Pacemaker Syndrome
- by hirwin
- 2008-10-12 06:10:39
- Conditions, Meds & Tests
- 2606 views
- 5 comments
Hello! I received my 1st PM/ICD for my 30th birthday present! Wow! Anyway, my PM's have only lasted 2-4 yrs. and I just had my 3rd one implanted in Aug. of this year. I've always felt great since my original implant until about a year ago. I've been having light headed spells off and on. Lately, they seem to be more on than off! I went last week for an interrogation and lead check and for a post surgery follow up. I seemed to be very sensitive to the lead checking. They said one of my threshold's measured at 5 something, which I know is high. The dr. said my atria lead is in a "iffy" location which causes the higher threshold. He said it looks as if it got knocked out of place after initial placement, but he said I'm too young to put in another lead at this time, so he wants to leave it there and leave the high threshold, which uses the battery power alot faster. I am 100% paced due to a low HR which for me seems to lead to a-fib, which is not tolerated at all for me. So, when I asked my EP and my card. about the light headed spells they both say my heart looks fine and they don't think it's from my heart. The other day when I was there for my checkup I thought I heard the Medtronic rep say something to the nurse about pacemaker syndrome, but they didn't say anything to me about it. Wouldn't they have said something to me? How concerned should I be w/ it? I guess I need to put in a call and ask about it. I know right now, I have a single lead to the atria and a single lead to the ventricle and am DDD paced. I've read that sometimes reprogramming the PM can help or even switching to a CRT-D pacer. How is the DDD pacing different from the CRT-D pacing? Sorry for so many questions. Just tired of feeling LOOPY. I have 2 young sons and always worry about not feeling good enough to play w/ them.
Thanks!
5 Comments
PMT and Lead
by bobad - 2008-10-13 10:10:17
PMT can be tweaked out by compromising some smoothness in the PM function, at the cost of a little battery life. I had 3 episodes of PMT. The first was a dead faint, in hospital, the 2nd was nearly so (still in hospital), and the 3rd was not close to fainting, but very unpleasant, and required an ER visit. If you truly have pacemaker mediated tach, get it fixed or it will be most unpleasant.
The statement made by the tech about the lead was bizarre. Leads don't get knocked out of place and still function. They are either placed in the proper position, placed in an improper position, or detach from the heart and are totally useless. If a lead is "knocked out of position", believe me, it will not magically reattach itself to the heart.
I suppose a few lawsuit-happy patient are mostly responsible for the docs keeping quiet. They are ruining medicine for the rest of us, and there isn't much we can do about it except vote for tort reform-minded lawmakers.
Good luck, and keep us up to date.
Get a printout
by ElectricFrank - 2008-10-13 12:10:43
Hi,
Call the doctor and request a copy of the pre and post checkup report. This is the printout that the Medtronic rep gets at the end of the reprogramming. You may have to insist on getting it, but it is your right to your own medical records. From it we may be able to help you understand what is happening.
As for the pacemaker syndrome I am very suspicious of it being a way of avoiding solving a real problem with the lead installation. The Medtronic rep is in an awkward situation where he can't tell you what is happening without the doctors OK.
By the way your age should not be a factor in fixing a lead problem. If you were 15yrs or younger it might be.
The sad situation is that we can no longer trust the medical profession who are no more ethical than a used car salesman. We have to learn to take care of ourselves when we see them.
sorry to be so negative about it,
frank
Follow Up: Went to ER last night
by hirwin - 2008-10-19 03:10:31
I kept having this funny feeling in my chest which would seemingly travel up into my neck. I would feel a lot of pressure in my neck and ears and could actually see my neck pulsating. A few times it happened made me feel a little light headed, so my husband and I decided to get in the car and drive 90 miles to the Heart Hospital. Once I got there they did labs, EKG, X-ray, and hooked me up to a monitor. This feeling happened again 3 times while I was there, BUT it didn't show on the monitor! It showed me having a normal rhthym of paced 69 BPM, with a normal BP and normal O2 sats. All my lab work came back normal, except my chloride was a little high and my glucose was high. She also said I was a little dehydrated, which I had drank at least 48 oz. of water that I know of. I did drink a cappucino that morning at 9:30, but I didn't have any problems until later in the evening. They said I may need to try cutting out all caffeine. My troponin levels were all normal, my coagulation tests were all normal. The dr. told me I was so normal it was scary and sent me home. I am stumped. I know I was feeling something that wasn't right. They told me to follow up w/ my EP on Mon. He was out of town when I tried to call him about what was going on. This is the 2nd time this has happened. It happened 2 wks ago the night after I went to my EP office and they checked all my thresholds and all that stuff they do. Although, it wasn't as bad as last night. Last night, I thought I just needed to have it checked out and although I'm glad everything was "normal" I kind of wanted someone to say "well, this is what's happening and this is what we can do to try and help............" Not look at me like I was crazy for driving 90 miles inthe middle of the night to be told I was normal.......Some of my other hematolgy results were a little off which I have no idea what any of them mean. I'm going to research that here in a few, but they were:
% NEUT 77.3, normal 43-65
% LYMPH 14.7, normal 20.5-45.5
% MONO, 4.3, normal 5.5-11.7
#NEUT 7.1, normal 2.2-4.8
#EOS 0.3, normal 0.0-0.2
Thanks for any thoughts or help! I'm starting to think I'm crazy!
Pacemaker with High Threshold
by raadaya - 2009-06-22 06:06:03
My son got his pacemaker replaced last year but need to replaced again this year, the new PM will only last less than a year because the threshold is needed to be on set as high as 6, 2 months after the operation, the doctor said that reason can be a wrong location of lead in the heart when the replacement was made last year. This is very disappointing situation and thinking to sue the doctors. Doctors even said that replacing the lead and batteries will not make sure that a low threshold can be achieved so to give long battery life. Currently my son is using epicardial system where his generator is placed on his abdomen, doctors are proposing to changed the system and use the transvenous but in doubt because he is too young to use the transvenous approach.
Has anybody undergone a similar situation. Please do share you experiences.
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It's much better to live with a pacemaker than to risk your life without one.
Pacemaker Syndrome Information
by Pookie - 2008-10-12 08:10:40
Hi.
I found the following, hope it helps.
What is pacemaker syndrome?
Some people who need a permanent cardiac pacemaker to control their heart rhythm find that they feel worse after the pacemaker is in place.
Although they no longer have fainting spells, they feel tired and listless. They notice pounding in the neck or chest, and generally don't perform activities as well as they once did. This is called pacemaker syndrome, and it sometimes make them wonder whether the procedure was worth the result.
Why does it occur?
The heart's pumping action depends on a number of things. It needs good inflow from the veins, a proper rate of beating, and heart muscle that squeezes well. The heart also needs to squeeze in a proper pattern. Each heartbeat starts with squeezing (contraction) of the upper heart chambers (atria). A short pause is then followed by contraction of the lower heart chambers (ventricles). If the pattern is changed even slightly, the heart doesn't pump efficiently.
Today's artificial pacemakers stimulate contraction of the ventricles, the atria, or both. They are designed to follow the heart's normal rhythm and programmed to stimulate contraction at the proper time. They can be fine-tuned so that the normal pattern of the heartbeat is maintained.
However, in certain people a pacemaker impulse delivered to the ventricles may travel backward, or upstream, to cause untimely contraction of the atria. A pacemaker that fires at a constant rate may be just fine for someone at rest but may not be adequate for exercise. Either of these situations may cause symptoms.
How is it diagnosed?
Pacemaker patients help make the diagnosis by telling their doctor about their symptoms. An electrocardiogram (a painless procedure that records the heart's electrical activity) or a 24-hour tape recording of the electrocardiogram may be needed to identify just what's happening. The doctor may find abnormal pulsations in the veins of the neck at the physical exam.
How is it treated?
Modern pacemakers can be programmed to change their pattern. The doctor may change heart rates, strength of impulse, and the small built-in pauses that are part of heart contraction. Most of the symptoms can be made better by changing these settings. Several tries with different settings may be necessary. On rare occasions, the pacemaker may need to be replaced by one that can pace both the atria and ventricles, or by a pacemaker that can respond to exercise by increasing its beating rate.
With the right pacemaker and the right adjustments almost all pacemaker syndromes disappear.
Pookie