Letter from cardio re: pacemaker fitted

Hello

This is going to be quite a long post so here goes.
I need some advice please about having a pacemaker fitted.
My history is that I have had AF for several years diagnosed by wearing an event monitor. I lived with it OK and took no meds. About 9 months ago I started to get a few dizzy spells, felt slightly breathless and fainted once so my GP put me on Flecainide and referred me to a cardiologist. The dizzy spells have stopped due I suppose to the Flecainide although the irregular heartbeat is about the same except I'm probably more bradychardic. My lowest pulse rate is about 50. .I am otherwise fit and healthy and do a lot of strenuous exercise, ie mountain walking - a couple a month, countryside walking about 4 to 5 miles about 4 times a week and I also do 2 hours of circuit training and 2 hours of Zumba which is a strenuous form of dance twice a week. I'm always on the go and don't relax much.
A couple of weeks ago I wore a 7 day heart monitor and have a follow up appointment at the end of March.
Yesterday I received a very short letter from the Cardio just saying that the monitor "showed that your heart was racing fast and also there were episodes when your heart was going a bit too slow". That was it really no other details. He then said I would benefit from having a pacemaker fitted to prevent slow heart beats and if I was agreeable to let his secretary know. He enclosed a small booklet on pacemakers and that was it. No other information about me. There was no mention of further discussions in the clinic. I was quite shocked really and not happy about hearing this news in a short letter. I wondered if this is normal procedure? Anyway, given that I'm a fit person with no other heart problems I have to say I'm reluctant to be bounced in so casually to having a pacemaker fitted. I'd love to know what you think about this and what advice you could give me please? If I don't go ahead what will happen to me? Still in shock!

9 Comments

Zumbagirl

by IAN MC - 2013-03-16 01:03:34

Your cardio is unimpressive to say the least ! I don't think it is common to be told by letter that you may need a pacemaker ! You have a follow-up appointment the end of March; I suggest that you have a list of questions to ask then; I'm sure people on here will help you compose the list .

For starters : -

- Why exactly do you need a PM ?

- What exactly did the 7 day monitor show ?

- How many episodes of bradycardia were there, and just how low did your HR fall ? What does "going a bit slow" mean exactly ?

- Could the bradycardia be caused by the flecainide; it is a well-documented side-effect ?

- In the cardio's opinion what is likely to happen if you don't have a PM ?

- Why do you need a PM in view of your very active lifestyle ?

- Does he normally give news like this by mail; does he not realise how worrying it is to have a letter like that fall on your door-mat ???

Best of luck

Ian

Thanks for the questions

by Zumbagirl - 2013-03-16 02:03:47

Yes, thanks for those very useful questions Ian. I'll certainly be asking all of them and look forward to getting more from others.

I thought it very odd to get the news this way from the cardio. I certainly was upset. Now I feel annoyed as well.

When I saw him the last time just before I had the monitor there were things he said that did not inspire me with confidence and I think his letter and your comments have confirmed this. I think therefore that I might just make enquiries about speaking to someone else about it all. Get a second opinion? Maybe thats a bit melodramatic tho.

Hi ZG

by Casper - 2013-03-16 03:03:54

Hi Zumbagirl,

It sounds to me your doctor has a very casual "matter of fact" type of attitude here, I don't blame you for your concern.

Does he realize you lead a very active lifesytle, often people who lead a very active lifestyle tend to run a little bradycardiac.

Did you have your monitor on, while you were excercising, this could have triggered of some kind of event, that might have concerned your doctor.



Ian, gave some fine examples of questions you should ask your doctor, when you see him at the end of the month.

Good luck with you next visit.

Casper

Will want more details

by Zumbagirl - 2013-03-16 04:03:52

Hello
Well yes I did tell him that I led an active lifestyle and I've identified that my arrhythmia certainly starts after I've pushed myself hard and also when I'm anxious so I'll certainly be wanting to know more details of the results of the monitor, which is what Ian has suggested I do. I'll have my questions written down and I feel more confident now about asking them.
Thanks everyone.

To Zumbagirl

by ROBOTICKER - 2013-03-16 07:03:35

You're doing the right thing asking questions. I was told by my cardio after wearing my portable heart monitor for 30 days. It seemed my heart would stop beating 3 to 4 times a day for short periods of time (Like between 6 to 12 seconds.) and then restart, and on 2 occasions my heart stopped for up to 3 minutes while I was asleep. My Cardio showed me the EKG print out. So for me a Pacemaker was a No Brainer... However, I would suggest you do the research first and go in Informed so you would be able to make a clear and rational choice. A pacemaker WILL change your life. Some simple things you used to do May have to be changed. For me, I had to leave a very well paying job in Over The Road Trucking because of safety Regulations. I wanted to get a Pilots Licence for small plains but that's out of the question now. Once again, Regulations..

Good Luck and stay Informed...

ROBOTICKER

Send him back a letter

by Grateful Heart - 2013-03-16 11:03:07

stating "No Thanks". Then run...don't walk to find another Cardio and thus your 2nd opinion.

Respect works both ways. jmo

Grateful Heart

Thanks for that

by Zumbagirl - 2013-03-17 12:03:59

More good advice. Thanks. I'm on my way. Ready, steady, goooooooooooooo! :)

Joe

by ncddog - 2013-03-23 06:03:45

1999...fibs started 2000 Fibs ER several times that year medications required 2005 Fibs Hospital 4 days medications changes required .....2007 Fibs ER back tonormal no changes in meds.....2012 Nov. Fibs ER changed meds...
DECEMBER 2 trips 'bout a week apart, 3rd time Dec 28, St Jude PM2110 dual lead pacemaker installed in left front shoulder.
Jan 1,2,3 severe pain from center chest to left ear everytime I took a little more than a shallow breath..had sore throat during this period, also....took pain pills for relief to make it bearable. Doc could find nothing and said never had that complaint before....pain while subsiding slowly, lasted til end of February, and since then no pain, but when I have frequent low rate --140/160 fibs . there is a sore throat feeling that accompanies them.........so far, when the pulse rate gets down to 58 the PM kicks in and it returns to no less that 60.... other than these symptoms, I do not feel any benefit such as feeling better or more energetic........but I do not have that squirming jumpy fib like before. So, I guess I needed the thing, wish I could really see myself able to walk a half block without having to hang onto a post or mail box to rest...but I just got no energy at all.

Oh!

by ncddog - 2013-03-23 06:03:46

I think 28, act 68 am 88, so I guess I am lucky to even be alive LOL Incidentally, the PM was installed on Dec 31, 2012 at Frye Regional, Hickory, NC

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