Waiting for Pacemaker

I'm 29, F, and i was diagnosed with complete AV block just recently.

All my life i was asymptomatic, I never really felt dizziness, chest pains or lightheadedness (or so i thought, cause i think i don't have any other comparison). I lead a very normal life. I play sports at least twice a week and I even went skydiving just the previous month.

One day, I was on my third day of fasting for my religion (dinner only), I went out with my friends to have dinner. I was making a joke so I stood up quickly then, I fainted. I woke up 30 secs after.

When i was in the hospital,I'm apparently already averaging 39bpm resting heart rate and my sleeping heart rate goes down to 30bpm. I did multiple tests (ecg, stress test, 2d-echo, cardio mri). They said that my tests such as MRI is good (my heart is structurally ok). During my stress test i reached anout 110bpm. During my 6 day stay in the hospital, i felt normal and i walk around and go to the toilet. No more fainting episodes. Doctor said that my lower chamber is independently beating as a survival mechanism and could be stressing my heart already.They told me that to have PM for preventive measures.

At first i was really scared of PM. Why would i need it? Me passing out could be because i didnt eat anything right? Why would i have surgery if I feel okay? I was scared that it will change my lifestyle and I'll be limited to what i can do. Once i was educated by the doctor and read messages here i become much more confident to do it.

 I'm scheduled to undergo surgery on the 25th, which is 2 weeks from now. 

Because of the incident, some nights i become anxious to sleep. I was scared that my heart will not beat anymore. Is 2 weeks from now a long wait? i ws thinking if it's an emergency the doctor will do it asap right?

 


5 Comments

Heart block

by AgentX86 - 2019-07-12 09:15:39

If you really do have a complete heart block, yes, you do need a pacemaker. This is a pretty easy diagnosis to make, so that would be my working theory. However, I don't trust ER cardiologists or any that just happen to walk by in the hospital. I'd highly recommend using that two weeks to find an electrophysiologist (not just any cardiologist) and make sure that you know everything that's going on. As you've surmised, you've probably been living with this for some time. Make sure they've got it right. In the mean time, be very careful of stairs and NO DRIVING. You got lucky once. One more syncope event could kill. You, or someone in the other car.

yes you need it

by Tracey_E - 2019-07-12 10:02:25

I think you are going to be surprised how good you feel after! I was similar to you, my rate didn't go up much and my resting rate was always very low all of my life. It's all we know so our bodies get used to compensating. When I woke up after surgery, I felt like I'd been mainlining coffee. I got in trouble with the nurses for pacing the halls that night but I had too much energy to stay in bed. I was 27 when I got my first one. I am 52 now, ran a couple of miles this morning, have been to the gym every day this week. There's nothing I want to do that I cannot.

The pacer completes the broken circuit and makes sure our ventricles beat when the atria does. If we have to have a heart condition, we have a good one because the pacer can easily fix it and give us a normal heart rate. 

If they were worried about your safety, you would have had emergency surgery by now. Take it easy, don't do anything strenuous, but there's no need to worry. If you feel worse, go to the ER. Not driving is good advice, better safe than sorry. If you have questions about the surgery or recovery, or just want to talk to someone who has been in your shoes, please don't be shy!

same thing

by SamanthaS - 2019-07-12 10:47:28

I walked around like you for years with intermittent heart block that was undiagnosed until 4 hours before I got the pacemaker.  The three weeks previous were the worse weeks of my life with terrible fog and head rushes.  It is a miracle that I did not have an episode while driving.  Get a good EP's opinion and then do it - it's quite something to have those horrible symptoms gone forever and not need to live in fear.

Complete block

by dogtired - 2019-07-13 00:39:30

It seems odd that they can diagnose a complete block when all your tests are normal!  I don't beleve it can be done unless you experience a block while on and ekg.  Even then it may not be clear unless its repeated.  I was just on a Holter for 7 days during which I experienced 1 episode of chest discomfort.  My EP stated it was a complete block.  When I questioned him he clarified that it appeared to be a complete block but couldn;t be sure.  More surprising he didn't recommend a PM because of the one event, and didn't even seem concered.

If you're asymtomatic except for the one incident, which may be related to fasting, I would question your EP asking how he knows its a complete block when the ekg was clean.

I'm surprised that at 29 and active in sports your max was only 110.

dogtired, clarification

by Tracey_E - 2019-07-13 10:30:41

There is a tremendous difference between an episode of complete heart block and being in complete heart block all the time. Tests that look for structural problems- echo, mri-  will almost always come back normal when we have heart block because our problem is electrical, not structural.

Only getting up to 110 on a stress test is not normal, and it's due to the heart block. The atrial rate is getting up like it should but the signal isn't getting to the ventricles so the pulse stays too low. That right there is why she needs the pacer, so the ventricles keep up with the atria and the rate goes up normally on exertion. In addition to the low rate being harmful, it's hard on the heart to be out of sync.

A resting rate of 39 is nowhere close to normal. A rate of 30 is downright dangerous and likely how she passed out and reason number two not to question the doctor telling her she needs a pacer.

My complete heart block was diagnosed 20 years before I got the pacer so I know first hand about being in block and not being paced, and when the signs point to giving in and getting it. I also know all about waiting too long. The signs were there and I chose to procrastinate, then one day my rate dropped to the low 20's and I almost died and had emergency surgery. Definitely not the easy way to do it! After my only regret was waiting too long. So, if the signs are there, just do it. My daughters are a few years younger at 21 and 22. If either of them had what ohtoodles describes, I'd be right there holding their hand and scheduling the surgery. 

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