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EKayG

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  1. New pacer causing afib?

    EKayG posted a topic in General Nursing
    Hi everyone, I have not been on this site for quit a while, its good to be back. Yesterday I had a pt that had a pacer AICD placed the day before. At the start of my shift, tele showed the pt 100% paced with occasional PVC. Pacer was checked by interventional staff which stated everything was working fine. Mid afternoon pt rhythm is irregular with HR of 150 to 160 sustained, with few if any paced beats. No CP, dyspnea, dizziness, but pt complains of heart feels like its skipping. BP 130s over 70s. Stat EKG done confirms afib with rvr, gave pt cardizem ivp followed by titrated cardizem gtt. Rythmol po given, as well as lopressor ivp. Took about 3 hours for HR to convert to Sinus with 100% paced beats. Pt received 50 mg toprol XL earlier that day. With all those meds on board why did it take so long for rhythm to convert? Also, is it possible that the placement of the pacer caused irritation to the heart which triggered this rhythm? Pt was SR with occasional couplet PVCs prior to placement. Thanks:confused::confused:

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