Could sleeping positon 3 weeks post PM implant cause Afib

Posted by mjv96469 @mjv96469, 4 days ago

June 9 I had Abbott PM 2272 - dual chamber pulse generator implanted because of Bradycardia - Mobitz type II. On July 2 I received a call from cardiologist office that they had received a report of aFib that lasted an hour and 7 minutes in which the heart beat ranged as high as 170, They're immediate concern was blood pooling, causing clot, leading to stroke. Without further discussion or exploration they prescribed Diltiazem to add some control to BP going too high and Eliquis as a blood thinner.
I've just received the report showing the time period coincides with the first and only time post op that I slept on my left side. I have called the mfr and they don't know if it's possible and said to talk to my doctor. Doctor is not very accessible so I'm fending for myself.
If I was an anomaly, I would rather not be on unnecessary drugs for the rest of my life.

Has anyone had experience like this?

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@mjv96469
I have to be careful here to not give medical advice just pass on my experience with this.
I am on my 3rd ICD/Pacemaker and have had one since 2006. I think I have experienced all you can experience having one.

First, you just had the implant and your heart and area is going to be very sensitive. If you had wires put in latent or screw in you heart could be irritated from the surgery which could cause irritation. Another is stress. You just had surgery so stress can cause (from my EP) AFIB, PVCs, PACs, etc. My EP stated stress is one of the causes of AFIB. It is common to have high stress after a ICD/Pacemaker surgery.

You mentioned sleeping on left side. If you had a device implanted with wires how you sleep and what pressure you put on your device and wires could affect your heart. I know this because of so many incidents of AFIB, PVCs, PACs and the causes.

AFIB is hard to deal with both physically and mentally. I too was told by my EP that the biggest concern from cardioloigst with AFIB is the increase in risk of blood clots. Thus the Eliquis as blood thinner.

I am not familiar with dual chamber pulse generator. Does it have wires? Do any of these wires go into your Atrial. If so then they are going to be irritated and also by where you sleep the wires can move with pressure and maybe cause so irritation as the device and wires have not been in long enough to have what they call encapsulation. Which is the body putting a covering over of the foreign body to protect it. That takes some time to do.

Regarding sleeping. I really have found ways to sleep that don't put pressure on my device. I can feel the pressure and it is uncomfortable. I found by having my arms in certain places when I am sleeping on my side prevents the uncomfortable feeling around device. I also can feel the wires push upward when on my back. I found when sleeping on my left side I get the most pressure on the area of device as it is on left side so you have body weight pushing down on left side.

It is sad to hear your device manufacturer was not more helpful. This is not what I have encountered with Boston Scientific.

REPLY
@jc76

@mjv96469
I have to be careful here to not give medical advice just pass on my experience with this.
I am on my 3rd ICD/Pacemaker and have had one since 2006. I think I have experienced all you can experience having one.

First, you just had the implant and your heart and area is going to be very sensitive. If you had wires put in latent or screw in you heart could be irritated from the surgery which could cause irritation. Another is stress. You just had surgery so stress can cause (from my EP) AFIB, PVCs, PACs, etc. My EP stated stress is one of the causes of AFIB. It is common to have high stress after a ICD/Pacemaker surgery.

You mentioned sleeping on left side. If you had a device implanted with wires how you sleep and what pressure you put on your device and wires could affect your heart. I know this because of so many incidents of AFIB, PVCs, PACs and the causes.

AFIB is hard to deal with both physically and mentally. I too was told by my EP that the biggest concern from cardioloigst with AFIB is the increase in risk of blood clots. Thus the Eliquis as blood thinner.

I am not familiar with dual chamber pulse generator. Does it have wires? Do any of these wires go into your Atrial. If so then they are going to be irritated and also by where you sleep the wires can move with pressure and maybe cause so irritation as the device and wires have not been in long enough to have what they call encapsulation. Which is the body putting a covering over of the foreign body to protect it. That takes some time to do.

Regarding sleeping. I really have found ways to sleep that don't put pressure on my device. I can feel the pressure and it is uncomfortable. I found by having my arms in certain places when I am sleeping on my side prevents the uncomfortable feeling around device. I also can feel the wires push upward when on my back. I found when sleeping on my left side I get the most pressure on the area of device as it is on left side so you have body weight pushing down on left side.

It is sad to hear your device manufacturer was not more helpful. This is not what I have encountered with Boston Scientific.

Jump to this post

I do have two wires and they are screwed into the heart. And I agree it is all so new that it is not encapsulated. I don't have a problem taking medication if what I had was actually AFIB. I generally sleep on my back so it hasn't been a huge issue to stay off my left side. The coincidence of that and the AFIB at the same time raise the question of whether something about the wire stimulated the AFIB. And if that's the case will it not happen again as long as I stay off my left side. And if that is the case, are the drugs necessary?

Since my PM is continuously reporting, what is the risk to wait and see if I have another event before using the medication (I'm 5 days on meds at this point).

is there any testing that could make the decision clearer?

REPLY

@mjv96469
Good questions.
Do you have access to a electrophysiologist? They are medical experts in electrical functions of the heart. Most ICD/Pacemaker are put in by them but some cardiologist do them too which is what I assume how yours was done.

You would not have encapsulation at this point like you said. That protects not only your heart and surrounding tissues but helps protect the wires also. I Have 4 wires.

Did you wake up or notice any discomfort during the time you had AFIB? That could pinpoint what is causing it. I hope you were told to prevent any outward pressure on your device and wires. Sleeping on your left side is going to push upward toward wires and device. I hate to asked this but how is your weight? I have gained a lot of weight and now notice when I sleep on my back my fat pushes up and the wires are pushed upward.

What do you do with your arms when you sleep on your side? I use a pillow to keep my arm level with my side so there is no downward pressure caused by my arm. I think important and this comes from my experience that movement can affect your wires. It can cause irritation in the heart. Three of my wires are screwed in and one is latent. I do water aerobics and they could tell from the time frame that the water aerobics was causing my wires to move. So I limited my arms movements and the wire and electrical changes stopped.

I would not be able, to or should I, to advise you on taking or not taking your medications. Are you having any signs of AFIB now? Can you do a manual device check to see if AFIB has happened since your report? I do this (manual) check when I feel something strange, fall, or have an impact around my heart and wires. What I mean by manual is there is a button on my device that I push and it does a manual run on my device versus the programmed days/times it is set for. I think notify my pace clinin why I pushed it and they can look specifically if anything shows up that indicates a problem. Medicare pays for this but I do it only when something is not right.

I know you have a lot of questions and again if you have access to a EP it would provide a further expertise into having a device and an expert cardilogist that works only with the electrical issues of the heart.

Can I asked again about your stress level after device was put in? If you have been having high anxiety and stress it can cause AFIB. I was told this not only by my EP but my original carilogist. So if you have high anxiety and stress over this try some relaxtion techniques you can find online to help reduce them.

On your medications just know they are a safeguard. Your cardioloigst has already told you that biggest threat from AFIB is strokes thus the medication for it. He/she could be waiting to see if you are having any repeated episodes of AFIB before any long term treatments. I think he/she is just being safe.

When is your next device check?

REPLY
@jc76

@mjv96469
Good questions.
Do you have access to a electrophysiologist? They are medical experts in electrical functions of the heart. Most ICD/Pacemaker are put in by them but some cardiologist do them too which is what I assume how yours was done.

You would not have encapsulation at this point like you said. That protects not only your heart and surrounding tissues but helps protect the wires also. I Have 4 wires.

Did you wake up or notice any discomfort during the time you had AFIB? That could pinpoint what is causing it. I hope you were told to prevent any outward pressure on your device and wires. Sleeping on your left side is going to push upward toward wires and device. I hate to asked this but how is your weight? I have gained a lot of weight and now notice when I sleep on my back my fat pushes up and the wires are pushed upward.

What do you do with your arms when you sleep on your side? I use a pillow to keep my arm level with my side so there is no downward pressure caused by my arm. I think important and this comes from my experience that movement can affect your wires. It can cause irritation in the heart. Three of my wires are screwed in and one is latent. I do water aerobics and they could tell from the time frame that the water aerobics was causing my wires to move. So I limited my arms movements and the wire and electrical changes stopped.

I would not be able, to or should I, to advise you on taking or not taking your medications. Are you having any signs of AFIB now? Can you do a manual device check to see if AFIB has happened since your report? I do this (manual) check when I feel something strange, fall, or have an impact around my heart and wires. What I mean by manual is there is a button on my device that I push and it does a manual run on my device versus the programmed days/times it is set for. I think notify my pace clinin why I pushed it and they can look specifically if anything shows up that indicates a problem. Medicare pays for this but I do it only when something is not right.

I know you have a lot of questions and again if you have access to a EP it would provide a further expertise into having a device and an expert cardilogist that works only with the electrical issues of the heart.

Can I asked again about your stress level after device was put in? If you have been having high anxiety and stress it can cause AFIB. I was told this not only by my EP but my original carilogist. So if you have high anxiety and stress over this try some relaxtion techniques you can find online to help reduce them.

On your medications just know they are a safeguard. Your cardioloigst has already told you that biggest threat from AFIB is strokes thus the medication for it. He/she could be waiting to see if you are having any repeated episodes of AFIB before any long term treatments. I think he/she is just being safe.

When is your next device check?

Jump to this post

Thank you for your comments, I wrote a long response this morning and was almost done when the cyber-gods swooped in and deleted it all.

My next device check is scheduled for net week. If the one week check in was indicative, I'll only be seeing a technician. I'm having problems accessing any help, let alone an electrophysiologist because of the relation between my provider and my insurance. Long story and off topic. An electrophysiologist did do the implant, but is not available for follow up.

My weight shouldn't be a problem - it's the same as it was years ago, I'm just 2 inches shorter. Roughly 5'4"+ and 140 pounds. I've learned to sleep mostly on my back as side sleeping makes me much stiffer in the morning. I do sleep with a large pillow (actually it's one of my granddaughters large Squishmallows) to lift whichever is the upper arm. Stress level isn't too bad either as I've already been through enough that procedures don't bother me much and I do have a good support system, husband, and kids who live nearby. About the 2nd or 3rd week I did go through a pretty grumpy period, but that seems to be ebbing as I've been able to do a bit more.

I have sleep apnea and have slept with a CPAP since 2012. One of my earliest symptoms was a headache when I woke up due to low oxygen levels, but it was eliminated with the CPAP. One of the things I've noticed since the PM was a slight headache again. Both my RingConn and smart watch were reporting lower levels again. Typically sleeping on your left side gives you the best O2 opportunities. That is what led to me trying to sleep on my left. Discharge instructions said no lifting arm, no twisting, jerking, lifting heavy things, and only mentioned side sleeping would likely be uncomfortable.

This morning after another lengthy call with nurse I did get a call back from a technician who had me do a manual download of all information. Apparently my machine protocol is set to only download unusual events. This download will covered all data. Hopefully it will provide better information to support the need for medication or postpone it. They will make the data available to me. I will be talking to them about whether it is possible for me to prompt a downlaod to them and what other access I will have.

It was probably inconvenient to have this taking place before the long 4th of July weekend.
Thank you again. It looks like I'll be able to finish this and finally post it. Sorry I'm not proof reading it and risking losing it for the 4th time.

REPLY

I had an pacemaker implanted for pauses in my heart rhythm. I also had episodes of afib that I always felt. Overtime i began to see patterns. Lying on my left side was one trigger. I had an ablation to correct the afib and flutter. I don't notice a change in rhythm like I did before my ablation. I still try to avoid the triggers. My dad told me on the day of my pacemaker that someday I wouldn't even think about it. It happened gradually. Two years out I rarely think about it. A body pillow became my best friend after surgery and I still find the extra support at night comforting. Hang in there.

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