Chronotropic Incompetence(CI) - Need pacemaker
I'm hoping to find someone here with similar experience/situation who received a PM and had his/her problems solved. I've read thro' several posts here but nothing fits exactly. I'm primarily looking for advice on whether a PM will help me.
My problem, after 4 years of testing and some missteps by docs along the way appears to be that my heart rate does not go up with exercise as it should. I get dizzy, never have passed out, if I start exerting at some point. It's getting worse. 4 years ago it took about 15 mts of running at 10 mt pace. Now it can start right away after running a few yards. Typically there are 3 stages. Stage 1 is the dizzy spell preceded by a clutching sensation in my throat (that could be PVC's) and then I have to stop. I have seen my rate as high as 140 before the dizziness. Stage 2 my rate can be 90-100 if I am walking briskly, I dare not go any faster. Stage 3 is after I stop, my rate goes down to 50-60 (my normal resting is low 80's). Stage 4 is recovery to normal after about 2 hours. Stage 5 hasn't happened lately but I can wake up in the middle of a night (again only on an exercise day) with actual brady - 40 and below, can't sleep because of the pounding, getting up and walking about mostly fixes it.
I've been told a pacemaker will help but haven't been assured that meds won't be necessary. The theory is that with a PM I can take the arrhythmia meds and not worsen things. I know I have sinus pauses and at one time when I went in to get a Holter during brady. they saw a junctional rhythm. I've had an ablation for an atrial flutter that was seen during pacing about 2 years ago.
Q: (1) docs can't tell me why if I have CI, my rate really goes down only after the load is removed (resting) (2) can my ablation have contributed or worsened existing problems (3)If I get a PM implanted how is it going to know that I've just stopped exercising, but my rate needs to be at,say, 120 because I am catching up for the oxygen deficit of 1 mts ago?(4)could there be anything else that is giving me this SOB and dizziness, other than a low rate, which may only be 10-20 beats lower than it should be(5)are PM's able to smoothly pace your heart according to load?
I'd like to run like I used to years ago. I need to fix my problem because I'm not exercising as I should because of the fatigue after. Then again I don't want to have to take meds in conjunction with the PM. I can get a good amount of exercise right now by brisk walking plus weights, but I'll never be able to run from a tsunami or a knife wielding mugger.
I'd like to hear from anyone who has been down this road. Thanks