Do I have to get a pacemaker?

Good Morning!

I was recently told by my Cardiologist that I need a pacemaker ASAP.
During a 24 hr haltor recorder, my heart stopped for 4 seconds while sleeping.
There are other symptoms as well, such as shortness of breath (dypsnea?), a bit lightheaded at times.
Diagnosis is Sick Sinus Syndrome with Heart Block.

I am not too excited about getting a pacemaker, because it has implications in my professional career- aviation.

I am getting a second opinion tomorrow.

Any thoughts?

Thank you,

Chopperdog

15 Comments

My thoughts...

by justme08_2000 - 2009-12-13 01:12:33

I guess I was on the opposite side of all this. Most posts I've read are of people who are told that they should get one. I was floating in the boat where they said there was nothing wrong with me. My family physician said I had Sick Sinus Syndrome and would need a pacer. The cardiologist said no that was not the problem. That things would eventually work out fine. So, the family physician refered me to an EP because he said that other then some form of a caffeine drip (think he was kidding) or an epi pen there would be nothing to keep my rate out of the 30s. Anyhow, I went to the EP and had a king of heart monitor put on on a Thursday. I got phone calls all weekend long from on call cardiologists who wantet to know if I was at the Hospital. They called me and told me to come in on Tuesday. They called for my strips, and the woman I was seeing in the office came back with a different EP who handed me a paper to sign for the pacer. I didn't have time to think about if I wanted it or not. I realize the whole job situation with having the pacer. There are things I can't do at my job, but I feel SOOOO much better. I guess too it kinda depends on what you want to deal with too. Like I was passing out all the time and they suspended my drivers license. So, I think it all depends on how you want to feel. I personally would say GET it if they tell you to. I've never felt better!

Pacemaker or Not?

by Pookie - 2009-12-13 05:12:29

Hi.

Please don't take this the wrong way, but if a Cardiologist tells you that you need a pacemaker and you need is ASAP; I would listen.

You mentioned your heart stopped for 4 seconds while wearing a Holter Monitor....next time your heart could stop for more than 4 seconds and may not restart.

No one that I know of is particularly excited about getting any heart device, but I'd rather be alive with one, then dead.

But by all means, life is life, and it is completely your choice. A second opinion won't hurt.

However, I don't understand how a pacemaker would interfere with your profession.

Best of luck with whatever decision you make.

Pookie

well

by Tracey_E - 2009-12-13 09:12:27

You don't have to do anything you don't want to do, but do you want to risk your heart stopping long enough for you to pass out when you're flying? Is it even legal for you to fly now that you've had the diagnosis? Pauses and low heart rate affect our judgment and ability to make snap decisions, that can be life or death if you're a pilot.

Seems to me the risk is a lot worse without having the pm than possible limitations in the future. Most people are able to go back to work without limitations because the pm more or less fixes our problems, some exceptions of course depending on what type of work you do. We've had some members in the military dealing with possible discharge and I know of one EMT who was not able to go back to work. Her doc cleared her but her employer's insurance wouldn't allow it. Other than those cases, just about everyone else I'm aware of has been able to return to work.

A second opinion is a great idea, but don't be too surprised when they concur. Four seconds is a heck of a pause, and things like this do not get better on their own. If you have questions about the surgery, recovery or limitations later, please ask away! We've all been there. It's not as scary as it sounds. I put my implant off until I ended up in emergency surgery and almost died, I don't recommend that path. ;o) It turned out the surgery was a lot easier than I ever expected, and I felt so full of energy that I regret stalling for so long, living with feeling bad all that time when I could have been feeling good and getting on with my life.

I didn't read your profile but assume you're young from your message. We have a lot of young people here with pm's who live full, active lives. Go take a peek in the member gallery. I'm 43 now, got my first pm at 27 for heart block.

Did they explain to you what a heart block is? It has nothing to do with blocked arteries, it's electrical.

To Have or Not to Have?

by Carolyn65 - 2009-12-13 12:12:41

After finding the PM Club, I wrote & wrote for five months re: whether or not to have a PM as the cardiologist/EP suggested. After so many qualified, educated comments by the PM Club and the urgings from everyone else, ie, my GP, my family, etc., I had the PM implanted 10/2/09.

I can not even tell it is there. The PM never "twitches", "plinks" or "hiccips", never travels from its lil' pocket insert, etc. like some members have mentioned. I have a Boston Scientific, but I think they all do the same great job.

Before I finally agreed to the PM, my cardio. had tried meds, stopped my heart/shocked it several times, all to no avail.

Have you talked to your cardio. re: what this PM might/will do to/for your job in aviation?

Let us hear from you after your Dr. visit, God Bless ~
HAPPY HOLIDAYS ~ Carolyn G. in TEXAS ( :

W/O PM you won't fly

by COBradyBunch - 2009-12-14 03:12:25

from everything I know, with your diagnosis (much the same as mine) you will not be able to fly IF you don't get a pacemaker. I was told that I was going to lose my drivers license w/o one (about the same diagnosis as you, but my pauses were at least twice and sometimes three times as long as yours). The pacer prevents syncope which will prevent you from passing out. I had two 'awake' episodes which caused me to pass out which led to a stay in the hospital and a visit by a crash cart (lucky they didn't need to shock me, I started back up on my own).

Now I cannot tell you what the FAA would say but based upon what i have read it seems that you will definitely not fly w/o a pacer. If you can with I guess will come down to a full physical and what your doc says.

Results

by chopperdog - 2009-12-14 04:12:58

Talked to an Electro-Physiologist today.
He thinks I am actually perfectly healthy, and that upon review of my records, that I do not need a PM.
Thank you for all the information.
For now,I intend on following the advice of the Cardiac Specialist I saw today.

Thanks again!

Chopperdog

diagnosis

by Tracey_E - 2009-12-14 05:12:47

How did he explain the pauses on the holter? I agree you probably don't have SSS and/or heart block because pauses aren't typical of either one, but something is going on if the holter recorded pauses and you have symptoms. Since your two diagnoses are so different, maybe get a third opinion? Good luck!!

explanation

by chopperdog - 2009-12-14 07:12:27

He said the pause was a Vagal (sp?) pause.
It had to do with my body being okay with it's oxygen level, and my body was going into a state of complete relaxation. My pulse was 38 bpm.
He actually said that the low pulse was very good, associated with the pause, because it indicated I was healthy. Or something to that effect.
Thank you,

Chopperdog

Thank you everyone for the resposes!

by chopperdog - 2009-12-14 09:12:30

Thank you. It's nice to have input.
I think that inside I know this is the right action.
I am not actually nervous, well a little, but I just want to do the right thing.

First and foremost I am a dad. I want to be around another 200 years or so (one can dream), so I'll do whatever helps me accomplish that.

Career wise, this won't greatly affect me.
I am in a non-flying position at the moment.
Legally I gave up the right to fly the minute I got the diagnoses.
The FAA is very strict, as they should be, regarding pilots physical condition.
Every pilot must pass a physical. The more responsibility you have, the stricter the physical requirements. In all cases, if you have a heart condition that requires a pacemaker, you may not fly, at least for some time.
Eventually I can get my medical back, maybe, but it requires quite a bit of hoop jumping.

I am 41 now, so I have a long time to fly again, if I decide to.

Thanks again everyone.

Today is the 2nd opinion. I'll update you folks this evening.

Have a Great Day!

Chopperdog

I would agree but...

by Tracey_E - 2009-12-14 10:12:50

if you weren't symptomatic, that would be a great explanation. The fact that you're lightheaded and short of breath says your body isn't ok with it. Getting by with a low heart rate is acceptable in very well conditioned athletes, in the rest of us it means our bodies need more oxygen.

I know you like what you heard today and I don't mean to be a downer, but I'd get a third opinion. Call it a tie breaker :o)

More Info.

by chopperdog - 2009-12-15 10:12:14

Thank you for all the input, it is great to read.

Okay, so apparently the whole vagal response explanation is not valid, at least according to my primary cardiologist.
This response is what makes people pass out when they're scared, or in great pain. It is not associated with deep sleep.
So, time for a 3rd opinion. Making the appointment tomorrow.
I guess the main concern is not that my heart will stop and not restart, because it properly will.
The concern is that it will happen at an inopportune time, i.e. driving, using power tools, etc.

Thanks again.

Law

by annaelliott76 - 2009-12-15 10:12:59

Sounds like you have what I do. They tend to use a lot of different terms for the same thing. I was told I had vasovagle syncope, orthostatic hypotention, etc. etc. It's sick sinus syndrome in the end. My EP chose, because of my age, to try ALL medication possibilities before a pacemaker. ALL served to make me completely miserable and did not help the problem at all. So far PM has done well. In my opinion he wasted a lot of time and money doing this. If you feel you need another opinion, get it. I did and every single one said the same thing. FYI- 2-3 of these syncope episodes in a month. I was informed that I was not allowed to drive, by law, for 3 months after the last episode. The PM will allow my driving privileges back. If I can't drive, they will not let you fly! Trust me! If they do, I will really be surprised.

Anna

pulse history?

by pacer30bob - 2009-12-16 02:12:30

Hi Chopper,

I would keep a record of your pulse rate now. I went from 70s to 50s to 40s over 30+ years and never one symptom and sleeping was in the 30s with a 3 second pause. One visit my cardio said "see you next year". . . after the Holtor
results and the 3 second pause he said "Time for a PM". I would not want ot be driving (or flying) with a 4 secord pause possible. The way my docs got my attention si to say "You only have to faint once at the wrong time". . .like going 65 on the Interstate. I asked my cadio about medications but I don't think that is the answer.

Play 3 sets of singles tennis and always was slow/lost the first set until I got my pulse up to 70 by the second and third. Usually won those. Looking forward to playing 3 sets in a few weeks nd see how the first set goes.

Keep an ey on the pulse rate. . .don't take many chances witha 4 second pause would be my thoughts. Do I love my PM. No. Am I worried about waking up in the morning after finding out about my 3 second pause and 33 PBM while sleeping . . .not now.

Cheers

New Pacer

wuw!!

by Hot Heart - 2009-12-20 05:12:21

I wouldnt fancy being on a plane with you without a pm!

Dont worry, better to be safe than sorry

where's Chopperdog?

by mock911 - 2010-03-20 03:03:11

Anyone know what happened at Chopperdog's third opinion visit?

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