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Pacemaker remediated tachycardia, and frequent PVCs
5 1/2 months after receiving my 2-lead Abbott labs pacemaker, I suddenly began to experience what I later learned was PMT. One PVC followed by one normal beat 24/7. (My loop recorder was removed when I got the pacemaker so I use my Apple Watch to view and record ECGs.) After four visits to the device clinic for adjustments, which decreased the episodes of PMT from over 250 to 80 over the course of about a month, I was told further adjustments would not be fruitful and I needed to focus on decreasing my PVCs. I doubled my metoprolol from 25 to 50 mg without noticeable improvement, although I’ve had a couple of isolated instances of sinus rhythm. My cardiology clinic is recommending 50 mg of flecainide twice a day, even though it could make my symptoms even worse. Has anyone had any similar experiences? I’m not sure if my level of PVCs are harmful or just incredibly annoying. Thanks!
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The only input I can offer is from my experience with PVC’s. I had a burden of PVC’s at 18% of heartbeats. I was told by my electrophysiologist that 18% would eventually result in heart failure. An ablation was recommended. I did so and now have an acceptable 2% as per the link monitor which was implanted.
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2 ReactionsHopefully I’ll soon be getting a Zio patch external monitor to determine my PVC burden. Don’t think it’s a good idea to begin trying anti-arrhythmic drugs until that info is available. I’ve had 2 ablations already, won’t have another. Wish I could go back in time and forgo the first ablation, which was for PVCs, because they really weren’t bad compared to now. At the time they said beta blockers were out because my blood pressure was too low. The second ablation was an emergency, ventricle tachycardia. Went on beta blockers thereafter, but kept having cardiac pauses - hence the pacemaker. Fortunately my physiology is good, otherwise flecainide would not be an option.
I had a two lead Medtronic pacemaker implanted in June 2026. I’ve had occasional palpitations and paroxysmal Afib for 30 years I’m 75 years old. Since the pacemaker was implanted, my palpitations have been non stop…PAC’s, PVC’s, SVT, atrial tachycardia. I take Dilitazem 120mg ER daily. My electrophysiologist has been pushing Tikeson but I’m reluctant to start it because of life threatening side effects of the drug.
Anyone else experience palpitations after a pacemaker implant? These frequent palpitations are affecting my quality of life and mental health.
Thank you for taking the time to read my post.
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1 ReactionDon’t understand why my electrophysiologist didn’t warn me beforehand that with my diagnosis – sick sinus rhythm and palpitations – that pacemaker, mediated tachycardia even a possibility. Crickets!
@jhallison Ask that question directly of your doctor. You deserve a complete explanation and all questions answered. Make a list. If you don’t get what you want and need, find a new doctor and tell him/her why you are leaving.
I personally would find someone now who respects your partnership in your own care immediately. Why? Because your doctor has already demonstrated that giving you essential medical information is not part of their practice. Unforgivable.
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1 Reaction@wcuro
I totally agree. @jhallison, do not stay with a doctor who doesn't give you all the information you need and who doesn't include you in all decision making.