Hello everyone.
I am new here. Sorry for my english.  Not good. I am 30 years old a man. My wife gave me a smart watch for gift. Because I am dieting and exercising, I lost 18 kg. When I measured with the watch, my heart rate was between 45-53 while I was at rest.That's why I decided to go to a doctor. I was given an effort test and a 24-hour holter test. In the effort test, my heart rate went up to 140. But there were 3-5 second pauses in the holter and the doctor told me that I should use a pacemaker.Then I went to another doctor and my 24-hour holter test showed no serious pauses. He didn't see anything wrong with my heart ultrasound. But he could see my 3rd degree heart block on the EKG.I do heavy sports. I walk for a long time. I play football matches with my friends every week and I don't have any dizziness or fainting problems.That's why my doctor wants to postpone the pacemaker because I'm young and I don't have any problems. But he asked me to have a heart MRI done so that there would be no problem in this process. I trust him. I don't want to wear a pacemaker right away, even though I don't have any problems. But I'm afraid of bad things if I don't wear it.Sorry again for my bad english. I hope you can understand me. It would be nice to know if anyone can give me an idea about this or have experienced something like this.



by Tracey_E - 2022-09-27 14:12:04

I was in the same position as you, however I was not able to do sports. Do not do what I did, I had symptoms but they came on so gradually I did not realize how bad it had gotten until I was paced and feeling good again. I ignored the symptoms and ended up having emergency surgery. 

Your resting rate and pauses are both borderline. If you are able to do what you want to do and feel good, it's ok to watch and wait on the pacer. As soon as you don't feel great, or start struggling to do your sports, do not be afraid of the pacemaker. Block is a very easy fix with pacing. I got my first at age 27 in 1994. I'm on my 5th now, still healthy and active, and feel great. I wish I had gotten it sooner.

Your English is excellent! 


by AgentX86 - 2022-09-27 14:30:05

A resting rate of 45-53 isn't horrible but does point to something being wrong.  You don't give any information about the results of the stress test. The idea of the stress test is not to see how high your heart rate gets or anything physical about the test.  There is no pass/fail on the exercise part of the test.  They're trying max out the heart's pumping action (however much that is) so they can take pictures of the heart at it's maximum output. These pictures are the important part and have to be analyzed by a cardiologist.

The fact that the Holter test is showing 3-5 second pauses is a bit concerning.  Three seconds isn't a huge worry but at five, it gets iffy.  Five is often the demarkation between a pacemaker on no pacemaker.

If these were seen on a 24hr Holter, perhaps a longer test is needed.  I've had Holters for up to a week and event monitors longer than that. With a five second pause, I'd think they'd want a longer test to make sure there were no longer pauses.

In my opinion, the above suggests a longer Holter test and if it comes back with no worse than a five-second pause and you have no symptoms, I'd say you're sitting on the fence.  You could go either way on a pacemaker but you would have to be watched very closely.  I went from three second pauses to five and eight, and a pacemaker in a very short period. Somewhere in here you become a real danger to yourself and others.  You don't want to go here.

Your third degree heart block is more concerning.  To me, that's an automatic pacemaker. With a third degree heart-block, there is no communication between the atria snd ventricles.  A pacemaker will resore this.

IMO, you need a pacemaker primarily because of the heart block but add the pauses and I think you're at risk and does include others (diviing, etc.). Don't worry about a pacemaker being a problem for you.  After a couple of months you won't even remember that you have it.



I waited

by dogtired - 2022-09-27 19:12:22

To be clear I'm not advising you what your best option is, thats between you and your docs. All I'm doing is summarizing my experience which has similarities to yours.

About three years ago my 2ed deg block turned into 3ed degree but would go back to 2ed upon exercise . My resting HR was in the 30s with a low of 28. My longest pause was 2.8 sec and the highest I could get was 115. BUT like you I was asymptomatic and in fact swam a mile one day prior to implant. Your high and low are much higher than mine BUT the 5 sec delay is much longer and its also puzzling that NO delays were noted with your second Holter.

I too was worried that I might have a sudden event and need to be taken to the ER, but my docs all agreed that was unlikely ( largely due to my 2.8 sec delay being too short) but they all recommended a PM. Now I'm 73 and if I were 30 the recommendation might be different.

I waited 3 plus years but finally gave in 2 weeks ago, when I noticed my HR was stayed in 3ed longer and longer. I feel I made the right decision by waiting. my surgeon started doing Left Bundle Branch pacing instead of Right Ventricle which I feel was worth waiting for. Theres lots of info on this site detailing the pros and cons of the different methods. I for sure can't say if I would have felt any better if I had done it 3 yrs ago when my max was 147

I feel that in the near future both His bundle and LBB pacing will become more common, especially as technical issues are resolved . Theres also the Abbot Avier AV currently in human trials which is leadless , removable and offers more capability than the Micra AV.

3rd degree heart block

by Persephone - 2022-09-27 23:12:13

Greetings, Crystal - your english is just fine so no need to apologize.Take your diagnosis seriously would be my suggestion. Get a second opinion if you feel it necessary. In my case, my heart block advanced very rapidly - scary fast - once I started experiencing symptoms. Best wishes to you.

Thank you very much for your kind answers.

by crystalarch07 - 2022-09-28 03:48:52


Everyone here is very kind and helpful, I feel very lucky in this regard. Thank you so much for sharing similar experiences in your own life.As you can imagine, it is not easy psychologically to accept a pacemaker without experiencing any physical problems.I got my MRI results yesterday. My mri doctor said that he did not see any major problems, but my cardiologist would make the decision about the pacemaker. @dogtired, It occurred to me that there might be a problem with the first holter test, with pauses of 3 and 5 seconds in my first holter test and nothing in the second.

I am grateful to all of you, I wish you a healthy, happy and wonderful life, I will let you know the result.

Psychologically difficult

by _Claire_ - 2022-09-28 14:25:27

Hi there 

I’m sorry that you find yourself in this position. I can definitely relate as I struggled psychologically when I got my pacemaker and still struggle with different issues now after 3 years. I didn't have any preparation or warning as I got my pacemaker in an emergency situation. It's really good that you are here asking questions and doing research so that you are fully informed. The members here are very helpful, so use their expertise to help you understand everything. I’m sure you will be fine and pacemakers aren't as scary as they may first seem. In the beginning everything is alien and it's a massive amount of information to learn and process. You will still lead a life very similar to now and can continue activities and sports. Just make sure you check with your doctor what is safe for your condition. Best wishes! 

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At age 20, I will be getting a pacemaker in few weeks along with an SA node ablation. This opportunity may change a five year prognosis into a normal life span! I look forward to being a little old lady with a wicked cane!