Urgency of PM?

It's great to see this club of actual pm "users".

I am a 55 yr old male who just discovered heart problems 5 days ago. I am vigorous and have no symptoms except exercise limitation (no fainting), and no recent change in my health. I am advised to get a pm immediately and I'm unsure of what to do.

My HR (normal until now) is stuck at around 40bpm. Initial EKG was 2:1 AV heart block, a later EKG showed complete HB, a Holter showed both intermittently. A cardiologist has urgently recommended a pm.

Q: How urgent is this? Do I have time to get a second opinion? Is surgery within the week soon enough? For practical reasons it would be much easier 3 weeks from now. Am I really at risk for sudden cardiac arrest? I would not even know there is a problem except I happened to decide to go by
my PCP's office to follow up on a minor issue from April physical. Any input welcome!

6 Comments

What to do....

by Joanna - 2013-10-05 03:10:23

You no doubt have had symptoms for awhile and just did not realize your HR was low. I had been complaining of fatigue and SOB for years. My low HR was not detected until I saw the NP at my Dr.'s office, and she ordered an EKG and it was abnormal. She then put a Holter Monitor on me for 24 hrs. which revealed my HR to be in the 40's during the day and lower 30's during sleep. I saw my Cardiologist, and she treated me with medication for over a year before deciding I ultimately needed my PM. I think you will be ok to seek out a 2nd opinion, but don't put it off. Write down all your questions and bring them with you when you go. You came to the right place for advice. There are a lot of members here who know a lot more than I do and will be glad to offer you some help. I hope you feel better soon, and if you do end up with a PM, welcome to the club....

2nd Opinion

by PacerRep - 2013-10-05 05:10:38

If you are in 2:1 block and INT complete heart block....I'll be honest there really is no need for a second opinion...I'll save you the money right now.

40 is not too terrible...if it was a normal sinus rate at 40, even then your probably getting a pacemaker. Right now you are having 2 atrial beats to every 1 ventricular beat. Now depending on the timing of that, they could be banging against your valves and causing undue stress. Your not getting normal diastolic filling of your ventricles which decreases blood flow and stroke volume.

There's a lot that goes into this, but 99.9% of all cardiologists are going to give you a pacemaker, the best research you can be doing right now is deciding which pacemaker you want based off of what's right for you and not let your cardiologist choose the device, they empirically use the same one out of convenience (in most cases)

Up to you

by ohiolaura - 2013-10-06 08:10:00

I wouldn't wait myself,but that's just me.
I was 49 last year,healthy as a horse,so to say for the most part,and all of a sudden started feeling off,the feeling went away,then came back,and I stayed off not feeling right,,and 5 days later had the PM put in.
I felt like pooh in the hospital,not a fan of my HR dropping to the low 40's at all, had tingly feet and hands,guess that was from the blood not being pumped the right way,and I didn't like the way I was,I knew I had no choice.
The Dr's just told me this was it,and I can understand the complete shock of being told this,as I didn't do well at all, cause Im not old,right? Didn't matter much,had to do something,there was no option for me,so I accepted it,as much as I could,like everyone else said,it happens.
If you have trust in your Dr(s),you know what to do,its different for all of us,but look at it this way,were all here telling our stories and giving our thoughts,so it cant be all bad,right?
Good luck,and get better!
Laura

opinions

by Tracey_E - 2013-10-06 09:10:51

It's not urgent, you are not at risk of SCA so if you want to get another opinion and wait 3 weeks, go for it. But ditto what PacerRep said, your case is pretty cut and dried, they are going to say the same thing.

I also have 3rd degree block. Most of us with electrical problems are otherwise healthy and active, electrical problems just happen. I found I had WAY more energy after the surgery. I had been tired for so long and learned to compensate, never realized how much it pulled me down until I felt better again.

And not passing out is not a reason not to get it. Unless you have a crystal ball, you don't now when you will pass out. We've had members hold off on the pm, pass out while driving and end up recovering from pm surgery as well as a car accident. The time to get it is before you pass out.

Tracey's right

by PacerRep - 2013-10-06 10:10:46

I had a patient that had a loop recorder (basically an implantable holter monitor) and the physician told her for months she needed one but her excuse was that she didn't "feel symptoms or pass out" so she put it off...

Fast forward 2 or 3 months, she passed out at the mall, hit one of those benches and broke her arm in 2 or 3 places and her clavicle.

Thanks - Just got PM!

by 2for1 - 2013-10-12 08:10:18

Thanks to everyone for their replies. I went ahead and had a PM implanted yesterday, overnighted in the hospital (yuck) and am now home & doing quite fine! No pain so long as I keep my left arm in position, had a long walk, and am just starting to get used to a pulse of 70+ instead of 40- --- meaning no throbbing in my abdomen, no swimming vision, etc. Much as I resisted the idea of having a machine implanted in my body, I'm looking forward to getting back to running, skiing etc. in the next few months, w/o the limitations I was feeling.

You know you're wired when...

Your electric tooth brush interferes with your device.

Member Quotes

In fact after the final "tweaks" of my pacemaker programming at the one year check up it is working so well that I forget I have it.