachycardia, occasional AF and reduced output.
Did you like the joke I posted earlier in your other thread?
They have a use if course but far better to get on with life than keep focussing surely? Sorry must have missed that in my current confusion. Spent most of yesterday morning filling in form H1 for DVLA and getting driven to post office to post it. Now trying to find the mental resliliance to advise the insurance company.
I think for anyone suffering from mixed arrhythmias or a conduction condition that might worsen. the devices are helpful and reassuring. As for getting on with life, I wouldn’t presume. Taking tablets daily is enough of a reminder of things.
I knew nothing of it till I was told it showed on an echo scan and then on an MRI. Mine is "left bundle branch block" as opposed to the more common "right BBB" form. It was the only thing wrong with my heart, I was told (apart from the persistent atrial flutter and tachycardia, at the time, before my ablation in 2019).
My GP says it is nothing to worry about, but the cardiologist tells me I should have annual scans. I think in some people it can weaken the heart's left ventricle which, thanks to the normal electrical pathway no longer working, picks up its signal to contract from a different, slower, route. This shows on an ECG as a "wide QRS".
Having told me it's not of concern, my GP did tell me that my multiple ectopic beats are likely caused by it. I'm thinking of emailing the cardio I saw for my ablation, sending him a Kardia ECG, as the palpitations seem to be worse these days.
Do you get lots of palpitations (not AF)? Mine are worse during breakfast, then in the evening watching TV, and after lying down in bed. Also, if I get into any kind of “confrontation”, if that makes sense - phew. It’s annoying more than anything, I suppose but makes me feel just a tiny bit breathless and with some “chest aching”.
That must be very hard work to put up with. Mine aren’t persistent for long - every fourth beat is common for maybe 10-20 minutes. It’s become quite a bit worse this past couple of months, though. I have a feeling the chest discomfort comes about because the output is knocked back a bit. I had that also when I had flutter . The cardio I saw wasn’t worried unless the AF gets more frequent, which is hasn’t at all, thankfully. He’s put me on losartan even though my BP is normal as he said it protects the ventricle long term. I imagine LBBB, harmless as it often is I gather, does carry that risk.
My GP told me to take bisoprolol as needed, so I take 1.25mg if the rate makes me feel uncomfortable or goes up (100-120 or so) for no reason and stays there. He said to take more if needed but I’ve never gone above 2.5 mg since a single really bad attack of AF after my ablation in 2019 when 5mg did the trick.
It’s good to talk to someone who has similar problems.
Indeed - I’ve had some wide QRS as well so I am agitating to bring forward my annual appointment with my valve cardiologist as I have a defective aortic valve too. It’s currently fixed for January 2023 . This is driving me mad . I am just about ok to ignore it during the day though aware of a ghastly feeling on the under my rib cage and throbbing in the throat . But it wakes me up at night when it gets really bad and I find ot hard to get back to sleep so I’m constantly exhausted ! What is the losarton you mention - I’ve never heard of that Good to talk as BT used to say - even through the ether !
Hi - you’re going through a rough old time. Mine has been worse today and especially this evening. It makes me breathe deeply - always has for some reason, not breathless, just the need to breathe deeply now and again. I’ll be sending an ECG to the cardiologist to see what he says. It’s not AF yet, thankfully.
Losartan is an anti-hypertensive but has also been shown to protect the left ventricle in the long term. I was told that’s useful with what I have (LBBB, some AF and wide QRS). It has lowered my diastolic pressure a bit (to 60-70mm) but it doesn’t seem to have caused any side effects (unless these ectopics are because of it).
It’s all a worry, that’s for sure. I wish you well. I thank goodness for an evening G&T this weather - very therapeutic.
Sounds like you may have sleep apnea which is a contributing factor to afib (and other health issues). The low O2 level and high heart are an indication. Do you sleep on your back? Have you tried mouth tapping and side sleeping?
You put a small strip of tap to keep your mouth closed so you continue nose breathing. The jaw can go slack at night and open, hence snoring/sleep issues. tape keeps the mouth shut, the mouth stays moist as well. It works for me and friends who have tried it. Use a bandaid or medical tape. Will feel odd at first but it doesnt take long to adjust. Or you can buy tape for this purpose.
See if your sleep changes and get more o2 and regular heart rate. Quick summary:
"There haven’t been a lot of studies on mouth taping yet, so any current evidence is largely anecdotal. However, many of these claims indicate that mouth taping for sleep can reduce health problems caused by mild apneas and prevent dental health problems. It can also be helpful in preventing snoring, dry mouth, and some sinus issues."
Best decision I made and have had the best 7 years of my P/A/F ridden life (had it for well over 20 years) and I certainly didn't want more ablations, one was enough, so good luck with yours Bob x
Good morning Bob, best of wishes with your PM. Had mine fitted 2021 and so far no problems. Mine was advised as I passed out on the golf course after being told I had an irregular heart beat, the Cardiologist said would solve my problem. So now am back to my normal routine of golf 3 x times per week
Do hope PM is successful for you. I have not got a PM yet but have had a similar experience. You answered me when I posted that my heart rate had gone up to 100 to 113 after an ablation for AF. I was then put on first Adizem and then Nebivolol 2.5 in morning and 5.00 at night. This did not make any difference so I have recently had a cardioversion which has brought heart rate down to 60/65. So far so good and I feel fine. No suggestion of PM yet but maybe that will be the next step if I revert to tachycardia
I am still on beta blockers. 2.5 morning and evening. Maybe stopping these will speed heart up. I will discuss this with Cardiologist when I see him in September. He wants me to have a 48 hour monitor before appointment. No mention of PM yet but I would be quite happy to have one
A PM can only speed up a too-slow or too-long-paused heart (often caused through needing lots of beta-blockers or heart block). There are a couple of other types of PM, one that can speed up but also try to stop the AF when it breaks through; the other takes over the heart's job completely.
I wonder, like many of us perhaps, that I shall be in line for one eventually. It's a life!
Hi Bob, so pleased all is ok and you now have added backup. I’ve felt very content having my PM as my ‘friend’ who keeps me safe from blacking out. I’m on my 2nd now. My first lasted 9 years. Being PM protected helps you feel you are back in tune like your engines. AF no longer rules my mind.
As smwdorset said, you are always very helpful with your responses to other people. So glad you’ve had your procedure & pacemaker now. Always stressful waiting for something invasive. Have plenty of rest & hope you feel loads better soon. Regards, Jane
Biggest problem is not raising my arm! Doing things with my upper arm clamped to my torso just in case. That and irritation from the dressing which is driving me up the wall but it will pass.
You know, I never understood the whys or whereabouts of a pacemaker and kind of looked negatively at them. When I was in the hospital having my Wolf Mini Maze last month, some of the pain meds I was given dropped my heart rate to 41. I have NEVER had a low heart rate But I was sick as a dog. Thankfully Dr Wolf inserts a pacer wire during surgery attached to an external pacemaker for just this reason. THey had unhooked the wire that morning because I hadn’t had any problems. That afternoon was when the pain meds did their thing. They hooked me back up to the pacemaker and all was good. That pacemaker was my best friend for the next two days of which I didn’t have another problem or the pain meds that caused it. I now understand pacemakers.
I totally get the safety net approach Bob and kudos for doing it. Great peace of mind in my book.
Bob, Your PM does indeed sound warranted and should offer you peace of mind and assist with any unwelcomed pauses you say you experienced. Those can be scary to say the least. Have had mine since 2018 and never looked back. Glad to have you in the club. Take good care. Sarah from San Diego. ❣
Speedy recovery BobD. I had a PM fitted in Jan 2020 after my HR measured 36 at one check-up. I felt fine and hadn't had any pre-syncope, although was a bit underpowered at times. Anyway, the consultant recommended a back up PM. It settled pretty quickly, though like you, I had to work out how to position myself in bed to sleep.
At 6 weeks they turned on a thing I like to call the accelerator (sensor responder) which picks up on the need for a faster heart rate. That took some getting used to because the slightest thing would set it racing and it started to feel like tachycardia! I got them to turn it down to low.
One good thing is that if you have any queries or concerns the clinic will see you very quickly - usually within a day. And you can have another ablation with a PM too 🙂.
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Wide QRS caused by the bundle branch blocks is different from other kinds (i /2 /3 degree...), I have been told. My experience of it is that it isn't as symptomless as much internet information tells, and that it causes runs of ectopic beats, mild tachycardia, occasional AF and reduced output.
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HR suddenly going over 150bpm ....? Hot weather affecting AFib ? 
