Neurocardiogenic syncope and pacemaker

Hi! I've had my dual chamber Medtronic pacemaker for one month today. I had it implanted due to neurocardiogenic syncope and Mobitz type 2 AV blocks. I've forever had episodes of pre syncope when eating bulky food, getting symptoms whenever I swallow a big piece of bread, for example. When I wore the monitor for a week, I would push the button whenever I felt this but my EP says nothing was happening with my heart when I pushed the button. Instead, there were other times I was experiencing heart blocks with no symptoms at all. This confused me because a prior monitor years before had caught an episode of AV block in response to eating. All this to say that in the past two days I've started noticing these symptoms again. I hadn't noticed it much in the initial weeks post implant but had a different setting the first two weeks and also don't have those symptoms every day. Is it possible I have dislodged a lead? Or do people still experience pre syncope with the pacemaker-and the pacemaker just prevents the full syncope? Or is it possible the pacemaker just doesn't address this particular problem? Any ideas are greatly appreciated. Thanks!

4 Comments

pacing

by Tracey_E - 2018-04-21 09:27:01

The pacer is only going to help when your heart slows down or is in block. NCS can be a combination of heart and blood pressure. The pacer can't help with the bp part of the problem. 

What a pacemaker can do

by Gotrhythm - 2018-04-22 15:48:41

When my friend got a pacemaker for NCS, the EP was specific that the pacemaker would not prevent presyncopal symptoms, nor syncope in all situations.

It will stop your heart rate from going too low, and it will keep your heart from stopping, but it can't prevent your blood pressure from dropping. If your blood pressure goes low enough, you will faint.

Last year, after several syncopal and presyncopal episodes, I was given the tilt table test, and although I had had a pacemaker for 6 years, my bp dropped to 34/10 and sure enough, I fainted.

 

Thanks!

by Jenni.k - 2018-04-22 21:52:34

Thank you! This is actually reassuring. We weren't sure if the PM would change these symptoms but since I hadn't felt them in the first weeks I was getting nervous I had dislodged a lead or something. I'm still learning what it can and cannot do!

leads

by Tracey_E - 2018-04-23 10:08:57

After the first few days, it's unlikely you'd dislodge a lead. There isn't much we can't do due to the pacer! Live your life and forget it's there. 

Did you get a home monitor? When in doubt, you can always generate a download so they can check and make sure nothing was going on at the time you had the symptoms. 

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