Presyncope due to low settings?

2 questions for you guys:

Have had my PM (dual lead PM) for 3 weeks. 32 years old. Bradycardia and syncope were why I got it. 

My settings were 50 bpm (low) 130 high, with rate response turned off. 

Over the last week I had 3 presyncope episodes (more than just feeling weird), thought I was experiencing syncope and at the last moment my PM would kick in and bring me back (pretty scary stuff!!). First one I thought "Oh well, that was weird, but everything is weird right now", second and third were last night (and one of them was worse than the other two), so went to ER and got my settings fixed to 60 bpm and rate response turned on High. 

Question 1: Did/does anyone else go through this? Does anyone else experience presyncope, light-headiness, dizzy, etc? Cardiologist doesn't seem too worried now that the settings are changed. Does it change over time (better or worse?)

Question 2: I think rate response solves this, but I noticed I was dipping into the 40's even with my setting at 50 bpm as the low (rate response was OFF before today). Now that my rate response is on - that means it kicks in much faster right?

Many thanks, everyone on here helps me sleep much better at night!


3 Comments

low rate

by davey - 2019-06-08 02:07:08

Hi,

From what i can work out it would appear that your device is a new implant, 1st one yes?, sometimes ive heard that pm has to be adjusted to suit the condition as to the patient needs.

What if you know is the pm mode?

What is the VP , Ventrical pacing doing setting ?

and same of Atrial, i take it you are set in DDD ? dual chamber device,

it seems strange that if baseline setting is set at 50bpm, it should not go below that, if you have discussed this presyncope episode with cardiologist, maybe baseline setting has been adjusted since.

The idea of fitting a pm is to improve your quality of life, its there to help you..

Hope this helps irish cat.....

 

+1, Irish

by AgentX86 - 2019-06-08 13:57:14

In addition,  I would suggest that anytime anyone with a PM has an issue like this, that the send a remote transmission to their EP. Then follow up withe the PM tech and EP's nurse with an explanation is the transmission, complete with a description of the episode. They can't fix what they don't know is broke.

Thx

by irishcat16 - 2019-06-08 18:07:16

Thanks AgentX86 and davey. Great feedback. I went into the ER so everything was looked at on the EP's machine there. 

@davey- in reply to your comment...

it seems strange that if baseline setting is set at 50bpm, it should not go below that, if you have discussed this presyncope episode with cardiologist, maybe baseline setting has been adjusted since.

>>>>Yea I guess that's what my rate response (originally set to the lowest) was doing. It was letting me try to figure it out before jumping in aggressively and shooting my bpm back up. So I was dipping lower than 50 bpm getting super close to syncope and then at the last moment my PM was kicking in and keeping me from passing out. 

I'm now set to 60 bpm and feel WAY BETTER, and my rate response is turned up much higher so I won't dip below 60.

Thx for your input.

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