Is a pacemaker right for me?

Hello, I am 27 years old. My story began in April 2018. At the time, I thought I just had nausea and vomiting, went to the ER, they said everything was fine and went home. Next episode happened in June/July. I completely passed out twice. Both times while sitting down. Second time I was sitting in bath tub, boyfriend found me passed out and lifted me up and was shaking me awake. He said he thought I was dead. He said there was no response. Called 911, sat in ER with monitoring. Told Dr. I was having same symptoms as before, when I passed out. Stayed alert but monitor recorded my heart paused for 5 seconds. The whole staff pretty much told me a was getting a PM. Went to cardio unit for 2 days under observation. Cardiologist said everything looked fine and sent me on my way. Next episode happened in August. Felt same as when I was in ER. Emailed Cardio, scheduled tilt table test. Test was at end of August. Passed out at 40-minute mark. Recorded a pause of "at least 20 seconds". My cardio sent me for a second opinion. Second opinion suggested medication. I pushed for loop recorder. I got recorder implanted at end of October. Only symptoms recorded so far are Tachy. Apple watch has recorded HR as low as 36 bpms. 

So, to break it down:

Recorded two pauses so far: 5 seconds and 20 seconds

Tachy recorded

Brady recorded

 

Any suggestions?

Thank you in advance.

5 Comments

decision time is eminent

by zawodniak2 - 2019-01-09 11:49:27

I had my pacemaker put in 10 years ago with less severe episodes than what you are describing and glad I did as I have not had a dizzy or fainting episode since.  I, too, was in denial but I also had a left bundle branch block which probably did not help my situation.  One thing that is pretty certain is heart rhythm episodes can be very intermittent and totally unpredictable and sudden with no warning and they don't heal themselves and generally get worse with time.  Obviously, this can result in dire consequences of scary degrees.  When I finally consulted a very reputable and highly experienced electrophysiologist for a tilt table test, the results were somewhat unremarkable but indicated I had a "lazy heart", which I took as meaning my ticker was in a bradycardia mode and at unpredictable times did not respond adequately.  When I asked the electrophysiologist what the downside was of getting a pacemaker if I really did not need one, he replied "you will be needing one someday"-----at which time I said, "let's do it".  My 6-month interrogation checkups have revealed I am 99.9% dependent on the pacemaker to keep my heart beating at 60 bpm or higher at rest and to raise my heart rate with exercise.  So the doctor in my opinion was right with his prediction. I also confirm this with my Fitbit on my iPhone with 24 hour total charts. 

Also, one of the elephants in the room is the constant related stress of when the next episode will occur.  I did not appreciate this until after I got my pacemaker and after the initial acceptance of knowing all is well---my anxiety was gone.

My advice is to consult, post haste, with an experienced electrophysiologist (a cardiologist who specializes in heart rhythm problems}  even if you have to travel out of your location as I did and in your case, consider a pacemaker like a seat belt. It's there if you need it.

Also, in my opinion, a heart rate of 36 bpm and pauses of 5 and 20 seconds indicate an accident waiting to happen!!

Hope this helps

Rodger

 

Get another opinion--now!

by Gotrhythm - 2019-01-09 19:36:35

It's entirely possible that your heart is completely healthy, no heart disease at all, but that something has gone wrong with the electrical system. A pacemaker can ensure that your heart beats fast enough and that it no longer pauses.

I think it's time you ask the doctor, not do I need a pacemaker, but is there any reason I shouldn't have a pacemaker.

I don't know but I'm guessing you've got a doctor who thinks you're "too young."

Yes, you need a second opinion from an electophysiologist (EP) And you need it now. You have a life-threatening condition. If you pass out in the wrong place or wrong time, say, when you're at the wheel of a car, you could die and take others with you. 

 

One more thing...

by Gotrhythm - 2019-01-09 19:39:13

You'll probably be surprised at how much better you feel with a pacemaker. A steady heartbeat is a beautiful thing.

What worries you about getting a pacemaker?

by LondonAndy - 2019-01-10 03:57:15

It seems to me that the question to ask is why do you NOT want to get a pacemaker?  Is it because of cost?  Concern that you are accepting you are not as healthy as you thought?  Perhaps it is because I like technology and have quite a few gadgets around my home, but even if a doctor said a pacemaker might be needed I would get one, as I am not sure what the down side is.  You have given good information in your post which as others have already said strongly suggests the need for a pacemaker. A bit like the need for glasses to correct vision: you don't have to have done anything wrong to need one, it is just one of those things.  

Find a good EP and get tested ASAP

by kmcgrath - 2019-01-11 16:40:06

https://www.ucsfhealth.org/education/electrophysiology_procedure/

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It's much better to live with a pacemaker than to risk your life without one.