###Human: Is it normal to get tachycardia after pacemaker implantation for bradycardia? ###Assistant: Hello. This is likely a part of the syndrome called as a tachy-brady syndrome. Here, patients sometimes develop slow heart rate while sometimes a fast heart rate. Slow heart rate is taken care of by pacemaker and for high heart rate needs medicines like Ivabradine. So, usually not a worrisome issue, but needs to be on medications. If he is having these frequently then should have Holter monitoring or ECG during high heart rate so as to optimize medicines. Also, considering his age and chest pain, it is better to take some test to look for blockages as well like stress thallium or CT coronary angiography.