Unsure about have pacemaker fitted

Hi,

I am 41 years old and have just been told that I need a pacemaker. I am not handling this news very well at all. I consider myself to be fit. I run every other day for a total of 20 miles a week, and usually squeeze in around another 20 miles of cycling. I weigh about 150lbs and am 5ft 8in tall, so not overweight. I have exercised all my life.

For the past 18 months or so, I noticed that I occasionally had an irregular heartbeat. My resting rate is around 60 bpm during the day. When lying down (eg in bed or on the sofa) it drops to around 52 - 58 bpm (although I have measured it at 42 bpm on one occasion). My blood pressure is in the normal range (if a little on the low side of normal). Several times during the day, my heart is beating irregularly (although never missing a beat for longer than around 2 seconds by my measurements). I occasionally feel dizzy when standing up suddenly but I have never actually fainted. I have dropped to my knees on a couple of occasions because I thought I might faint, but I did not actually blackout. I have got some mild chest pain on the left side occasionally, but on a scale of 1 to 10, I would have to say it is 1.

I reported these symptoms to my doctor, had an ECG done (it was fine) and went home with a Holter Monitor to record my heart for 24 hours. Based on this single recording, the cardiologist recommended that I get a pacemaker fitted. He wants to do a scan of my heart to rule out any other conditions, but says that this would not change the fact that he thinks I need a pacemaker but would be to rule out any other undiagnsed conditions.

To be honest, I was stunned by this diagnosis as my symptoms don't really seem that bad. My wife wants me to get the procedure done, but I am really worried about going ahead. I have read reports that up to 40% of pacemaker implanatations result in thrombosis of some kind (often assymptomatic), that can result in pain and swelling in the arm and face (or worse). We have a 4 year old son. Will I be able to put him on my shoulders anymore? I am really quite frightened and reluctant to go ahead with this surgery. I am inclined to wait and see if the symptoms get any worse. Is there anyone else out there that is in or has been in a similar position?

Mark

15 Comments

It is a bit of a shock

by RobertS - 2013-01-21 09:01:01

to find out that you suddenly need a pacemaker. It is not an age thing - there a people here who are in their teens and 20s who have pacemakers.

I didn't have the same symptoms as you and I am a lot older [coming up on 70] but I had been very fit all my life - long distance running, tae kwon do and that sort of thing. Then one day out of the blue about six weeks ago I couldn't walk 10 yards without gasping for breath,

I had what is called heart block where the electrical impulses that cause the heart to beat regularly get blocked for some reason. My heart rate was down to 30 and stuck there and it wasn't going to get better so pacemaker put in next morning .

I was awake for the procedure which is usual and home in the evening. Now, six weeks later I can do virtually everything I want - except arc welding!! [big magnets can be a problem]. All I'm really saying is that most people who have pacemakers have no real problems so don't let that aspect worry you unduly. There is lots of info on this site. Use the search button on the top right and somone will have answered the question you want the answer to and there are some really knowledgeable people here too.

As to whether you need a pacemaker - that is a different question. You obviously have doubts so I'd go back to the cardio and ask him to explain why he thinks you need one now. Never be reluctant to ask questions - it is your body and you need to know what is going on. And if you are not satisfied then you can seek a second opinion.

Wish you all the best and, if you can, do come back and let us know how things go.

Robert

Surprised huh?

by ohiolaura - 2013-01-21 09:01:17

Mark,
What youve said sounds normal to me,its alot to take in isnt it?
Im 49,female,and have been working out daily,not like you sound to be,but 7 days a week,about an hr a day,and feeling great,until 1 day I felt off,and it stayed that way on and off,more off,until 1 day it went really off,and bam,I went into the ER,the first ER that is,was kept overnight,tested,sent home w/the holter on too.
Then less than a week later(with no results on the monitor yet) was back in another ER,and this time I was able to select going to the Cleveland Clinic(I live about an hr from there),and was tested out the ying yang.
Then came the news,my only option,a PM.
Ah, well,I didnt take that so well,my kids are older than yours,both in college at the time,but still,PM are for older people ( sorry guys),not someone "young" like me,right?
I had no time to find this site,get info or anything like youre able to do.Youre lucky.I know this would have helped me to deal with things alot better,so I waited in the hospital til they could do the surgery,Wed to Mon,then went home next day.
I think physically Ive done well,mentally,it was rough at first,just ask donr,he'll tell you,Ive talked to him alot here,and he's helped me so much:)
Physically,maybe Im lucky,I am good with no pain,and back working out full force,it's been 6 months since my surgery,I didnt mention I had open heart surgery as a child for a congenital
hole I was born with,dont remember that surgery,the last one I do!
Get all the info you can,talk to people here,and try not to think the worse.
This is alot to deal with,all here know that,and others,including family maybe cant understand what you are thinking,they say they do,but unless theyve gone thru it,I doubt they can.People here can,and do.
Keep posting and asking questions,folks here are more than ready to help,they helped me alot,and one still does,donr,contact him if you like,he is a fountain of information,and has the best stories and ways to explain things!
Laura

my experience

by Reboot1212 - 2013-01-21 09:01:28

Mark
I'm 57. Like you I felt pretty fit. My symptoms came on fairly suddenly, but similar to what you describe. Didn't blackout but had several "soft landings". My PM was put in after a night in the ER. I have third degree heart block.it is now seven weeks later. Feel great and looking back it was not a big - deal. Started working out this week per Doc's greenlight. Going well. Looking forward to better quantity and quality of life. Hope you are too.
best to you and your family.

Johnny

To share ..

by Ramnarayan - 2013-01-21 09:01:28

Hi Mark,

I am 64, Male. 8 years ago - to this date, I was carrying my 8 months old grand son, for a stroll in the park. Suddenly I realized that I couldn't carry him any more with out dropping him. Struggled to get back home, handed over the baby to my daughter and by instinct checked my pulse - it was around 40. Met my Dr and was advised to go for a PM, after an ECG and consultation with a Cardiologist. From some time before that, I couldn't climb a flight of stairs without resting at least once, though, with out any difficulty, I could briskly walk 3 to 4 miles on level ground. I now have my 2nd PM - replaced 25 days ago. I am back to my 3/4 miles daily brisk walk and attend to my business full time.
My Dad had his 1st PM the age of 67 and lived till 88, with 2 replacements. He stopped playing tennis after his 82nd BDay!!
I guess, our experience has been good.
With Best wishes
RN

Afib

by ebfox - 2013-01-21 10:01:04

Mark,

Couple of questions- did your cardiologist say anything about afib? Your description sounds a lot like paroxymal afib and you fit the profile of a vagal Lone Afibber (chronic exerciser, irregular heartrate lying down).

I am a little concerned about his diagnosis based on only a 24 hour holter. I wore one for a week when I first started.

The other thing- you are seeing a regular cardiologist, correct? If so, you need a referral to an ElectroPhysiologist; EP's specialize in rhythm disorders. Frankly, some cardiologists don't know how to treat afib, especially Lone Afib. If I were you, I would go to an EP very quickly for further diagnosis prior to having a PM put in.

If you have paroxymal lone afib, a pacemaker is not the correct course of treatment.

Anyway, I hope this helps and please do let us know how it comes out.

EB

You have a wicked case of Cardiodenial!

by donr - 2013-01-21 10:01:09

Hi- I'm the infamous Donr that laura mentioned. I don't know what you have, so I made up a diagnosis. You do have something, however, & you don't want to believe it.

You did not tell us what your cardio says you have, but your body has been trying to tell you something for 18 months & you just aren't listening! If you can sense things that don't feel right, they probably aren't right. Further, you went to see a Dr., so you really know something is awry, now that you have an answer, you want to disbelieve it. Not really smart.

Your second para is telling: First off, it tells us you know darned well that something is wrong by all the niggling little things you have documented as happening during the past 18 months. Second, it's SCARY - CHEST PAINS. All the ittle stuff you mentioned just point to electrical problems, which are easily fixed by a PM. Chest pains generally do NOTaccompany electrical problems, but do signify PLUMBING problems, which are spelled HEART ATTACK. Not so easy to fix, & at YOUR age can be easily fatal. Not so much for us old coots (I'm 76).

Now, again, you did not mention a specific diagnosis, but the Holter results must have been pretty significant for a solution to be a PM after merely one day. There could have been all sorts of asymptomatic things he saw that you don't feel. ASK ABOUT IT!

Meanwhile, I have a recipe for your wife: Husband is being stubborn. If you don't have one, buy a 12 inch cast iron skillet; Season well according to instructions that come with it. Heat to temp capable of making blackened fish, Cajun style. Put on a pair of high quality heat resistant kitchen gloves, using two hands, pick up skillet & severely beat husband about the head & shoulders till softened up & listens to good advice. Take husband to Cardio for Appropriate treatment.

Cheers.

Don

Diagnosis?

by golden_snitch - 2013-01-21 10:01:44

Hi Mark!

So, what's your doctor's diagnosis? From everything you told us, I do not understand why he thinks that a pacemaker is what you need. Definitely would go for a second opinion, and don't let yourself be rushed into the pacemaker decision.

Feeling dizzy when standing up is rather a blood pressure issue than a heart rate issue. And since you say that your BP is normal and sometimes a little bit on the low side, it perfectly possible that this causes the dizzyness.

You are very active, so the heart rates you are reporting seem pretty normal to me.

Good luck with the other tests!
Best
Inga

be thankful

by Hope - 2013-01-21 11:01:14

Hi! You are dealing with a lot with a family to think of also. Hard to say whether it is easier to get a forecast with time to thnk or get hit in a life or death moment. Get informed, including a second opinion. You can do this. You want to be with your precious son as he grows up. My daughter did not know her heart needed help. She went with God at 42 in 2011, and her children now are with me. I dry their tears and try to keep going. It doesn't have to be that way for your child. Please, if there is a need, accept it and do what is best for you and your family. I will keep you and your family in my prayers. Hopeful Heart

Doesn't make sense

by IAN MC - 2013-01-21 11:01:14

It seems that you have blood pressure issues so you need drugs , not a PM for that

A PM only takes care of a low heart rate. You have had one reading of 42 bpm which is a bit low but you were asymptomatic so that does not justify a PM. What exactly did the 24 hr Holter show ?

Ian

Armed with questions

by ma_ku - 2013-01-22 05:01:05

Thank you so much for all your replies. It helps knowing there are others that have similar stories.

I will certainly be armed with some more intelligent questions the next time I see the cardiologist thanks to the responses on here. I will let you know the outcome.

Thanks again

Mark

Mark,Mark

by hopeing2 - 2013-01-22 06:01:33

I would get a 2nd opinion-sounds like you have Atrial Fibrillation to me. I have had this same condition for a good number of years and was and still am taking 80 mg of Betapace once every 12 hours. You need more tests-Athletes have a slow resting heart rate and many ectopics. You need a Nuclear Stress test and an ultrasound and an ejection fraction test for starters. I had the exact symptoms you describe and I was a bit overweight so a weight loss doctor prescribed amphetamine to spped up my metabolism and this threw me into A-Fib, that went to V-Tach that went to V-Fib and nearly killed me-now I have a heart loop monitor-not liking it because I'm still getting skips and flutters but about 10 years ago I had a Carediologist who said I needed a PM-I said yeah, right and left. My arteries are clean-my cholesterol is perfect, ejection fraction excellent.
I want to know why my heart will not settle back down and I may need a PM now but not without a 2nd opinion.

Simular situation

by battery_operated - 2013-01-24 01:01:31

Hey Mark,
I am 3 weeks into my "healing" and 3 weeks to go. I am 44 and in good shape. I have been weight training for over 20 years and into defensive tactics for even longer. I am also an instructor for my department which includes defensive tactics. During November and December I was recertifying our officers with very physical defensive tactics training with no problems. On Dec. 28th a passed out after dinner without any warning what so ever. I woke up with my wife over me and I said "What the F*** was that?!?" I felt fine getting up but knew I had to get checked out. We went to the emergency room and found out I was in 3rd degree heart block. After getting checked for Lyme disease (which I was told can cause this, but was negative) I received the pace maker. It turned out I have Bradycardia as well. I tell you this because it was hard to wrap my head around needing PM. Thank the Lord I wasn't driving in the car with my kids when this happened. I am comforted that this piece of hardware will prevent that from happening. I plan on going full tilt after 6 weeks, within reason of course, and asked a lot of questions, the type the cardiologist are not used to being asked. He put it this way; he had put a PM in a Navy Seal who had simular symptoms as mine. After 6 weeks he went back to being a Navy Seal. Made me feel very confident about going back to my modest routine. I am using this time to use the eliptical machine and shed a few pounds so I can hit the ground running in 3 weeks. I thank God for this peace of mind in my chest. So, if you happen to need a PM, embrace it and get back to living life. I plan on it. This site has given me very good information and advice.

Thank you all and good luck to you Mark.

Paul

More information

by ma_ku - 2013-01-24 08:01:07

So I just spoke to the cardiologist. He says that from the 24 hour tape he could see that I have Wenckebach Type A-V heart block and occasional episodes of Mobitz Type 2. The latter is the reason for the pacemaker implantation. The surgery is scheduled in February for a dual chamber pacemaker.

Thank you all once again for the comments. It does help some, although I am still coming to terms with this news.

Mark

2nd Opinion from Sports Cardiologist

by ma_ku - 2013-02-06 12:02:20

I just had some additional tests done by a second cardiologist who specializes in sports cardiology.

An ultrasound was done. This in combination with a previous MRI scan showed that I have no structural heart problems, I have perfectly working valves, and structurally all looks fine. I was then given a Fit Bruce stress test. This involved a 12 lead ECG before, during and after exercise. Just before I started exercising, a Mobitz Type 2 skipped beat was observed. I have the printout and it is undeniable, showing constant PR intervals prior to the skipped beat. A "classic" example right on cue.. Or "serendipity" as the cardio later put it.

My heart responded perfectly during and after the stress test and is performing slightly better than predicted for my age with max bpm at 184. My blood pressure was fine during the test, changing as it should.

Taking into account the fact that Mobitz Type 2 was again observed (there and then) and in the previous Holter recording, and that I have dizzy spells, the cardiologist said that the consensus opinion would be to recommend a pacemaker. If I were not having the dizzy spells he said his opinion would be 50/50, but due to the other symptoms its a 60/40 recommendation for implantation. He said it is probable that I have some scarring on the AV node (which could have been caused by previous illness years ago - we will never know). As I age, this will not improve, rather my symptoms will likely get worse. He did not say it was inevitable that I would get 3rd degree heart block, but that dizzy spells have a high probability of turning to fainting spells and if this happened while driving, walking downstairs.. you get the idea. So basically, he recommended I get the pacemaker. I just have to come to terms with that and get it out of the way. All being well I should be running again in about three weeks. Can't say I am happy about this, but at least my heart doesn't have any other issues that I need to face.

Mark

I know the feeling

by wantstoknow - 2013-03-24 07:03:53

I'm 63 yrs old and just was not ready for a pm.I got my pm in 2009 but when they told me i needed one my hb was 40-42bpm.to make a long story short i waited over a year because my hb went back to normal and i wasnt mentally ready, well my hb did start beating slower again so i decided to get one. but i never passed out or anything, its just so complicated.just get all the info you can and decide from that,Good Luck you"ll be fine

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