Considering the pros and cons of a pacemaker for bradycardia

Don't mess about with sinus pauses....

by Zoë - 2018-01-29 05:41:05

Hi Lissh,

Everyone is unique and therefor treatment plans differ, however - suggestion of a pacemaker would be enough of a nudge for me to "choose" one.

in my personal experience, my electrophysiologist was pondering wether I needed a dual chamber pace maker way back in 2009 (after I started developing intermittent AV block after my second ablation)but decided against it although I "chose" to have one.

2yrs ago I had a documented case (rhythm strip with vitals) of Polymorphic VT. Again it was debated wether I needed a device - that said device then being up scaled to a dual lead ICD Pacemaker.  Again, it was decided against although I "chose" one.

last October, I suffered a cardiac arrest at home (I'm 36yrs). After quick thinking from my girls, and CPR from a neighbour, I spent next 6weeks in hospital...I won't bore you with the details, you can read them in my profile. It was without hesitation then that I got my ICD pacemaker.  The official indication for it:

Polymorphic VT and Sinus Pauses.

There maybe a chance that you can get by in life just fine without the device. However, that one time you may really need it you will always be forever thankful you "chose" it.

Getting a cardiac device is not an easy choice, many people don't get to choose but for me it felt like an obvious one.

wishing you all the best with your informed decision and kindest regards,

Zoë

Pacemaker

by haley108 - 2018-01-29 06:16:20

I understand your issue I went through the same thing! My heart rate was 38-42 24/7. A pacemaker helped me tremedously and really did help my energy. There are pros and cons of everything of course. But it really did help me and makes a huge difference. And having one is no where near as bad as you might think. I promise 

ugh

by Tracey_E - 2018-01-29 09:16:51

One of my BIG PET PEEVES is putting it off due to age. Why should you wait until your life is in danger???? Your quality of life is compromised and there is a fix. Seems a bit of a no brainer to me.

My doc was the same way, I was young (early 20's) and he didn't want to do it if we didn't have to. The internet wasn't around then and I didn't know anyone else like me. I was terrified and happy to procrastinate, figured when  couldn't stand it anymore I'd have to go through with it. One day my heart rate tanked (21 when I was admitted) and I  ended up in emergency surgery. Not the easy way to do it!

One little detail no one mentioned.... I would feel a million times better with it. I never thought beyond the life saving aspect. I struggled for more than two years when I could have been feeling good all that time. A low heart rate is hard on the body. Organs need oxygen they aren't getting. Can we get by? Yep. But it takes a toll. Unnecessarily. Afterward, I was resentful that the doctors let me get so sick before they did anything about it. If I'd been 60 or 70 or 80, it wouldn't have even been a discussion. Age is irrelevant. My advice is if you can't do what you want to do, don't put it off.. Get it then get on with your life. 

Simple

by ROBO Pop - 2018-01-29 11:13:51

Your heart supplies oxygen and nutrient enriched blood to the organs of your body which keeps them alive and functioning properly. Cut off that food supply or diminish the flow and the organs slowly begin dying. Pretty simple decision

Braydicardia

by zawodniak2 - 2018-01-29 11:53:18

After passing out and being hospitalized  and several near episodes thereafter,  I had an electrophysiologist perform a tilt table test..Results were a "lazy heart" which means it beats slower than normal and does not respond to demands as fast as it should and is limited on the upside of activity.  I asked him if I really needed a pacemaker and he said I would be needing one some day; at which time I elected to get "Sparky"put in.  That was10 years ago at the age of 65.  Over that period of time I have become 99,9% dependent on the pacemaker to keep my pace at 60 bpm or better depending on my activity level.  I have good energy and periods of dizziness have completely disappeared.  One of the main symptoms seldom addressed on this great site is anxiety.  The subconscious feeling of not feeling well or fear of dizziness and in my case, passing out, was eliminated after getting my pacemaker.   Good luck with your decision and I hope this helps.

                                       Rodger 

It is my four year anniversary today

by Scout - 2018-01-29 14:02:03

Dear LISSH,

Today is my four year anniversary.  I am 61.  I didnt feel well for 3 years and my doctor would not listen to me.  Finally a NP put a monitor on me and my pulse was as low as 27.  I feel so much better now.  Also, this may sound crazy, but even my nails were starting to change due to lack of blood flow to my extremities.  Today, my nails are almost completely AOK.  You should get a pacemaker if you have bradycardia.  I have Sick Sinus Syndrome.It took me a month or so to get used to my pacemaker but it has totally improved my life.  I know now that I have had heart problems all my life, but I was very active and ran/swam most every day and somehow I did OK even though I had this problem.  Best wishes to you and medical engineering has made people's lives much better! 

don't put it off

by islandgirl - 2018-01-29 16:26:21

I have SSS.  I had always had a slow resting heart rate, had some light-headed issues and was wearing a 30-day holter monitor. My EP called me early in the morning (a Monday) and told me to get to the ER (EP directed me where to go to the hospital he worked out of--2 hours away--my rural hospital would have transported me to a different hospital) as I was in a junctional rhythm and my rate was in the mid to upper 20s and my rate had dropped into the upper teens at night and was having long pauses.  I felt terrible that morning and could barely function.  I was admitted right away and scheduled for pm surgery for the following day.  That night as the nurse was coming in I was panicking that I was going to pass out, I was shocked and came to with the nurse telling me I was ok now, cardiac care unit was full so nurse sat with me all night with crash cart in room, constantly calling my EP.  I told her he needs his rest as he's going to be working on me the next day lol.  It was a long night, as I couldn't sleep.  The monitor kept sending alerts to her. The next day I waited quite a few hours with a nurse at my side in pre-op with alarms constantly going off.  It was one of the worst experiences.  Don't put it off.  You will feel so much better.  

You will be able to go back to your activities.  Mine is placed subpectorally/under the muscle, so it doesn't get in the way of my active lifestyle.  Healing was a little longer and a little more painful.

I'm glad you are having time to do some homework, as I didn't get any time to prepare.  

It's really a pretty clear decision....

by MartyP - 2018-01-29 17:01:23

If you don't get the PM, you may die in your sleep, driving a car or climbing a mountain, or feeding you family breakfast or dinner.

If you get the PM you won't die from your heart stopping.

"When in doubt, there is no doubt"

"We know a thing or two because we seen a thing or two"

For me, a 31 second heart stop, I was lucky I was in the hospital as I had fainted, 4 hours later I got Sparky and I'm alive for me and my family ....

So just do it !!

Thank you

by LIssH - 2018-01-29 17:56:17

Thank you for all the comments. 

The decision is hard as my cardiologist says "my life it not currently in danger and i don't 'have' to get a PM" though if i do, it will likely improve my quality of life. 

It would almost be easier if i didn't have a decision but also feel i am lucky to get a PM before something more serious happens. 

I'm glad to hear a lot of positive comments because reading some of the other threads on this site was making the choice harder. 

Be Careful You Have a Choice

by Terry - 2018-01-29 18:12:40

You may have heard, and your doctors know, ventricular pacing more than 20% of the time causes heart failure in 10% to16% of patients. Two ways to avoid heart failure, see if atrial pacing only works for you or be sure to get His bundle pacing (His-pacing.org) to pace the ventricles. You may have to go to a university hospital or a place like Mayo or Cleveland Clinic to get it done.

Terry

Do it...

by Washingtonienne - 2018-01-29 22:39:00

Hi LIssH, 
I was 34 when I got my pacer in October 2017.  Like you, I used to come home from work, sit down, and fall asleep before I even got dinner.  I too had a "choice" - getting the pacer wasn't required but I also didn't like the idea of pausing, as caught by a loop recorder, so I chose to go ahead with the pacer.  
Oh. My. Goodness!  I get so much shit done in the evenings now!  And I wake up in the mornings with much more energy.  So, do it.  Get your life back.  

reduce the risk

by wilfj - 2018-01-29 23:40:31

Your Doctor  should be making the call here. I would certainly have a Doctor set your PM . I had a lab techie do mine THE FIRST TIME  and it screwed up !! The Doctor specialize in PC etc( per Robin2 post ) reset mine in the hospital .. he was at a complete  lose how the Lab had set it  !! I have mine now checked very 3 months rather then the normal 6 months......It's a small computer and it does need a check up from time to tme other then that it does it's job 24 hours a day.

I'm in Canada and I really enjoyed the Tennis the past week... Good show !!

His bundle pacing

by Paced2017 - 2018-01-30 06:39:35

You are wise to seek advice and think about the options carefully, and even get a second opinion if you are worried and concerned about going ahead.. Terry has made a good point. At your age, if the problem is sick sinus syndrome I would think that atrial pacing  (single chamber) is the way to go so you can avoid having a second lead put in at this stage. Pacing technology is moving ahead quickly so there are likely to be great advances in the years ahead.  If you need a second lead at this stage to pace the ventricles then as he said ask to get a referral to a cardiac electrophysiologist who has experience with his bundle pacing to discuss this option. I'm Australian and there are  EPs in Australia who have started using this technique. But find one who has experience with this - ask how many they've done. Good luck! 

As Nike says, just do it

by Bionic babe - 2018-01-30 07:41:40

I'm so glad I didn't have a choice as I was underage. My parents made the decision and thank god they did. I was having seizures every second day, losing bowel control, frothing at the mouth, always tired and puffed out. If I had the choice now, my decision would be clear as day. I live a full life and always have thanks to my PM. It has become the norm for me. Most people don't even know I have one unless I decide to tell them. 

It's all about quality of life!

Xx

Would feeling better make your life work better?

by Gotrhythm - 2018-01-30 13:53:49

As I understand it, at this time you have a quality of life issue. And it's hard to imagine how it would feel to feel different, and of course there's no way of knowing how different you might feel.

With hindsight, I realize I could have used a pacemaker ten years, maybe more, before I got one. I think about the days I was too tired to move "for no reason." I think about how I knew I wasn't working up to my potential, but some days I just couldn't do certain mental tasks because of brain fog. My memeory was sharp some days, completely unreliable others. I worried about early onset demetia. My hands shook more and more until I could no longer paint. I would tell doctors my symptoms and they would diagnose depression. They weren't wrong.I was depressed. Life was hardly worth living. But depression was the symptom, not the cause.

Who knew what was going on was that my (perfectly healthy!) heart was working a lot better some days than others?

Only you can know how much better your life, and your children's lives, might be, if you felt better, more able to do the things you want to do. But it's worth thinking about.

It Was a Good Choice for Me

by Lisa48 - 2018-02-01 17:58:58

I developed Bradycardia at age 49 and I was very worried. As soon as I woke up after the surgery, I felt good. The only problem I had was panic issues off and on for 1 year.

I have learned that I can count on my pacemaker to handle things and my panic issues have gone away. Someone on this site wrote, "There is no downside to having an on-demand pacemaker." Those words are true for me.

Thank you

by LIssH - 2018-07-09 22:34:23

Thanks everyone for your advice. Reading your comments makes the decision much clearer.