Hi all,

I just found out I have heart block, second degree mobitz 2. Dr.'s recommendation is a pacemaker. It seemed pretty straightforward but now I am full of internet info, concerned and confused. I am 43 years old, strong, active, healthy and my symptoms are pretty minimal. I have had random arrythmia over the years and since my brother died of sudden heart attack a year ago I thought maybe I should have it checked out. After a holter test she found heart block during sleep with episodes of mobitz 1 and 2.

The whole thing is weird to me and I am a little freaked out about having a PM. Is this going to affect the time I feel/felt normal or is this potentially going to save my life? Because I am not super symptomatic there is a part of me that wants to ignore it but from what I read, partial heart block can progress to complete heart block and well, that is not a good thing.

Any wise words? Any one else with heart block who has little symptoms and a pacemaker?

Thanks for being a club!
Emily

 

 

First of all, av blocks are completely unrelated to heart attacks or sudden cardiac arrest. If you are at risk for sudden cardiac arrest, they give you an ICD which will jolt you out of a dangerous rhythm. Nothing you've said indicates you are at risk. Heart attacks can be genetic, or can be the result of lifestyle choices which leave our plumbing system impaired- clogged arteries. An av block has nothing to do with clogged arteries, it's an electrical signal that's blocked. Most of us with av block have structurally normal and healthy hearts, just a bit of faulty wiring which the pm corrects.

What symptoms do you have and how bad do you feel? Sometimes 2nd degree block is treated, sometimes you just watch it and wait until it progresses to 3rd degree or you become symptomatic. How low did your hr dip when you had the holter?

I'm 43 also. I was born with 3rd degree block and have had a pm since 1993. I'm very active and feel terrific. It doesn't slow me down at all and I have considerably more energy with it than I had before.

At this point, a pm might make you feel better but 2nd degree av block will not kill you. If your hr dips too low, it will make you tired, kill your stamina, and it is hard on your organs, but it is not fatal. There is no right time to get the pm, some drs recommend it right away, others sit back and wait. I'm not a dr, but unless your rate is dipping really low while you sleep or you are feeling bad, in my opinion you have some time to think about it and make your decision.

 

Thanks for your comments.
My symptoms are minimal, mostly arrythmia on occasion. I did have an incident of heart fluttering that had me dizzy and out for a split second, that was 2 years ago. I just recently decided it was time to ask a Dr. She thought it was probably premature contraction but the holter showed heart block. I think my heart rate got between 30 -40. What is really low?

I am just at the stage where I have an appointment scheduled to ask her questions. Your comments help a lot. I certainly don't want to do anything that is not necessary but don't want to play around either. If I can wait I would prefer.

 

Tracey covered the details so I'll just fill in experience. I had the same experience as yours about 5 yrs ago where my HR dropped to 40 with no response to exercise. By the time I got the pacer a few days later it was down to 26.

I chose to remain totally awake with no sedation during the implant and had the experience of finding out how lousy I had been feeling. When they turned the pacer on in the OR I could have jumped off the table and danced around I felt so good.

It is almost a certainty that you will need a pacer in the next few years. Might as well get it now and enjoy life.

By the way I'm coming up on 80yrs and enjoy hiking, Jeeping, and generally raising heck. Without my pacer I would likely be a lot less active.

best,
frank

 

I'll add to Frank's experience. My rate was in my 40's my whole life. With 3rd degree block, it never ever went up with exercise. I always knew I'd eventually need a pm but when my hr dropped, it was so gradual that I had no idea how bad I felt until I got the pm and felt good again. Over the course of a year I got more tired and the dizzy spells got more frequent. When your rate gets too low, it's like being drunk and your brain doesn't work well so part of me knew it was time, but the rest of me floated along in a happy haze. When my finger nails turned blue, I thought it was funny. My doctor wasn't amused, he had me in emergency surgery that day! My rate had dropped to the mid 20's which put me at risk of cardiac arrest. My experience was like Franks, a very immediate surge of energy when it was turned on. I haven't slowed down since.

30's definitely isn't good, but it's not awful either. Under 50 is technically bradycardia but many get by in the 40's and even 30's and do okay. You could use it now. Every time your hr dips below 40, it puts stress on your organs. Some day a year or ten years from now, who knows, you will need it and it will no longer be optional, but when you do it is ultimately up to you. An alarm is not going to go off saying Do It Today and if you ask ten drs, you will get ten opinions.

Don't be afraid of the surgery or living with a pm. When you search online, you tend to run into worst case scenario. Even here you will find that. For every one person with an unusual problem who comes here for answers, there are probably dozens of people out there doing fine and getting on with their lives with no reason to seek out a place like this. Complications happen less than 3% of the time.

If you have questions, please don't be shy. For me, knowing what I'm getting into always gets rid of the fear, nothing worse than the unknown and building it up in my head to something awful from lack of facts.

 

I DISAGREE WITH TRACEY's statement - "For every one person with an unusual problem who comes here for answers, there are probably dozens of people out there doing fine and getting on with their lives with no reason to seek out a place like this."

- She's wrong there are hundreds of thousands who sail through with no problem. There are over three million Pace maker patients in the US alone and very few have complications or issues. While not everyone who has a problem finds this club, rest assured a large majority do and there are less than 11,000 members world wide so that should highlight to you how few have problems.

If you have reasonable medical guidance that you need a PM then you should give serious thought to doing so.

Good luck to you

.

 

This is all helpful and I am certainly still educating myself about this condition. My understanding is the holter test showed the low rate and the block type 2 during sleep only. I took a stress test and that was normal. My baseline ECG was normal as well.

I don't know that I am feeling other symptoms, I get mostly dizzy and lightheaded from low blood sugar. I feel like I can wait but it does seem like it is degenerative and is not a condition that will heal on its own.

Thanks Tracy for your comments about the internet, I have to remind myself that lot of worst case scenarios are what get posted on the web.

All your comments have been educational and helpful. Thank you.

 

Okay... well.. the above comments were well written and outlined... so I'm gonna just be really really myself and not mence words here.

The answer will come and it should be made with YOUR physician. You have to live with the decision more than anyone, so why not let it be your decision? Nuff about that..

Please understand that low heart rate can cause severe organ damage. One example: optimal kidney functioning is impaired when the heart rate is constantly lower than 40. And there is a big difference in heart block and low heart rate (bradycardia). So don't take the statement "some organ stress" lightly!!!

When the electrical system does not fire to make the bottom of the heart pump blood one must begin to consider alternative methods to assist with this process. Be it medication or mechanical means. I, by chance, was given an antibiotic for a respiratory infection and had a reaction to the medication which lead to full blown third degree heart block. Much to my surprise the MD's reported that I perhaps had had 2nd degree block and was 'living with it". If you should decide not to persue the internal bling bling option... Please google medications which widen the QRS complex and see what could push that 2nd degree heart block right into 3rd degree. Having 2nd degree heart block and knowing that you have it could be an advantage as you can make health care choices before a crisis arises.

Whatever you decide to do or whatever is decided for you... understand that YOU are always welcome here!! Each reply is unique and each has a person attached to it who has lived their own journey and their own experience.

Cheering for you and hoping you find the answer which is best for you.

Zoom Zoom...
Harley63

 

Hi, my name is Jessi & I am 30 years old. I am a stay at home homeschooling Mom of 4 boys & I have been married for ten years. I am healthy & active.
I have dealt with farely minimal random abnormalities all my life. In October I went & saw my family doctor because I didn't feel right. I was more tired than I was used to & I was having palpitations at night. He referred me to the greatest cardiologist ever (I've had some crappy ones in the past...so I know this guy is a gem!), who diagnosed me with bradycardia (low heart rate) and a 2nd degree block, then sent me to an electrophysiologist. When my cardiologist said I needed a PM I was scared. I was unsure whether or not it really needed to happen. I had dealt with it for so long already and I am only 30! I wanted to believe he was wrong.
I went to Spokane to see the EP & he did all his own tests. He said the same thing my cardiologist did...PM for sure. By this time I was ready, though because from October to February I got very symptomatic. In October I felt a bit cruddy...by February I was sporting a sexy gray circle around my mouth and 2 white ones around my eyes. I was sleeping up to 18 hours a day some days. When I was awake I felt disconnected & foggy. I couldn't care for my kids. I felt like I was watching them live their lives from the sidelines. It was heart breaking. I didn't have the energy to have conversations, I couldn't drive, it got lonely. I was surrounded by people who love me but I was watching them live while I sat there. It was very hard for me.
When PM time came, I was excited! I had a terrible time sleeping the 3 or 4 days before hand. I just wanted to feel better!
Now the PM is in & I feel great! There were some weird feelings I wasn't used to that concerned me (I got myself all up in an emotional tizzy) , but I saw the doctor today for my 2 week check & everything is perfect! I am feeling the PM when it kicks in, which I will get used to with time. It is a lot easier to get used to now that I know what is going on. Knowledge is power! I have found that the more I know the less fear there is.
When I saw the doctor today we were talking about the amount of time I am mechanically pacing (which is 21.7%, now) vs. the amount of time my heart paces itself. He said heart block always gets worse. The numbers will go up as time goes by. I am thankful for my PM. It is an adjustment, but one that I am happy to make.
As the others said, I felt better when I was in the hospital than I have ever felt in my life. I did not realize how much the block effected me , even before I got really symptomatic. I literally have more energy than I have ever had. When you are missing something you have never had it is hard to know its missing. I feel great. I just have some extra parts, now. And a scar that is so much sexier than a gray mouth circle...that refused to be hidden with makeup.
If you want to chat sometime send me a message & let me know. Also, I am on facebook if you want to look me up. Just search for Jessi Way. Take care & take advantage of the support that is offered here!

~Jessi

 

Hi!

Just a short comment: According to the guidelines for pacer implants (AHA, European Society of Cardiology etc.) second degree heart block type one (wenckebach) is not an indication for a pacer, type two (mobitz) is not either, especially not if the patient is not symptomatic. If you are symptomatic and that symptoms are definitely related to the block, a pacer might still be suggested. There are even patient with a third degree heart block, mostly congenital, who can live with it for years without needing a pacer. They have one implanted when they start having symptoms.

So, I would say if you are feeling good and have only very minimal symptoms, just watch it, keep the pacer in my mind, but don't get one right now.

Best wishes
Inga

 

you and your doctor should make the decision....if your doctor says you need or should get one for me there wouldnt be any question If i should get one the questions would be how will it help, what will it do, when do I have to have it, and fianally what will happen if I dont get it. my two cents. Lots of good advice from members on here and alot of good advice to put in front of your doctor, and get some answers.

dave

 

I am 42, was born with 3rd degree heart block. First pacer at 19 years of age.

Getting and living with a pacer is easy, gives you peace of mind.

As far as the decision goes, how do you feel about this doctor? Maybe there is another doctor you can talk to independently. I have had a few bad ones and mostly really good ones over the 30 years I have been seeing cardiologists. They wont be able to explain every little thing about why they think you should have one unless you are a cardiologist yourself. This is the person or office of docs that will be taking care of you now and on into the future. Do you trust them with your well being? If not keep looking until you find one or two that you really trust and are convinced of their diagnosis either way (with or without some device or procedure).

Beware of what you read on the net, the medical institutions are very afraid of malpractice suits so they will create a long list of risks that you basically will never see. Notice how the drug commercials are almost all warnings now and little other content. Folks that post reviews or comments online about something mostly give bad news. Some that are uber happy give good news but some of those work for the company/industry and want to sell product by pretending to be someone else.

When I was 19 and faced with this decision, well most of the decision was not mine, I could have vetoed it but didnt. Our family had lost a 15 year old a year or two before, and I didnt want to see my folks go through what my aunt and uncle were going through. So I didnt object, by that time the doc had been watching over me over a third of my life and I trusted him. It doesnt sound like you are at risk of what happened to your brother, but if there is a risk of other problems there, maybe think about your folks if they are around, your spouse and/or kids. Other brothers and sisters, etc. I have had a pacer more than half my life, we will never know if it has doubled my life or would not have made a difference. Married with children and parents and grandparents still around, I am not going to roll those dice. Living with a pacemaker is trivial, I look forward to having many more installed.

Leaving the hospital the first day with a pacemaker was quite different. I was young and athletic so I didnt see an energy boost, but my heart felt very weird. It was quiet, I had gotten used to an oversized heart with forceful beats that I could feel at all times. The pacer smoothed it all out. Starting out in your 40s with your first you may see an energy boost, who knows. Your sleep will probably be different as they will probably keep your lower rate from going below 50 or 60. I think I had problems sleeping for a bit but got into a new routine.

My bottom line is if you trust the doc, and you can tell the doc is convinced of his/her decision. then do it. Living with a pacemaker is not difficult or scary. The procedure is nothing to be afraid of, in and out, after a few weeks you are getting better every day and within a year you forget you have the thing. Lastly think about what can happen to you if you DONT get one.