Dizziness ?

Please could anyone advise if when straightening up from bending they feel quite disoriented. My husband has pm too and feels the same. 

Bent to look at something on a very low shelf today, stood up and too scared to move. Tried to walk four steps to chair and fell on coffee table. 

Most odd feeling 



Please consult your pcp

by Lavender - 2024-01-25 09:18:07

It's an awful feeling I am sure. Might just need to move more slowly when bending over and getting up. Please consult your husband's pcp just as a precaution. They might want to check him out. 💗


by piglet22 - 2024-01-25 09:39:22

It's quite common if your blood pressure drops when you go from sitting or lying flat to upright.

It's postural hypotension.

However, it can signal changes in your condition that the pacemaker cannot correct such as ectopics (PVCs or PACs) that interfere with the generated heartrate.

Have you tried simple things like checking your pulse or blood pressure?

Your PM should maintain a base rate sometimes called the IPG rate, for example 60 or 70 BPM, but the rate you feel at say your wrist can drop below that to 30s and 40s and that is when you can start feeling dizzy or worse.

I believe you are in permanent Atrial Fibrillation

by Gemita - 2024-01-25 10:59:14

Di, I am really sorry to hear you are still struggling.  I thought no news was good news?  From your last post I see you were having problems with a lead too and I note you are in permanent atrial fibrillation which can cause the symptoms you describe.  You have also had an AV Node ablation. 

You are clearly not always stable and this is a worrying sign.  As you are in the UK I would consult the pacing clinic first and have them look at your downloads and perhaps ask for an urgent device check to see whether they can see what rhythm disturbance caused your fall.  Alternatively see your GP or go to A&E.  I know not something any of us want to do.  I cannot remember if you are on an anticoagulant because of the risk of an AF stroke.

Dizziness can be a common symptom but when it causes falls, it may need assessing, especially with your arrhythmia history.  Keep well hydrated and try not to bend or rise too quickly.  When you are in Atrial Fibrillation, blood flow is not particularly good, so that is another factor to take into account.  

Additionally I have been told that venous return to the heart is diminished due to the bend so the heart rate slows down. The normal physiological response is to increase the heart rate as soon as possible to compensate for this happening, but apparently with a pacemaker this does not occur quickly enough.  Any extra weight around the tummy too may worsen the bend problem (or after a heavy meal).

I wish you and your husband well

Postural Hypotension

by Selwyn - 2024-01-25 17:29:24

The problem is fairly common and is due to blood pressure dropping as you straigten up from the crouched position.  ( Combat pilots wear G suits to stop their blood pooling as they climb at great speed in their aircraft - the G suit squeezes the lower part of their body ). One easy answer for some people is to wear long elastic support hose to squeeze blood from the legs and also to stop venous filling of the legs.

Having said that there are a number of medical conditions associated with postural hypotension from neurological to dehydration, with such things as Addision's Disease ( an underactive adrenal gland), anaemia etc..  It is clearly important to stay hydrated. I have the same problem after a fast, prolonged swim, from sitting to standing, especially in the heat ( The swim dehydrates, the heat causes the leg blood vessels to dilate and ... the blood pressure drops.

What can be done?

Keep hydrated. This is especially important in hot environments.

Maybe have a little extra salt in the diet ( this can increase blood pressure).

The pacemaker does not stand a chance of coping with an immediate drop in blood pressure. The relationship being,   BP= HR X SV  ( providing peripheral resistance ie. blood vessel dilatation is constant. Where BP is blood pressure. HR is heart rate. SV is the stroke volume of the heart).  So in order to stop the fall in BP resposible for the lack of blood to the brain and the dizziness you need to have an increase in heart rate. If your peripheral resistance falls- ie. your arteries and veins for instance get wider, as in the heat, that is a problem.

The easiest way of  coping wiith a sudden BP drop  is to increase the base rate of the pacemaker ( ie. the lower rate limit). This will help, if may not prevent, the postural drop in BP. ( Remember BP ...HR association).

Rising slowly. Waiting for the dizziness to go, before walking ( Walking lowers your BP further ) may be helpful. Anything that increases intra- abdominal pressure worsens the venous return to the heart and makes the problem worse ( eg. body  weight, carrying weight, holding the breath, tight abdominal clothing).

It is certainly worth having a word with your pacemaker clinic about the problem and if necessary your physician. There is also medication that can help, though all the simple measures need to be tried first.

So can you faint?  - well try alcohol ( a venous dilator) laying on the couch,   running up stairs ( a venous filliinf of the legs) sitting on the toilet ( increase in intra-abdominal pressure, in a well heated home (vasodilation). Standing up ( a drop in BP) and then walking -- and the result is dizziness - I was planning to lay down on the bed , however never got there and fainted hitting my head on the wall on the way down . The saving grace is at least I did not fall down stairs. So much for World Cup Soccer!

Take care!

Best wishes to get this sorted.


by piglet22 - 2024-01-27 06:23:11

I can certainly vouch for the dizziness.

Early last year (2023) I started to notice an erratic pulse with apparent skipped beats despite pacemaker set to IPG 60 BPM (CHB)..

This was definitely relaxation/postural related.

It got to the point where I had to judge when to get up out of the chair, like a surfer waiting for the best wave.

Sometimes that didn't work.

I got up, took 3 or 4 steps, got as far as the kitchen door and that's the last I remember.

Instant blackout. Came round on the kitchen floor on a tray full of broken crockery.

For what it's worth, touch wood, an increased dose of Bisoprolol (10 mg daily) prescribed by the consultant seems to have stopped that but at the expense of extreme exercise fatigue.

You know you're wired when...

You can hear your heartbeat in your cell phone.

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