pacemaker decision

I recently turned 70 and have been a jogger for about 29 years. Jogger (9-10 mile pace when at my best, 3-6 mile typical range), not a runner. Have a low heart rate, typically 45-50 in rest mode. There is also an occassional skipped beat in my heart rythmn. This range dates back at least 20 years. The doctor at Baylor College of Medicine (Houston) says I am suffering from Sick Sinus Syndrome and need a pacemaker. I have no symtoms, and this was discovered when I was having other medical work done. I would just as soon not have a pacemaker inplanted unless the dangers are critical. My research has not defined the real dangers too my satisfaction. If any of you could offer information about this subject I would appreciate it. I am being pressured from both family and doctors to make a decision.

Jim

Ps: I have had treadmill, echo cardiograms, holter tests, and blood work done

9 Comments

normal

by Tracey_E - 2009-01-25 02:01:31

SSS is when your heart rate drops off at rest, but it picks up again with exercise. It's very possible to have it and not have symptoms. The holter should show how low you get. 45-50 is certainly not dangerous! If you have episodes where you drop in to the 30's or even 20's, you still may not feel it but it's getting dangerous and you need a pm. I'd at least get another opinion! I'm no doctor but if your treadmill was normal and the holter doesn't show anything less than mid 40's it doesn't sound to me like you need it.

What Tracey said plus

by BillMFl - 2009-01-25 04:01:03

Having been in ICU, I know I set off the alarms below 50. But nobody got worried until I went below 40. My doc says if one is asymptomatic in the 40 to 50 range, and there is no underlying coronary disease, then a pm isn't necessary. You probably have an efficient respitory/cardio vascular system that compensates for a mild sinus node problem. I am soon to be 67, in very good shape for my age, and initially resisted the pm but the doc convinced me that I was getting very low while asleep and the risk was not waking up some day. I could go 12 to 14 mins on the treadmill stress test with a perfectly normal sinus rythm and until I reached the appropriate heart rate. It was only at rest that my problem occured. If you ever start to feel dizzy, clammy, light headed, etc. then you will want the pm. If you drop significantly below 45 to 50 at rest or when sleeping, then think of the pm as life insurance for a guy who is otherwise in very good shape for his age.

I have SSS

by denise61 - 2009-01-25 04:01:38

Hi,

I have SSS and had a heart rate that would drop in to the 15 to 20 ange when I was at rest. I passed out one night while at bingo with my mom, I dont remember much but the next day at the hospital they were doing a brain wave test and I dropped down to 12 the Dr. came in and told me to call my family they were putting in a pacer. Thank goodness I didnt have time to think about it.

If you have any questions feel free to email me or send me a private message.

Have a GREAT day
Denise

Decision

by SMITTY - 2009-01-25 04:01:39


Hey Jim,

Do you need a pacemaker, well here is my story.

I was 71 when I got my pacemaker in 2000. I had a quadruple bypass in '82 and had a heart rate before and after that in the 50 to 60 range accompanied by an occasional skip beat. While I was (am) not a runner, I am not a couch potato either. I like physical activity and spend as much time as possible out doors doing whatever comes to mind.

In '71 I became very short of breath and my wife hauled me off to the ER and after more tests than I could count I came home with no firm diagnoses and some pills. Then a few days letter, I had to go for an office visit with my primary care physician and I was referred to an electrophysiologist. I saw him one after noon and got a pacemaker the next morning for SSS. And that my friend is when my fun(?) began.

First, I didn't need that pacemaker. But things were happening so fast that I had no time to ask a question. The PM did nothing for the SOB because it was caused by a partial blockage in one of my bypasses. A stent a couple of weeks later solved the SOB problem but now I had a new problem that was caused by the new PM. That thing shocked the hell out of me and try as I may I could not get that problem solved I couldn't and 2+ years later I demanded that it be turned off. They lied to me again. Said they were turning it off, but the settings were just lowered to the point it never came on line, but if my heart rate had dropped below 30 the PM would have supposedly kept it from going lower. (From what I have since learned it seems that a PM cannot actually be turned off.) My heart rate never dropped below 30 so I have to take their word that it would have happened. Then about 2.5 years later the SOB returned and a cardiologist persuaded me to have the PM reset to try and help. It didn't help the SOB and that PM has been a pain in the butt since, but I got a nerve deadened and the shocking part stopped.

Why do I tell you all this? To emphasize the need to be absolutely sure you need a PM before getting one. From what you tell us I have to question that you really do. Many long distance runners have a low heart rate. The few skipped beats you mention having don't sound as if they are really abnormal and anyway, my PM has never altered the number of skip beats I have. Another reason I say be sure, is I don't trust doctors and PM implants. So far as I know there is no peer review for this surgery like there is for other surgeries and on top of that the PM can be a cash cow for a doctor. I'll not even attempt to guess the cost of a PM implant today, but I do know that my quarterly checkups go for $115 to $150 and that does not include seeing the doctor. So, as mentioned earlier by others, if possible get another opinion before taking the plunge.

By way I know Baylor well. I lived in Harris County for 40 plus years and have been a guest of Baylor, Methodist and St. Luke's at various times although my bypass was done at St. Joseph's. My PM was implanted at S & W in Temple.

I wish you the best,

Smitty

I also have SSS

by Bionic Man - 2009-01-25 05:01:58

I was also told I had SSS. I've always kept myself in shape. My heart rate was always low (mid 40's). It began to drop into the high 20's to low 30's. When this happened I would feel as though I was going to pass out. I'd get dizzy, short of breath and have chest pain. I'm a guy who is constantly on the go. Suddenly I was having problems walking the dog around the block. My life style slowed right down. The first time I went to the hospital I was told my heart was perfect and that I had the same heart rate as Lance Armstrong. I'm no Lance Armstrong. I was monitored for a month and had dozens of these episodes. I was also having episodes of A-Fib. I ended up getting a pacer 9 mos. ago at age 45. Although I feel better than I did, this has been a battle. If I were you I would seek another opinion. As long as you are feeling fine and aren't having any problems I'd be hesitant about getting a pacer.
Good luck,
Bob

decision

by Tracey_E - 2009-01-25 06:01:50

Don't make a decision based on how you feel! A lot of people with SSS who have very low dips and pauses in their hr have them while they are asleep so during the day they feel fine. Go by the numbers on the reports.

Below 30 Danger zone

by Rachel316 - 2009-01-25 08:01:16

I'll be 24 next month and have had my pm for almost 5 yrs. For many years I regretted getting it and wanted it out! They daignosed me with SSS. Now they may think that I need a cathetor ablation. So I do agree that you can't always trust doctors, they're just educated guessers.

However, In response to what Smitty said, you're heart should never go below 30, so if the pm is set at 30, it IS basically off. If it does trigger the heart, then it was definitely needed because one's heart should not go that low.

I think that a PM might be a good option. Today, I am glad that I have it. Make sure you get a few other opinions, but don't rule out the possibility just yet. It could save your life. Sure you can walk a tight rope carefully without falling, but wouldn't it be nice to have a safety net underneath, just in case?

Rachel

Reply to Comments

by Wodank - 2009-01-26 04:01:27

Thank all of you so much for your replies. They are very helpful. I have not recieved information concerning the tests taken last week. I just want to be prepared when I have a follow-up with the doctor. One of the tests, which I was not fimilar with, involved enjecting a radiation (?) solution into my system. I was then place under a machine that rotated over my torso and recieved the signals which diagramed my heart. The PM is somewhat secondary from my real problems. The SSS was detected while I was in St. Lukes Hospital having a procedure that was to place stent(s) in a brain artery that had two segments 75% blocked. The procedure could not be performed because the right carotid artery was too blocked to pass through with the caterer. Instead, the doctor placed a stent in the carotid artery. Now, I'm told that I have to have the PM matter taken care of before they will go back in and place the stent(s) in the brain artery. Time is of essence for me.

Jim

no decision

by Tracey_E - 2009-01-26 09:01:46

Jim, the other stent is much more important than the pm! And if they won't do the stent without the pm, it sounds like your doctors are unanimous. Which most likely means you need truly it ;o)

Please don't be shy if you have more questions after you see the doctors again and get more details! We've all been there

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Yesterday I moved to a new place in my mind and realized how bad I felt 'before' and the difference my pacemaker has made.