4 months later and still presyncope but no syncope

Hello
I am a 34 year old healthy, active male. I received an emergency PM installation while visiting the hospital after approximately 15 episode of presyncope and syncope over a 5 month period. No pattern as to why or when, my episodes are random. While in the hospital the monitor registered 8-10 second pauses and the doctor recommended a PM. Since implantation I am still having episodes of presyncope, the feeling of nausea and lightheadedness but not fainting. I am wondering if this is common and if so what kind of adjustments my PM may required.

12 Comments

8 - 10 second pauses in heartbeat

by GSlack - 2014-01-31 05:01:56

New member, just found this site. I am a 49 year old active male who had a 2 wire Boston Scientific implanted in late 2011 for the same type of issues. 8 - 10 second pauses in heart beats. I kept telling my general med doc that my heart was stopping. After passing out and busting my head open I got the PM implanted. I still have some of the same symptoms. My heart beat pauses and I get very light headed and somewhat disoriented. I feel very tired afterwards. Most often these pauses happen when I am resting, not during physical activity. Stress is a MAJOR trigger for me. Stress causes instant irregular heart beats and the stress related episodes last MUCH longer than the random episodes. My cardiologist says irregular heartbeat is normal and I should quit worrying but it's hard to stay calm when your heart stops beating.

Light-headedness

by Elleninminn - 2014-01-31 06:01:31

Have you considered other causes not directly related to your heart problem, such as medications, dehydration, low blood sugar? Could be your body is still adjusting to the pacemaker. I went through episodes of feeling weak and light-headed, but those seldom happen now, five months after implantation. When they do, it's due to the metoprolol lowering my BP too much.

blood pressure?

by Tracey_E - 2014-01-31 07:01:09

What are you doing when it happens? It's common to need the settings adjusted. The ones they send us home with are just an educated guess. We're all different so it's common to need to tweak.

Do you know if your blood pressure was dropping when your heart paused? Syncope can be a combination of the two, the pm only fixes the pauses. Write down the day/time it happens and take it with you for your next check. They can see what the pm was doing at the time. Have you had a tilt table test?

pre-syncope feeling

by busby - 2014-01-31 08:01:44

I have a similar condition to you, with >30sec pauses recorded in emergency. I have had my PM now for over 10 yrs. For the first few years I would still get that pre-syncope feeling until the rate drop response was turned on. This meens that when my heart decides to pause the PM detects a rapid drop in HR and starts pacing at 75 bpm for 2 minutes. This helps to overcome the drop in blood pressure that happens at the same time as the pause. Since then I have only had an occasional pre-syncope feeling (about 1 every few years). So you may just need to have a few adjustments to your PM.

pulse during pre-syncope

by jrd210 - 2014-01-31 09:01:38

Learn to take your own pulse rate and see what it is doing during your symptoms of pre-syncope. How long do these episodes last? If pulse rate stays normal during the episodes then it is not likely to be anything to do with sinus "pause".

tilt

by Tracey_E - 2014-01-31 11:01:02

If you were sitting still, odds are it's something else. Setting issues are more likely triggered by activity.

A tilt test moves you into different positions trying to trigger a response in people who randomly pass out. They watch for heart pauses (which you already know you no longer have) or sudden drops in blood pressure. The bp drops can trigger the heart pauses. The pm can only fix the pause part, meds and diet can help with bp. Look up vasovagal syncopy or NCS (neurocardiogenic syndrome). I'm no dr so I'm just guessing, but it's a place to start.

How can I monitor blood pressure during episodes

by 34withsss - 2014-01-31 11:01:54

Hi TraceyE
I am not doing anything out of the ordinary. Yesterday I was sitting at the table doing a puzzle with my son. I am not sure what my blood pressure is doing at the time of my episodes. I have written down the dates and times and nothing is showing when I go to my check up. They have the brady response set as well. What is a table tilt test?

Hi jrd210
My episode itself last no more than 8-10 sec but I feel unwell for up to 20 minutes after. The doctors were certain when they recorded my long pauses on the monitors at the hospital that this was the problem. I haven't completely fainting since the pm was put in but I am still feeling episodes.

Another Episode

by 34withsss - 2014-02-01 01:02:23

I just had another episode. That is 2 in the last 24 hours. This is the first time I coukd feel the brady response kick in. My wife told me I went very pale. When she checked my pulse my heart rate was beating fast, likely the passmaker doing it's job. I am still feeling these episodes.

Definitly presyncope not anything else

by 34withsss - 2014-02-01 01:02:41

Thank you for your insight. It is definitely a pre-syncope feeling. I know what it is like to have low blood sugar, I am not on any medication and never have been, ever in my life. I drink plenty of water to keep myself hydrated. Stress, possibly, but I know for sure when I have an episode it's like nothing I have ever felt before 9 months ago. My body feels light and I feel like I am going to faint along with severe nausea. Hard to explain. I have the sudden HR drop response set on my PM that is why I am unsure why I am still feeling this way. My episodes are approximitly monthly at the moment.

Go to the ER

by Tracey_E - 2014-02-01 05:02:17

If you are having multiple episodes, you need t be seen. Something else is going on. Get to a hospital where they can monitor you and figure it out.

Has anyone mentioned POTS to you?

by Vmurph - 2014-02-03 12:02:32

I had the same issues you sound like you're having. I actually passed out cold 2 hours after my PM was implanted and was unresponsive for 10mins.

After testing done at Cleveland Clinic and OSU, I was diagnosed with P.O.T.S. (Postural orthostatic tachycardia syndrome) It explains a lot of my symptoms and they are able to treat my symptoms with medications.

You may be like me and have multiple issues that presented as one. I am no doctor, but I have been through the ringer the last few years with multiple mini strokes etc. So if you read up on it and it sounds like it could be part of what you're experiencing, Mention it to your EP and they can test for it..

Best of luck.
Vanessa

Any answers?

by Jbcb03 - 2015-06-25 05:06:42

I realise this thread was started last year but I've been doing Internet research and found this....my husband has identical symptoms as described by the original writer of this thread. Just wondering if any relief and/or answers were found.

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