Can a 71-year-old have palpitations after a pacemaker?

Question

Hello doctor,

My 71-year-old father was admitted to the hospital due to heart palpitations and a rapid heartbeat of 143 beats per minute. He felt dizzy that morning. He was given injections to reduce his heart rate and underwent Holter monitoring for one day. Previously, he had two stents placed for blocked arteries. According to his Holter results, the doctor noted that his heart pauses for two seconds at some point during a 24-hour period. He has both bradycardia and tachycardia. They recommended a biventricular pacemaker implantation.

He is allergic to penicillin. Upon discharge, he was prescribed the following medications: Metoprolol succinate 25 mg twice a day, Rivaroxaban once daily, a combination of Glimepiride and Metformin (one and a half tablets daily), a combination of Atorvastatin and Aspirin once daily, and Pantoprazole once daily. He takes his medications regularly, but every 10 days or so, he experiences palpitations lasting about 10 to 15 minutes, with his heart rate fluctuating between 20 and sometimes up to 105 beats per minute before it stops. The palpitations are not daily. The doctor has assured us there is no need for concern.

However, I am worried about why the palpitations occur even after the pacemaker implantation. Is there any way to stop the palpitations, and should this be considered a serious issue?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through the report that you have provided. He is having the tachycardia-bradycardia syndrome. In this case, the pacemaker avoids his bradycardia episodes only. For his tachycardia episodes, drugs can be given. Sometimes the drug controls it perfectly and sometimes it does not.

You have to adjust the drug doses to control his tachycardia episodes. Consult your doctor for dose adjustment. In addition to the Metoprolol, I suggest Digoxin can also be added. Consult your specialist doctor, discuss with him or her, and with their consent take the medicines.

I hope this helps you.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

This indicates possible heart failure.

Could you share his left ventricular ejection fraction (LVEF) from the echocardiogram?
Also, what symptoms is he currently facing?

Your response will help me provide more accurate guidance.

Thank you.