Mood Disorders


44yo female, AV Heart block type 3

implantation May 2022, resting heart rate 24 at implant

I used pacemaker 100% of the time for first 6 months

now I am using 66% of the time, dr is perplexed about why


Prior to the pacemaker I was having severe mood swings and irritability. I did not know that I had bradycardia for likely over a year. My doctor has since told me that it was related to underlying heart condition and the COVID-19 vaccine. There was a period of time where I had depleted oxygen to my brain and was experiencing intense frustration and confusion. Directly before pacemaker implantation, I was experiencing dementia.

I was experiencing neuropathy also from the vaccine and had a total hysterectomy which was not necessarily related, but I did have issues there after the vaccines.

The last month I've been without any illnesses and it's been somewhat nice to not be in the hospital or the ER, but I've been having issues with relationships and my ability to form positive relationships with coworkers. this started about 18 months ago around the same time that I got the vaccines.

My job has been high stress, having said that it seems that I should be able to navigate a conversation more calmly than I am able to in high tense situations. This resulted in my suspension from work. This is some thing that is completely out of norm for me, and I am at a loss. I have always been the most stellar employee.

I guess I am trying to understand if it is possible that the bradycardia for the extended period of time cause some kind of permanent damage because I have not felt like myself in most situations in over 18 months, well ...since the vaccines.

I realize this is a longshot, and maybe not totally pacemaker oriented, but I'm really lost.



Complex Situation

by Penguin - 2023-03-19 05:54:36

Hi and Welcome, 

Your symptoms sound complex and very difficult.  3rd degree AV block, Dementia, Neuropathy, gynaecological issues and mood swings are 'symptoms/diagnoses' which need to be picked apart and analysed for their effect on each other and for cause. That's a job for your doctors I'm afraid, particularly if they suspect the Covid 19 vaccine.  

Re: Dementia. Have you received a Dementia diagnosis or are you saying that 'dementia type' symptoms appeared and then resolved following the implantation of a pacemaker?  I'm not medically qualified but as far as I know pacemakers don't treat dementia, but may improve blood flow to your vital organs - including the brain if your heart isn't working as it should.  I hope that a cardiac cause can be proven and that you don't have to suffer dementia. 

Stress in the workplace and stress which is derived from other sources is something that your employer should consider carefully both for the impact on you and your work and the impact on other employees. I'd encourage you to speak to them about your current medical situation. You might like to consider whether or not it would be helpful to request a doctor's letter to share with your HR department which explains what has been happening to you.  

I will leave your question re: a reduction in v.pacing from 100% to 66% for 3rd degree AV block to someone who has this diagnosis.  They should be able to provide a more knowledgeable response than me. 

Best Wishes



by Persephone - 2023-03-19 12:03:36

Hi Silent - so sorry to hear of your health issues. Has an endrocrinologist been consulted in the situation?

Tough one

by Gotrhythm - 2023-03-19 14:19:39

I'm sure it must be devestating to lose your job because you couldn't emotionally handle situations you were always good at dealing with in the past! That would be hard to take. And totally confusing.

Even after re-reading your post, I'm having trouble following the timeline of when the mental symptoms started and when you got the vaccine and when the pacemaker was implanted for heart block, so I really can't comment on any of that.

What I do know is that cardiac arrythmias can cause what looks like dementia. Been there. But I don't know how long bradycardia would need to go on before permanent brain damage would result. That's really a question for a true expert in brain health. You say before you got the pacemaker you were experiencing dementia. Have you even had a cat scan or MRI of your brain?

I also don't know much about heart block. I do know with heartblock it can be tricky to get the pacemaker settings dialed in just right.

Here's what I do know from what you say. You have a very complex problem. Regardless of the cause (or causes) what's bothering you appears to be mental/emotional. Because the problem is complex, the average doctor or even neurologist probably doesn't know enough to help. 

If I were you, I would go to a major medical center that deals with complex cases of major mental/dementia issues. Somewhere they can see you for mental/dementia problems and cardiac problems at the same time. You need a firm diagnosis of what is really going on with your brain and what can be done about it. Travel if you have to.

I mean it. This is your life we're talking about. It's worth the price of a plane ticket even accross the country.

You probably can't do it by yourself. You will also need a family member or friend you can tell everything to. Someone who will go with you to appointments, fill in the blanks, and help you navigate the healthcare system.

God bless.

Thank you

by SilentH - 2023-03-19 14:48:27

I really appreciate your feedback and I think that all of the medical situation that I had been through in the last eight months is really pushing me to make some big life choices about my career path and what I'm doing. It's been a wild ride. I'm grateful for this group over the last 10 months 🙏

It’s challenging

by Lavender - 2023-03-19 16:06:12

Sometimes we are forced to change career paths and it's the best thing that's ever happened to us! 

bradycardia for the extended period of time

by Persephone - 2023-03-19 17:28:07

Similarly, I turned into someone I didn't recognize very well when I had iron deficiency anemia related to pregancy, childbirth, and breastfeeding - not disimilar to bradycardia in terms of lack of blood O2. 

I don't know how long I experienced bradycardia prior to PM since I didn't have a reason to directly measure HR besides the occasional carotid artery check during exercise, but it was likely only a matter of about 4 months. Definitely influenced my coping ability in some situations during that time, though the overall life stress levels were down compared to the anemia period.

Mood Changes and Hormonal Imbalance

by SeenBetterDays - 2023-03-19 19:06:23

I'm so sorry you are going through such a difficult time, it's sounds as though you have had a lot to contend with. This may not be of relevance in your case but you mentioned your hysterectomy and I just wondered if you have had any hormone tests.  I had quite a difficult time during my perimenopause which started in my mid forties and led to anxiety, depression and panic symptoms.  Fluctuations in oestrogen can have significant effects on mood for some women.  It can also have an impact on heart function.  Obviously you have a complex set of symptoms which, as GotRhythm wisely said would require thorough investigation.  I just thought it might be worth mentioning as I know how much that hormone shift affected my whole demeanor and ability to deal with stress. In relation to your heart block, I have AV node block and was told that once I was 100 per cent paced in my ventricle it was extremely unlikely that percentage would decrease so the fact that you have decreased to 66 per cent does seem puzzling unless there is some reversible cause for your heart block.  Maybe others in the same situation can chime in if they have a different experience as I am only talking from my own personal situation and I know I shouldn't generalise on that basis.  I hope that you get to the bottom of your symptoms and are able to potentially move towards a less stressful working environment, not easy to achieve I know, but maybe a wise move to support your health going forward.  I wish you all the very best and please keep us updated on your progress.


by Penguin - 2023-03-20 06:28:00

SeenBetterDays raises some very good points. Would it be impolite of me to ask you whether you've been offered any hormone replacement therapy since the hysterectomy? I'm not sure whether or not you can take it alongside a dx of 3rd degree block, but could this be something to consider?

I can't comment with any certainty or evidence but I remember that there was also mention of the Covid 19 vaccine having an effect on women and their menstrual cycle.  Is that worth following up with your doctor?   

I assume that you've already had screening blood tests for diabetes / thyroid issues / hormone levels? Did they show anything of note?

Regarding the reduction in v.pacing are there any medications which you have stopped taking?  There is a long list of medications which can cause prolonged QT intervals. Conversely this also means that they can reduce QT intervals when they are stopped. I have absolutely no idea how the QT interval applies to AV block and may be way off the mark suggesting this, so take this suggestion as an uneducated guess at best, but as we're talking about something that so far hasn't been understood I thought it might be worth a mention.

I enclose a list of potential medication offenders below taken from the Mayo Clinic's website: 

Certain antibiotics, such as erythromycin (Eryc, Erythrocin, others), azithromycin (Zithromax) and others

Certain antifungal pills used to treat yeast infections

Diuretics that cause an electrolyte imbalance (low potassium, most commonly)

Heart rhythm drugs (anti-arrhythmics) that lengthen the QT interval

Some antidepressant and antipsychotic medications

Some anti-nausea medications

The effect of medications that you have stopped is always worth discussing with your cardiologist particularly if there are unexpected changes to heart rhythm and seemingly no other explanation.  

I'm so sorry that you're going through this. 

Mood Swings

by Stache - 2023-03-21 18:53:08

I have a 3rd-degree heart block that would drop to 22 bpm at times while sleeping.  Now dual chamber 100% paced for 2 years so far.  I have had major mood swings since my cardiac arrest and prefer to be alone now.  Many have noticed the change I have gone through.

I don’t have any answers for your condition but I understand what you have and are currently going through.  I read the comments on the page all the time and it provides me with the comfort I am not alone.  I am not vaccinated but I have many of the same issues you described. I did catch COVID 4 months ago and lost taste and smell and felt like a zombie for a while.

My wife tells me I read too much trying to find answers to this, however, I want to be informed and not dependent on other's opinions at the hospital who have not had our experience.  I wish you well and the only advice I can give is to try to stay positive even in the darkest times.

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