New pacemaker - does it get better?

Hi Everyone

I didn't expect to be joining the pacemaker club but here I am. I'm looking for some advice as am having a few problems. To give a bit of background...

I'm 41 years old and have suffered with ectopic beats for about 15 years which were managed with beta blockers until about 2 years ago when they improved to the point I was able to come off the meds.

2 months ago I had an episode with an erratic heart beat with pauses lasting up to 6 seconds and low heart rate - about 38 BPM. These symptoms were completely new to me and I was feeling very unwell. After putting up with them for a few days I went to A&E as was getting quite anxious.

After ECGs, bloods and x-rays I was told I probably needed to get back on some meds but basically was OK and not to worry and was sent home and asked to go to my doc for a referral to a cardiologist. About 24 hours later the symptoms disappeared and all was good.

A few weeks later I got a call from the hospital out of the blue. A doctor said he'd reviewed my tests and was very concerned and wanted me to see a cardiologist ASAP. I went back to my GP who ordered more tests - bloods, 24 hr trace, echo cardiogram etc.

Before the test were done I had another episode same as before so ended up back in A&E. This time the doctor immediately said sick sinus and admitted me. After wanting to send me home again they eventually (after much pushing from me) managed to get the pauses on ECG so moved me to the cardiology ward and was told I needed a pacemaker. It was fitted a couple of days later. This was three weeks ago.

Since having it fitted the pacemaker has fixed the slow heart rate and the long pauses, but in some ways I'm feeling worse.

I now seem to be having issues with my heart rate jumping around. It's most noticeable on inhaling and exhaling. The base rate on the pacemaker is 60BPM. When I inhale my heart rate jumps to 75BPM and then as soon as I exhale I get a short pause then drop back to 60BPM. I guess my sinus rhythm is kicking in on inhale then fails on exhale and back I go to 60BPM. I'm finding it very distracting and difficult to concentrate with my rhythm switching all the time. By the way, my resting heart rate before these problems was usually between 68 - 75.

I also get worse symptoms drinking alcohol. Not much - just two beers or glasses of red wine. It causes my heart rate to jump around and an increase in pauses. I'm also very tired much of the time and get breathless quite easily. Also I get very light headed for a few seconds when I stand up. Almost to the point of feeling like I will faint.

I went back to the pacing clinic last week as was worried. They found a problem with one of the wires being too sensitive so adjusted the settings and said it should improve. If not then to go back and they will try tweaking the rate. They said at the moment I'm being paced 88% of the time (atrium) and 0.2% (ventricle). They said the tiredness and aching in my chest were likely just due it only being a few weeks since having it fitted, but that everything looked fine.

I'm really worried that the pauses and heart rate changes are with me forever now. They are affecting my quality of life and the thought of not being able to have a drink and socialise like I used to is really getting me down. I feel too young to have to miss out on the lifestyle I was leading up until the pacemaker. I'm otherwise fit and healthy. Walk loads, cycle loads including to work. I'm back at the pacing clinic for my one month appointment next week so will talk to them about all of this. Hopefully I can get back to some kind of normality, but am still coming to terms with it all and hoping this isn't how I will be from now on.

Hopefully some of you have been through the same and can offer some words of comfort and advice?

Thanks for reading.

Mark


2 Comments

Getting Better

by PeteFindlay - 2014-08-18 11:08:54

3 weeks is still quite early, and you'll still be feeling the effects of having someone digging around in your chest. Some aches are to be expected, though don't ignore them if they get painful. Try to keep moving, within the limits given, so keep your shoulder mobile. Even just walking briskly will help keep your shoulder moving.

I can certainly empathise with you feeling worse now than before implant. Unless you had symptoms of breathlessnes or fainting before, it's often difficult to see where the PM actually offers a perceived improvement. It's a safety net that should stop the cardiac episodes you've had in the past, whether they had yet had a serious impact on you or not. That said, it's interfering with your natural processes, so is likely to need some adjustments. Mine felt uncomfortable (and scary!) for the first few weeks, until they turned my minimum rate down, and adjusted some of the ventricular pacing parameters. You may need other settings adjusting to find your sweet-spot, but hitting that sweet-spot is one of the primary goals the medics have - it's about quality of life as well as potentially saving life.

Make sure you note down how you feel, and if you are feeling the PM (or your heart) doing things you don't understand. Hopefully, the clinic will be able to either adjust the settings to suit you, and/or explain those things that can't be adjusted.

It's early days yet, but in a few weeks, I'd hope that you'll be back to walking, cycling etc as before.

Hang on in there!

Pete


I'll Chime In With Pete

by NiceNiecey - 2014-08-19 12:08:39

and agree with all that he said. I honestly felt worse with a PM those first several weeks. I had no idea I had a problem in the first place so I was dealing with all sorts of emotions as well as the physical problems.

Rest assured, Mark, YOU WILL GET BETTER and better but it takes some time. I'm now 7 months out and feel infinitely better than I did at 2 months. It really does take tweeking and time to get things just right for each person. It may also take putting you back on a beta blocker so don't be surprised if that happens.

As far as drinking, you need to be concerned with overall heart health. While the problem you have is electrical, you don't want to add plumbing issues to the list. That said, I still enjoy a glass of wine but I know others that have stopped all alcohol, all caffeine, etc because it brings on aFib and other concerning symptoms. And some of those people also have replaced valves and ICDs! You may begin to notice that certain foods, drinks, or activities cause you to experience funky rhythms or other problems. If spicy foods make you tachy, avoid them.

In time, you will feel better and you'll have a better understanding and handle on what activities cause you problems. It's a bit early to tell at this point but keep an eye on it. You want to feel better, not worse!

All the best.
Niecey

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