New to pacing and feeling lightheaded

Hi all,

I have had my new pacemaker for 8 days after my bradycardia got too bad. At 63, they found a 30 bpm at night at the hospital after being admitted through ER for  cardiac pauses of 3 to 5 seconds. Anyway, they diagnosed that as 2nd degree AV heart block and so I received an Assurity dual chamber pm2722. My heart other than the sinus node issues is very healthy. I am only taking Synthroid and Esomeprazole. No blood thinners needed either. I like lifting weights and cycling. 

My concern is the feeling of maybe passing out though I never do. Does this go away? I want to ride my bike, but I am a bit frightened. Right now, I am just riding stationary and doing leg weight machines with my hubby keeping an eye on me. 

Not sure if rate of response is turned on but pretty sure it is as by swinging my arms I can get my pulse rate increased quickly. Oh, and before this my resting rate was 53. They have me set 60 to 120. I think I can rise on my own, and I know their 120 won't cut it on a hill when cycling.

Any advice or personal experiences would be helpful. I have been reading the forums but still concerned about lightheadedness/wooziness or whatever the heck it is.

Thanks in advance. 



Your case sounds a little more complex

by crustyg - 2023-07-15 13:35:34

No EP-doc is going to diagnose 2nd degree HB and then blame the SA-node, so you may have more going on than you think.

Yes, if your heart muscle is otherwise healthy, at your age and level of athleticism you're going to need a much higher maxHR than 120BPM.  It's very common for PMs to be left at factory default, or close to, when first implanted.  Your first follow-up at 5-6weeks is the best time to get things adjusted.  Go prepared, explain the detail of your lifestyle, the activities that you undertake and check that your heart team don't think you have IHD.  Then, with maximum charm, push for a much higher maxHR - 150-160BPM, and, possibly, a lower HR if you're used to a much lower resting HR.

Road-cycling is always going to be difficult if your PM only responds to an accelerometer feed.  You need something else to tell your PM that you've hit a hill and need more output from your heart (== higher HR).

Re: complex

by katmer59 - 2023-07-15 13:42:56

Thanks for your comments, crustyg. I might be totally mistaken about the Sinus Node, but they did mention SSS. Believe it or not, my first PM clinic visit is this coming Tuesday,  so hopefully I will find out some good information. 

PS. Ejection Fraction is 60 to 65%. O2 stats are good.

first appt

by new to pace.... - 2023-07-15 14:13:26

Make sure you write down all your questions before your visit.  There are no dumb questions.  Here is your time to ask  about all your concerns.  Remind them to answer so you understand them.  It is good that you have been reading the forums.  If you need more answers you can always use the search box.  Next to the word "logout" there is what looks like a magnifing glass click on that.  In the box that appears put in your question.

Since you just recieved this implant will take your heart and you time to get ajusted  and feel  at ease.  Best is not to worry about what you think might happen.        Do make sure you stay hydrated, water is good for now.

new to pace                                    

SSS and Heart block

by AgentX86 - 2023-07-15 18:41:57

As Crusty pointed out, these have nothing to do with each other.  Either there is something else going on to cause both or it's not a good time to play the lottery.

The 30pm nightime heart rate and pauses sure indicate SSS. 3-5 seconds, by itself, probably wouldn't be enough to buy a pacemaker (5 sec is on the line for most EPs) but along with a 30bpm heart rate, SSS is assumed. Most often, SSS brings along CI (chronotropic incompetence), the failure of increased exertion to increase heart rate sufficiently,  If this is the case, rate response would be needed.  Otherwise, it would just get in the way. Your test of swinging your arms seems like a valid one. Driving on a bumpy road is another.

Heart block is the failure of the AV (atrio-ventricular) node. This small bundle of nerves times and transmits the electrical signal to the ventricles,  This synchronizes the two for optimum pumping efficiency.  If this fails to transmit the signal completely (3rd degree), the ventricles will still beat, though perhaps too slowly to stay consious.

Second-degree heart block means that some signals get through and others don't. There are two types of second-degree heart blocks.  Oddly, they're named Type-1 and Type-2.  Type-1 isn't generally considered serious and usually resolves itself.  It's normally caused by illness or drugs (not necessarily illicit). Then the illness clears or the drugs are change/eliminated the heart corrects itself.

Type-2 is more serious.  By itself, there isn't a lot of worry because the heart will still be fairly normally.  However, it almost always develops into a third-degree block.

So, what you say could be the case but there are then two issus to deal with.  The good news is that your two-lead pacemaker will fix both.  These problems are really simple to fix with a pacemaker.

The fact that you're on Synthroid indcates hypothyroidism, which would easily explain any of these heart problems. As you probably know, the thyroid gland is the master gland (along with the pituitary) control every hormone and organ in the body.  Screw these over and it's hard to know what soup you're going to be in.

To get to your question, eight days isn't enough to draw any conclusions.  Many jump right off the table and are ready to fight the world.  It takes others a lot longer.  Since you're fit now, you should bounce back quickly.  In the meant time, explain what you're feeling to your doctors and tell them what your lifestyle is.  Don't let them ignore either. It's your body and you're paying them to make you whole. You'll get there soon enough and all of this will all but be forgotten.


Hi Tex! 🤠

by Lavender - 2023-07-15 20:12:31

Great ejection fraction 💕!

You are having a major heat wave in Texas-could it be affecting you? When I got my CRT-P almost 2 1/2 years ago, I learned real quick that my heat tolerance had changed. I also learned that I needed much more water than I used to need!  With the heart pumping more efficiently, more liquids were needed!

Be sure to hydrate and stay cool 😎!!

I fainted for six months before they finally figured out-duh-my heart was pausing. After getting the pacemaker, my brain was on hyper alert thinking I might faint  but I never have again! Could a bit of anxiety be playing on your mind?  I had myself so worried that one night I ended up in the ER with a high blood pressure event, that turned out to be ANXIETY 😥.  My heart was fine!

Hang in there-only eight days in-this isn't an indicator of how you're going to feel in the future! Be good to yourself! 💐


by katmer59 - 2023-07-16 00:08:16

Thank you Agentx86 and Lavender for your explanations and advice. I will give it some more time and yes, anxiety is part of it. Felt really good most of today. Trying to drink more water! I am very optimistic as I don't feel so very, very tired anymore. Amazing!


by katmer59 - 2023-07-18 20:11:24

Visited the PM clinic today. They turned off rate of response and had me walk with them down the hall quickly and back. I did great without it so it is now off! I have a feeling much of my lightheadedness will be gone now as the RR was having me go from 60 to 90 upon standing. My breath couldn't catch up!

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The experience of having a couple of lengths of wire fed into your heart muscle and an electronic 'box' tucked under the skin is not an insignificant event, but you will survive.