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Heart Pounding in Neck and Chest

Hi
My Medtronic dual chamber pacemaker was implanted on 4th Feb 08 for secondary heart block.  Since the implant I haven't felt good - very tired, breathless, racing pulse with only slight exertion and feeling my heart pounding in my neck and chest all the time.  My cardiologist seems to want to find all sort of reasons for me feeling like this, other than the PM.  I would stress that I had NONE of these symptoms before the PM implant just some palpitations which is why I had the 24hr ECG, which showed up problems only during the night.  Have had all sort of tests - xrays, lung function, CT scan of my lungs. exercise ECG - all normal.  Also had an angiogram just before PM implant and my arteries are fine.

At my first PM check this week, the technician reluctantly talked to me about the rate response switch - which had been switiched on at the low level.  At first he decided to he was going to turn it up to medium - but to me this just did not make sense as it seemed like it would make my pulse go faster!  Anyway he then decided he would turn it off.  Doesn't sound too scientific!  Since then my breathing has improved and I seem to be much less breathless but not quite back to normal but I have probably lost fitness over the last seven weeks because I have been in slow motion.  During my PM check I noticed that the pouding in my chest had stopped and my breathing was much easier so I asked what he had done and he said that everything was turned down (off) and he was surprised I had noticed.  Well I did and it felt like the old me for a few minutes!  By the way the PM had been pacing less than 5% split between the two chambers.

Sorry this is so long.  So really I am asking a question about the PM settings and can something be done to stop this horrible pounding in my neck (just above my throat) and the flutterings in my chest?  

Sue
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Avatar universal
Thanks for your reply - it really helps that this is real.  

I have taken my pulse using my BP monitor while I have the pounding in my neck and it has not been racing since the rate response was switched off  earlier this week - it is about 82bpm.  And for the first time ever (had a BP monitor for years) when the pulse is detected and the machine starts beeping and counting down, there are now missing beats here and there which sound like gaps.  I presume I should mention this when I next go which is supposed to be in six months but I will bring it forward. The technician didn't say anything about tachyarrhythmias - but when he was doing my check and I said my heart felt like it was behaving strangely he explained (but I can't remember exactly) that it had skipped a beat or put an extra one in - not sure which.  He didn't seem bothered and didn't seem sympathetic to the heart beating in my neck.  My cardiologist, who has looked after my aging mother and put in lots of stents with very difficult angioplasty as she was too frail for a triple bypass, doesn't seem to be an EP - his specialities on his website are arteries and valves.  I presume we have electrophysiologists in London (UK) but I only heard about them recently reading posts from the USA.  What I do need is someone to listen to me with my post PM problems and not say as he did - I am sure it's not the PM!  And the technician, when I told him about my breathlessness said - very unlikely to be the PM!

Thank you for listening and I now feel a bit more confident to make another appointment.

Sue
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242509 tn?1196922598
MEDICAL PROFESSIONAL
During the pacemaker check, did it show any tachyarrhythmias? If so that could be the cause of your palpitations and/or heart pounding. If not then another possibility is that you have pacemaker syndrome, which is less common in people with dual chamber pacemakers but still can occur. It is difficult to explain in layman's terms, but make sure that your cardiologist has set the PVARP period as small as possible, because if not it may cause inappropriate pacing when beats are not sensed by the pacemaker because of this long refractory period.
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Avatar universal
Forgot to say that I am female aged 61.  Take medication for high blood pressure - amlodopine, lisinopril and indapamide.
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