Confused patient

Several months ago, I began to feel short of breath and unusually tired. I am 72 years old and quite active – swimming and biking every day. I went to my family doctor and was sent for several tests, the last being a Holter monitor for 24 hours. The follow day after I did the Holter, I received a call from the lab analyzing the results. The technician told me to go immediately to the emergency ward. The results showed pauses of 5.20 and 5.24 at night. After being in the hospital for 3 days, the doctors said that I have bradycardia, I was a borderline case and, should I want, they could put in a pacemaker. My question is the following: Are pauses of over 5 seconds borderline? Is the above live-threatening? And I have always thought of operations as something one does when there is no alternative, so why should I elect to have surgery? I would like to hear other responses so I can make up my mind. Many thanks.

8 Comments

I had no choice

by bluebowtye - 2014-05-28 03:05:22

Hi Bob,

In my case the decision was pretty much made for me. My only symptoms were fainting twice in one night, the first while I was just sitting on my couch doing nothing.

Where I live (Iowa) the law states that if you have any fainting episodes or seizures you lose your driver's license for 6 months and if you have another episode during that time no driving for another 6 months! There is no way I could have gone that long without driving so my Dr. told me I needed a PM asap. 5 days later I was having my surgery and since I was no longer in any danger of fainting again I could drive after I waited the 2 weeks following surgery. I have heart block and they told me since my heart paused for several seconds that I could faint while driving and seriously injure myself or others.

I wish you the best. Good luck with your decision. I have had mine for just over 3 months now and it did take some getting used to at first but I am pretty much over that now and am living a very normal life.

Take care,
~Sheila

Quality of life

by boysmom - 2014-05-28 07:05:22

I had been having near fainting/fainting spells for over a year. All normal heart tests came back fine. Finally landed in the ER while working one day. Diagnosed with vertigo and sent to neurologist. He thought my symptoms were cardiac in nature and ordered a 24hr holter. During those 24 hours I had three episodes of complete heart block, each one longer than the one prior. The longest was just about 5 seconds. Saw cardiologist on the 2nd of May. He also said it was my decision, but what would happen if I was driving with my kid in the car? I spoke with my primary who said if it was her she would have the pm right away. I also spoke with another cardiologist group who told me the same thing. Had my pm on the 16th of this month. While I was very scared, it was pretty much a no-brainier given the fact that you don't know when or where you may have symptoms. My decision was solely my own, but I did not want to put myself or anyone else I danger.

Death prevention

by Selwyn - 2014-05-28 08:05:19

Present guidelines in the UK ( if memory serves me properly) is that anything of 2.8 seconds stoppage or more is an indication for a pacemaker. Why? Because longer than that there is a reasonable risk of sudden death. Sometimes the heart starts again, and sometimes it doesn't. Are you feeling lucky?

I would not hesitate in having a PM with a heart stop ( asystole) of over 5 seconds. This is not borderline. The technician seems to have the right idea!

The vast majority of people receiving pace makers have no complications and an improved quality/longevity of life, including exercise.


Hi Bob

by Pookie - 2014-05-28 09:05:15

Personally, I would get the pacemaker....for all the reasons stated above.

Did the doctor not explain to you that your next pause could be a permanent one and your heart may decide not to start again?????

I'd err on the side of caution and go for it.

But again, it is your decision.

For peace of mind like someone above mentioned: go for a 2nd opinion, but I think you're going to hear he/she say that a pacemaker is your only alternative.

Having a pacemaker is not that bad. If you decide to go ahead with it; you may be bothered emotionally because of all the unknowns, but that is why we are here:) Yes, it is surgery and all surgeries come with risks, but that is something your doctor will discuss with you.

I guess bottom line is: if it can make you feel better, why not?

Take care and please keep us posted on whatever you decide.

I had my 1st pacemaker at the age of 42 - that was 10 years ago and I have approximately one year left before I have to have surgery again for my new one.

Wishing you the best.

Pookie

Hi Bob

by IAN MC - 2014-05-28 09:05:22

I can understand you being confused but really it is a no-brainer :-

i) You are short of breath and unusually tired; this could be because your heart rate is falling too low and you are not having enough oxygen pumped around your body. A pacemaker could prevent this !

ii) Your heart is pausing at night for over 5 secs . Next time it might be 6 secs, then 9 secs , then maybe 15 secs and then it might start happening during the day .Electrical problems of the heart have the nasty habit of getting worse . A pacemaker could prevent this !

iii) Is it life-threatening. ? Death is a permanent pause of the heart so yes it is !

iv) Before you get to the dying stage though, you may start blacking out . Many of us on here have blacked out prior to having a PM. Some of us were driving at the time and crashed into trees or other cars. Some fell downstairs, some broke arms. If you're lucky, you survive the fall . A pacemaker can prevent this !

v ) Having a PM implant is not even referred to as an "operation" . It is a very simple procedure, usually done under a local anaesthetic.

I have deliberately tried to scare you, because it really is best not to have cardiac pauses !!!! . ( but there is a tiny chance that you may go through life having nothing worse than 5 second pauses during the night,) at the end of the day it is YOUR decision

I know what I would do !

Best of luck

Ian

symptoms?

by Tracey_E - 2014-05-28 09:05:32

Pauses of 5 seconds aren't good, but they aren't likely to be life threatening. That doesn't mean they don't cause damage and make you feel bad. Bradycardia means sometimes your heart dips below 60 bpm, a pm can fix that also.

When you are borderline, the deciding factor is how you feel. Operations aren't only for when it's life and death. In this case, this is the only alternative if you want to feel better. If you are short of breath easily, if you can't do what you want to do, if you are too tired to get through the day, then getting it is a good choice.

Pretty Common

by ebfox - 2014-05-28 09:05:48

Hi Bob,

Your story is not unusual, especially on this website. It is ironic that people who are active, the swimmers, runners and bikers, are the people impacted by sick sinus syndrome. Over time, all that high rate cardio exercise messes up your heart's electrical system (my doctor said "running is great for the plumbing, bad for the electrical..")

Regarding alternatives, there are none, although if you completely detrained it might impact the wonkiness of your sinus node. Your doctor is going to want to put in a pacemaker anyway.

You have a mental adjustment to make. A pacemaker does not mean that you can't be active (in fact, the opposite is true- it will allow you to remain active). But is the PM necessary? Think of it like this: a 5 second pause is a rate of 12 beats per minute. You would not survive at a 12 bpm rate-

Read all the stories on this website about PM wearers completing marathons and triathelons; it will protect you and allow you to be active.

Anyway, best of luck and keep us informed on how it goes.

E. B.

Great response

by bobgoldman8 - 2014-05-29 08:05:20

Thanks so much for all the great input which helped me decide positively about putting in a pacemaker. If my doctors had explained more about the procedure, I would have been less confused and would have acted sooner.

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