Hi All 

I just wondering if any of my fellow PM recipients have experienced fatigue after their surgery.  Im about 2 1/2 weeks post surgery and im trying to get back into my normal life.  I usually get about 7 to 8 hrs of sleep every night and typically start my day around 9 am. Ive been going to the office and dealing with my typicall business stuff, try to get out a little for a lunch or dinner and even get to the gym for a light leg workout and a little fast walking on the treadmill.

Pre surgery even with my condition id be out by 730 8 am to work,  work 10 hrs and squeeze in a good gym workout along with  a dinner or night out. Get to bed by 11 1130 and do it all over again.  Now im looking for my couch by 7pm lol.  Just wondering if its common to be a little tired and fatigued in the weeks post surgery and can I hope and expect to get my old energy levels back now that I have my new PM.  Im feeling like an old man right now lol. I am 54 so maybe I am.

Thank you all for the great support.


It might be something completely different

by crustyg - 2021-01-28 03:37:14

As you say, 54 is *not* old - you're not even a Young Senior yet.

Chances are high that you've picked up a virus - *any* virus - and that's why you're feeling low,  no energy.  In all the fuss about SARS-CoV-2, we seem to have overlooked the usual seasonal infectious diseases (although it is true that notifications are lower than normal).  It won't be Influenza-A - *nobody* can possibly mistake Influenza-A for any other disease, and so-called 'man-flu' is *never* Influenza-A, it's usually one of the Parainfluenza viruses.  Proper 'flu can be diagnosed over the telephone, as you usually can't manage a single sentence without coughing, and in the first couple of days, you can hardly find the energy to rise from your sickbed to use the WC.

Get Well Soon!


Oh fatigue I know it well

by Gemita - 2021-01-28 04:47:49


Let us break this down into manageable bits because Fatigue is a huge subject and can be caused by a wide range of conditions and I suspect most doctors get consulted about Fatigue more than anything else.  And it is a problem which I am not trying to diminish because it affects our very enjoyment of life and can ultimately lead to accidents due to poor concentration as I well know.

Some of us can feel extreme fatigue following pacemaker implant.  I did for a variety of reasons.  Your body Steve may have been traumatised both emotionally and physically by the implant procedure and this can take a heavy toll on your health, leading to fatigue.  This is not uncommon initially.  Leads have been attached to your heart, your heart is being paced for the first time by a device which may not be completely in tune with your own body, with your own lifestyle just yet and which may still need some adjustments to get the pacing right for you.  And then let us not forget, your device may not be very comfortable to sleep with for the first few months and our quality of sleep is often poor while our wounds are healing and the device is settling in to its new pocket.  For example I couldn’t comfortably sleep on my side for the first few months.  Poor quality of sleep will quickly lead to fatigue.

The other problem that can happen following pacemaker implant is that we may temporarily become aware of our hearts throwing additional heart beats called ectopics, or if we are arrhythmia sufferers, we may find that our hearts get upset by being paced and having been traumatised and this can lead to a temporary worsening of any arrhythmia(s) present until our hearts settle.  A paced heart, which is still adjusting to pacing and settings which may still need adjusting to suit you better, together with heart rhythm disturbances, can quickly lead to fatigue.   When the rhythm is off, we feel off.  But Steve, heart rhythm will naturally settle if you give it time.  

If however your fatigue is so overwhelming that you cannot function, that you notice a worsening of your general health and this continues, then you need to speak to your doctors for a few health checks.  In this instance too, I would let your EP/cardiologist know as well just in case they want to carry out a few checks on your heart function.  I am hopeful though this is all very very normal while you and your pacemaker are settling down.  

Have just seen crustyg's response and I totally agree with him too, this is the time of year for all manner of viruses to appear and you might want to get on top of them quickly to protect yourself and your device at this early stage.  If you have an infection that can be treated (say a bacterial one), start treatment early, drink lots of tepid water to keep well hydrated, eat lots of fruits, vegs and have lots of warming nutritious soups, get more rest if your body needs it.  Don't push through fatigue. Don't be afraid to listen to your body.  It will guide you back to health.  Remember too this is SAD (seasonal affective disorder) time of year when our body clock can get out of whack quickly leading to poor quality of sleep, so there may be lots of things going on.  Have I made you feel better, or worse!?

I too wish you well and let us all try to smile 😊 Life will be worth living again soon


by Tracey_E - 2021-01-28 12:06:12

I napped more days than not the first month or so. I felt fine, but I just could not stay awake all day. It's a minor surgery but it takes a toll on our bodies than we think. It didn't last. 

Settings need tweaked?

by ar_vin - 2021-01-28 13:48:36

Beyond recovering from the procedure and your body adapting to the PM I'd suggest having your PM settings checked, and tweaked if needed. In my case the settings changes made a world of difference. But I would wait a month or two post implant to mess with settings.

Thank you for replies

by SteveV - 2021-01-28 23:02:58

To all respondents

Thank you for your replies. I greatly appreciate you sharing your experiences and your knowledge. I apologize if I might have mislead some of you in that I am not so exhausted that I cannot function. Its just that pre surgery i seemed to have more energy in general. Now I just get tired alot earlier during the course of the day. Im going to go with the suggestions that my body and my mind have definitely been affected by the surgery and I just need to heal over time. Again both physically and mentally. My one month check up is scheduled for February 9th so I will definitely discuss my settings with the Dr as well.

Thank you again guys for all  your insight.


Listen to Ar_vin Settings matter

by Gotrhythm - 2021-01-30 17:28:58

Ar-vin has already mentioned settings, but I want to underscore his remarks.

I didn't understand what settings were, much less how much difference they could make in how   well one can feel.

Right now, your pacemaker probably still has the one size fits all settings all pacemakers come with. Fortunately for you, you're younger and fitter than the 74 year old who is the average recipient of a pacemaker. The settings that would work well for them will keep you alive but they won't support the activity level that's natural for you.

When you go for the next check up, mention the tiredness and be sure to tell them about the activity level that you are used to. In "pacemaker-years" you're fairly young. It's possible, even probable, that you need the rate changed and the response rate adjusted.

Do be aware that getting the right-for-you settings is largely guesswork. Trial and error. Sometimes it takes several visits to dial it in just right. But having the settings that fit you and your lifestyle can make all the difference. Don't accept feeling half good, too tired too quick, when you could be feeling great.

Follow up visit/settings

by SteveV - 2021-01-31 11:15:00

Ty for feedback.

Im.wondering if there are any very specific questions I should be asking my Dr at my 1 month follow up??

I definitely want to discuss my lifestyle and my future now that I have a Pm for the rest of my life but are there any other things I shoukd bring up to discuss. How about any technical things??



Follow up visits

by Gemita - 2021-01-31 16:30:48

Steve, I suggest you go over all your recent Messages and our replies to them and then make a list of questions based on some of our questions/answers.  Let me start you off.  You could ask:

. What pacing mode am I in ?  (for example I am in AAIR mode)

. Is my Rate Response switched on or is it off?

. What is my Upper Tracking Rate in bpm?

. % time I am paced in right ventricle?

. % time I am paced in right atrium?

. Have any significant events been recorded (for example any high heart rates or arrhythmias)?

It is important you tell them of any troublesome symptoms you get like breathlessness, palpitations, fatigue.  Be specific.  Don't just say you feel a bit tired when in fact you might feel so tired you are unable to do even simple daily activities.  They need to know how you have been before they will adjust any pacemaker settings.  Anyway these are just a few of my thoughts.  You need to do some homework now Steve.  Don't forget to discuss what you want to achieve with exercise.  Unless you tell them they won't be aware of your lifestyle.

If you ask them nicely they might give you a summary sheet of your important settings which you can bring here for future discussion.

Thank you Gemita

by SteveV - 2021-01-31 17:22:07

Thank you Gemita 

Your list was a great starting point for me and all.the  info you have provided thus far has been extremely helpful.

Greatly appreciated.

I woukd love to reciprocate someday so if you ever need construction advice or home improvement advice do not hesitate to reach out :)))

Fatigue is my biggest problem

by TLee - 2021-02-05 11:56:01

Yes, yes, and yes! I was walking every day before my implant & it felt really good. After (1 week + 1 day), I have to force myself to get up & out. Also, I should say that it was mainly encouragement from the folks here that even gave me the incentive to try! It feels good, but not as good. I feel tired the whole time, and even feel a bit weak/shakey in the legs. It was a concern, but the comments here have reassured me that in time my body will adjust & get back to normal. Here's hoping, and good luck!

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Sometimes a device must be tuned a few times before it is right. My cardiologist said it is like fine tuning a car.