Ventricular Ectopics

[Stumpy47]

Hi everyone,I had my PM implant 4 months ago for Bradycardia & have been blighted continuously with ventricular ectopics. My bisoprolol has just been increased to try & alleviate them by my EP. Has anyone else had this problem & managed to resolve it for good! Hoping for some resolution asap .

[Coco51]

Oh dear poor you. I am not sure if mine are ventricular.

What do they feel like? How were they picked up? I know before I had the PM 3 weeks ago I had many ectopics, which felt like a skipped beat followed by a thump. But it never occurred to me to ask if they were ventricular or atrial or if all ectopics were the same! I still get them more mildly I think, but as they don't feel as bad as Atrial Fibrillation I haven't yet mentioned it. Every time I mention ectopics EPs say they are nothing to worry about! I don't like the idea of even more Bisoprolol. It would slow me right down even more than the dose I am on.

It's never straightforward is it!

[Stumpy47 in reply to Coco51]

Hi I didn't realise there were ectopics from different chambers, they were picked up by a 72 hr Holter before my PM implant. I've drastically cut down on alcohol & cut out caffeine which doesn't seem to be a trigger as I get them every day. They feel the same as everyone's description a pause then the strong beat , there is no significant length of pause which would cause concern. My pacemaker was set to a DDIR setting which ignores the pause & so does not send a pulse. I think I will get back to my pacing team. Harmless or not they are a real burden! Bisoprolol increase has zero effect either.

I wish you well on your recovery it's not so bad & beats the alternative 😂😂😂

[Coco51 in reply to Stumpy47]

Yes indeed!

Sounds like the pacing clinic might be the answer. I must confess I dont know what a DDIR setting involves, but maybe a little tweak might sort it.

I think on reflection possibly all ectopics are ventricular. I just never heard them referred to as that before.

Sometimes my ectopics settle and stop, sometimes I get more. Usually when I am stressed and tired, which becomes a vicious circle.

Best wishes

[Cubiczee1252]

Hi! Yes I’ve had bouts of both atrial and ventricular ectopics. I’ve had my Pacer over 10 years and have had months where I had them every day (several a minute) and then gone through quiet periods (again months) where I only had an occasional skips. No explanation can be given by my doctor- just learn to deal with them.

Hope yours settle down quickly!

[Stumpy47 in reply to Cubiczee1252]

Thanks, have your pacing team ever tried any different settings, I fear my options will be to live with them or have another ablation, which may make me totally PM dependent!"!

[Cubiczee1252 in reply to Stumpy47]

We’ve played with settings for reasons other than ectopics. In the beginning I had a difficult time - I was in and out of block so often I was confusing the pacer- setting it at 100% solved the problem. My doctor does not believe that the pacer is responsible. I am very sensitive to experiencing more skips when having GI issues such as excessive air. I had PAC/PVCs prior to needing the Pacemaker which I had placed for second degree AV block in 2007. Never had an ablation as my doctor said the origin of my ectopics was “everywhere” and not localized and he couldn’t guarantee results. I am currently on a low dose of Flecainide and I also take Atenolol. So, I just enjoy the quiet months and hope they don’t return. I hate them no matter how often I am told they are not “life-threatening”. Hope you find some peace- they can make one crazy!

[Stumpy47 in reply to Cubiczee1252]

Many thanks.