Under 30 Bradycardia Athelete

Hello,
My name is Vinny and I am a 29 y/o male diagnosed with symptomatic bradycardia. I have always been very active throughout my entire life exercising 7 days a week, eating healthy, and living the healthiest lifestyle I could.
About 6 months ago I started to feel terrible after exercise. I started having bouts of lightheadedness that would last for hours, difficulty concentrating, chest palpitations, difficulty sleeping, severe fatigue, very little tolerance for exercise or stresses of everyday life.
I just had a visit with an electro physiologist at UPenn who recommended a pacemaker to resolve my symptoms. He said some people are predestined to have pacemakers and I somehow accelerated the process by performing high intensity exercise for prolonged periods of time.
I have almost completely stopped exercising and my symptoms have decreased some but are still significant. I don't want to never exercise again but I am also not sure If I want to have a pacemaker at such a young age. I know I may not have a choice down the road but I am looking for other young active people around my age with PM for guidance.
I have never lost consciousness because of my symptoms, but I don't think I should wait for that to happen. I also don't think I will be happy with my quality of life if I can never exercise again.
Please, If anyone has been in a similar situation before share your story with me or just some advice.
Thank you for taking the time to read my post, I have never reached out through an outlet like this and I appreciate all the feedback I can get.
-Vinny

15 Comments

Not a hindrance

by Theknotguy - 2015-03-25 05:03:21

Vinny:

First question I would ask is if you've had the heart monitor, tests, consultations, and know for sure the PM is the best way to go?

Assuming you have had the workup and know the PM is looming in your near future, I would next explore the posts on this forum. You'll gain a lot of information. Probably a lot of it will be comforting for you. You'll see people with PM's who are living fairly normal and sometimes better than normal life styles and who are not limited or hindered by their PM's. After being on this forum plus personal experience with a PM, about the only thing you can't do in the USA (with a PM that is) is (I think) get a private pilot's license. And that isn't because you couldn't pilot an airplane, it's an FAA regulation. Otherwise you can do anything you want. The only limiting factor is the underlying heart problems.

We have members scuba diving, sky diving, skiing, swimming, running marathons, weight lifting, and doing just about every sport. Members are working, having a family, running businesses, and leading full lives. Most of us who comment regularly on the forum don't look at our PM's as a hindrance. Rather (since I wouldn't be alive without mine) we look upon them as a great help.

As far as quality of life goes, I'm better now, post PM, than I was before. I have a steady, regular heartbeat. No longer do I have to work around my heart going into weird patterns. I no longer get dizzy every time I stand up, nor am I constantly short of breath. I feel better, think clearer (although my wife and some members on this forum would disagree), and have more energy. I still get afib sessions but due to a software program on my PM and medications they aren't as intense as before.

The point I'm trying to make is a pacemaker won't be a hindrance to your life.

As far as age is concerned, we have babies with PM's and we have 90 year old people with PM's. As far as your age goes, you're about 1/3 of the way in. But that isn't a problem. People who didn't live in an age where they could get PM's were destined to live a limited life style (as you've found out) and were destined to die early. Now, with a PM, you can look forward to living a normal life and living a "normal" lifespan. (Although I would exclude those who jump out of perfectly good airplanes as a sport.)

Another thing in your favor is medical science. I received my PM in 2013 and it's already outmoded. They now have PM's that fit inside your heart. I sit next to a guy in church who's battery on his PM lasted 9 years. I can look forward to the battery on mine lasting as long, if not longer. His PM doesn't have all the software features mine has. And since he's due to upgrade soon, his new PM will be better than mine. At present we have to wait for the battery to run down in order to get a PM replacement. I feel, in the near future, advances in PM technology may drive replacement times instead of battery life.

While I'm not in the age group for whom you requested responses, you'll find if you look around the forum posts that people your age with PM's are doing quite well and don't consider their PM to be a hindrance.

I hope everything goes smoothly for you as you transition into a new phase in your life.

Thanks for your response

by VJSaraceno - 2015-03-25 06:03:25

I can't thank you enough for your quick response.

As far as testing done: I wore an event monitor for 10 days, had a nuclear stress test, echocardiogram, and carotid ultrasound. I have had consultations with my primary care physician, two cardiologists, and two electro physiologists.

My average heart rate hovers in the low 40's and dips into the 30's throughout the day. My heart structure and size is fairly normal. My echocardiogram showed some minor deviations and my stress test demonstrated normal function. However, resting EKG demonstrates sinus bradycardia with escape rhythms. I have symptoms daily that are exacerbated after exercise. I have never lost consciousness but have had feelings of near syncope, difficulty concentrating, and severe fatigue. If I have an intense exercise session I feel like I don't want to do anything the rest of the day because of fear I may pass out.

The first EP said that since I'm not passing out he wouldn't put a PM in someone my age. The second EP said that he thinks that I need one and that I am going to need a PM if I ever want to completely eliminate my symptoms and prevent possible future syncope. The way he explained it was that after exercise my heart rate drops too fast and way too low to sustain the blood flow needed for proper function and stays that way until my veins return from being vaso dilated producing the symptoms I have today.

Thank you for the words of encouragement, I am actively exploring this site for more information in hopes to help guide my decision making.

my thoughts

by Tracey_E - 2015-03-25 07:03:11

My first thought is a bit disrespectful ;o) Anyone who would say 1) you need to be passing out and/or 2) you're too young to be paced is not the dr for you. You're too young to feel old when there is a fix. I vote for EP #2.

Passing out, unless you have a crystal ball to predict when it will happen, that's a stupid approach. JMHO. What if you're driving or on stairs or anywhere else inconvenient to go unconscious? After hovering in the 40's then dropping to the 30's, my hr dropped to 22 the day I got my first pm. I did not pass out. I did, however, almost die. But for some crazy reason I did not pass out.

Age, if you can't do what you want to do, if you are too tired and struggle to get through the day, if you can't work out and there is a FIX, what difference does it make how old you are?? This is a big pet peeve of mine, in case I was too subtle and you did not pick up on that yet! My dr thought the same thing. See comment above about almost dying. He said I was too young so I toughed it out and felt worse and worse over a period of about two years. I thought a pm was the end of the world and a very last resort so I happily took his advice to wait until I absolutely had to. The little detail he never told me was that I would feel incredible and have my energy back once my heart rate was normal again. I really resent losing those two years when I could have been feeling good. I wouldn't have ended up in emergency surgery, I wouldn't have freaked out my family, and I still would have had a pm.

Ok, off my soapbox now!

This is an electrical problem, which means your heart is structurally healthy and normal. Think a beautiful, well built building with faulty electric. Eating well and exercising prevent clogged arteries- plumbing problems. Electrical problems just happen. Nothing we did caused it, nothing we could have done differently would have prevented it.

I disagree that your exercise brought it on faster. Not exercising may have masked the symptoms longer, but it wouldn't have prevented it or changed anything unless you really exercise to extremes.

Imo, the very best thing we can do for ourselves is prevent more heart damage, which means exercise to keep our heart strong. If you can't do that then it's time to think about fixing it so you can.

Check out the posts here. Not the complication ones, we get an inordinate amount of those because this is where people come when they have a rare complication. Look for the fun posts, bragging about our latest. We have members who run, bike, skydive, scuba, lift weights, triathletes, anything you can think of. I do Crossfit, kayak every chance I get, hike or ski every vacation. I ran my first 5K last year to celebrate the 20th anniversary of getting my first pacer. The pm gives me a normal heart beat so I can do whatever I want. It doesn't hold me back at all. I got my first one at 27 and haven't looked back or regretted it once.

One more thought. Once you decide to get it, talk to your surgeon about placement. If you are active, you may want it a little lower and deeper than the usual placement, which is just under the collarbone, just under the skin. If it's buried a bit, it's less likely to get in the way when you are active.

If you have questions about the surgery, recovery or living with a pm, please don't be shy! Many of us have been in your shoes. Most of us find the pm fixes our problems so we can get on with our lives. I honestly rarely give mine a thought, other than to be grateful I have a problem with a fix.

sinus bradycardia

by Tracey_E - 2015-03-25 09:03:40

If you have sinus bradycardia, you are going to be depending on the pm's rate response feature to bring your rate up for you. There are several technologies for this, some are considerably more sophisticated and appropriate for an athlete than others. If Inga (golden_snitch) does not reply, you'll want to check out her other comments. She is extremely knowledgeable on the differences between them and this discussion comes up often.

Also, it will be tempting to get an mri-compatible device. There are not a lot of mri-compatible devices to choose from and at least one of them will only pace up to 150. This is fine for someone sedentary but likely insufficient for someone active so be sure to ask what the upper limit is of the device you get. More and more hospitals can now do mri's on patients with regular pm's as long as the leads are newer, so don't sacrifice the rate response function you want to get a device that is mri-compatible. Hopefully you can have both (I don't know devices well enough to know if the best rate response is also mri-compatible) but if you have to choose, I would go for rate response.

thank you

by Rower33 - 2015-03-26 01:03:26

Hello Vinny and other responders above.

I, like Vinny, have been having all the annoying symptoms of sick sinus - bradycardia, tiredness after exercise etc And having seen a cardiologist a couple of times and done 2 x 24 hour ecgs which clearly demonstrate my heart stopping for many seconds at a time quite frequently, I have now made the decision to have a PM installed. It has been an emotional time deciding, but I think reading comments on there have really helped. I am a competitive rower and sculler age 49, and the cardiologist told me this water sport wouldn't be possible with a PM. Whilst Im happy to hang up my competitive sculling blades I actually had a plan to be sculling on the Thames into my 80's! So he upset me somewhat!

But the more I dig around here the more confident I am he is worried about his precious leads wearing out (which is his excuse) as opposed to my QOL! There seem to be loads of rowers and people who use rowing machines with PMS here and across the net.

So I'm taking the plunge and will tell him in May I'm ready (NHS in UK takes a wee while to get on the list; once on its quick)

So Im writing this to say thanks really - I have taken all those informative comments above for Vinny and used them as reassurance myself I am making the right decision., And as I sit here with my light headedness Im thinking - cant wait to not have this feeling any more and to be able to hopefully do all the training I want to do without feeling so sleepy afterwards. Look forward to learning more from you guys on here, and good luck Vinny!

Risk vs Reward

by PM12March2014 - 2015-03-26 02:03:07

My story - I passed out 3 times over a period of two days. Once lying down, twice while sitting. Doctors found nothing. Admitted to hospital (Doylestown, PA) for observation. A couple hours later, passed out. Heart stopped 8 seconds, then one pulse, and stopped another 8 seconds. All captured on the monitors. Cardiologist came in and said, "I'll see you in the morning to implant a pacemaker". I was shocked. From "we can't find anything wrong" to "see you in the morning for a pacemaker". Basically, they said, if I'm passing out sitting and lying down, how am I ever going to drive? I was a risk. Most pass out while standing, they said. Surgery was excellent. Most issues were the shock of this medical event occurring to someone that was never hospitalized or had an IV in them. Have to go to my 6 month routine checkup with cardiologist and pacemaker tech. Every case is unique. You're doing right by educating yourself. Good luck.

more

by Tracey_E - 2015-03-26 03:03:36

Rower, talk to the surgeon about placement. Excessive rowing can be a problem with the usual under the collarbone placement. Rowing here and there is fine, I was rowing this morning :) They can place it lower and deeper so serious rowing is not a problem.

Vinny, I'm not an EP obviously, but here's my opinion as someone who's been around this block. Your heart rate is consistently under 40 (under 60 is borderline, under 50 is generally treated if symptomatic), you can't exercise, you don't feel well. You are 100% sure your symptoms are coming from a low heart rate, right? There is only one fix for a low heart rate and it won't go away on its own. If you're going to need it eventually anyway, why wait? Fix it and get on with your life.

By all means, get another opinion. If you are between Philly and NYC you have access to some great hospitals. It's important to feel good about both your decision and your dr. You not only want someone who will do the surgery, but who will be there for follow up in the years to come.

It's not at all uncommon to take some time to get the settings tweaked to your needs. We're all different and settings are not one size fits all. Some drs are better than others at this. Some will try once or twice then write you off and say you're as good as you're going to get. Others understand that you are an athlete and will go the extra mile to get it just right. My own experience has been that having a dr who is athletic himself makes all the difference. He doesn't have any other patients like me so I understand that he doesn't always have the answer, but he's willing to do some homework to get the answers. Imo, that's the difference between a good dr and a dr appropriate for someone young and paced. Just something to keep in mind as you shop for a dr.

I felt the difference the minute I woke up in recovery. My heart rate was more than double what it had been before surgery, it was like mainlining coffee! I kept trying to pace the halls, the nurses were fussing at me to get back in bed but I felt too good to stay still. Not everyone has such a drastic, immediate difference but many of us find that we compensated for so long that we didn't realize just how bad we really felt until our oxygen flow was back to normal again. Many also find that their workouts improve once they heal, stamina is better.

Know the feeling!

by edwardtk - 2015-03-26 05:03:43

Hi Vinny,

Welcome! I'm 31 and had a PM installed in Nov 2014 (4+ months ago) due to bradycardia, syncope and heart-block. Let me preface this comment by telling you that i am not an expert, i am a relative newbie, but others on here really know what they are talking about! But here's my story.

After 2+ years of similar symptoms to you (dizzy, tired, light-headed, brain fog etc..)...and having had every medical test imaginable...i eventually found a Dr who didn't think i was crazy and agreed to do another test.

During a Tilt-table test at the hospital, i passed out and my heart stopped for about 14 seconds...this is not a nice feeling...at all! My PM was installed immediately.

My surgery went well, with little or no pain after. I had a lot of issues with anxiety initially (because i'm a worrier), but think that is a normal hurdle to overcome. It does take some getting used to, having a foreign object in your chest, but now i hardly even notice it's there.

My symptoms have almost gone. I do have bad days, but they are getting fewer and far between as time goes on. I am very active, i run 10KM per day on a cross-trainer and just finished a local 10 Mile / 16KM road running race last weekend. I sail boats, run, play golf, swim and do Yoga (good for anxiety) and have never had any problems in my 4+ months with a PM.

I can't think of anything that i cannot do now, which i did before...with the added bonus that i don't feel terrible all the time.

Once again, i am not a Dr, but i would get another opinion (i got 5). I don't see why your age is relevant, you either need it or you don't need it...waiting for Syncope does not sound like a very sensible option to me.

Anyway, good luck and hope you feel better soon! Keep us informed!

cheers,

Edward

I agree EP #2

by wjs1954 - 2015-03-26 07:03:28

as the others have said a PM most likely will do the trick. I am a bit older but my heart rate was 42 average with lows at 30. 24 hour monitor and weeks of Garmin HR data showed this. I had passed out maybe one time a year, for maybe 10+ years, also just felt drained most of the time. My PCP had sent me to a cardiologist who even with my VERY low HR and passing out still did not really think i was ready for a PM. The reason is the Stress test looked ok, Tilt table dizzy but did not pass out, EKG looked a little strange but she was still not convinced. She sent me to an EP, after he looked at all the results and did a 'EPS" he told her a PM was a good idea, his group put it in.
Now one year later, back to the old fit me. I have run 5K up to the 1/2 marathon as well as biked up to 100 mile rides post PM. So if they say you need it, get it. It will not slow you down.. You may need a few adjustments and at times feel a bit off, but things will be better..

Go for it!!!

by Firefoy - 2015-03-26 08:03:38

Vinny,
I got my PM just over 4 years ago. I am an active duty fire fighter in Southern California. I have been a pretty serious runner and triathlete for 25 years. My heart problems put a temporary stop to all of that. My PM gave it all back to me. There is nothing better than working a hot flank on a brush fire hiking major hills and passing kids in their 20s who are out of shape. They have no idea I have a pacemaker. Only my crew knows. I had a similar experience with one doc telling me I was too young. I went with the 2nd doc. Best decision in my life.

And my kids think the scar is cool...

Pacemaker

by Ellen - 2015-03-26 09:03:39

I had bradycardia and my heart monitor showed that my heart rhythm was 30-40 bpm during the day and went down to 14 bpm at night. Before then, I was a 48 year old woman that did aerobics and yoga that could wrap her legs around her head and do crossword puzzles. I weighed 103 lbs., had perfect cholesterol levels, and perfect health. I never passed out from my low heart rhythm, so that doctor's a quack. It took doctors a while before they found out what was wrong with me because I had a bad cough and kept seeing my family doctor and he would say it was a virus. He never checked my pulse once. This went on for a couple months. Then one day I saw another doctor and my pulse was checked and right away an EKG was done. It wasn't good. The longer you wait, the weaker your heart gets. Remember, your heart is a muscle. I blame the wait on having atrial fibrillation and congestive heart failure. This is my own personal opinion. But your heart rhythm should be more than what it is and prolonging getting a pacemaker isn't good. You will still be able to do the majority of the things you used to do after you heal. I had a nurse in the hospital tell me the night before I had my pacemaker implanted that she had one too. And she still does scuba diving which is her favorite thing to do. A cardiologist told me I should've had a table tilt test done years before when I would get dizzy. My stupid family doctor said it was bad nerves doing it. The best of wishes to you.

Tracy & Knot Guy Said It!

by NiceNiecey - 2015-03-26 12:03:31

You got some weird advice my friend. Wait til you pass out? Like Tracy, I never passed out either but I was awfully close and the thought that I could have dropped dead is truly frightening, especially since I'd wake up some mornings with an aura that I was going to die. (Listen to your gut!)

It is true that you're young for a PM at 29. It is also true that life as you know it will be over. Yes, gone for good will be all those days of feeling lousy and needing to rest all the time. Gone will be all the light-headed spells and exhaustion. Gone will be your INABILITY to think!!! Yes, I missed my mind the most! Ha! I had no idea just how badly my life was being affected by a problem I didn't really even know I had until it all came to a screeching halt 2 days before Christmas in 2013.

Now we will pray that you recover from the 'operation' quickly. Most people snap right back. I was not one of them but I have finally gotten to the "better than I was before" stage and it REALLY feels good!

Keep us posted, VJ, on your plans.
Niecey

Thrilled!!!

by Trinurse - 2015-03-27 02:03:43

Vinny--I am 66 and like you consider myself an athlete. I completed Ironman triathlons and more marathons than I can count. Knew for several years that I had conduction problems, with several episodes of passing out, but still had what I considered a great quality of life. Had 2 cardiac caths that showed my arteries to be clean as a whistle. However, that began to change last year with shortness of breath, fatigue, dizziness, etc. Ran a 1/2 marathon and by the next month I could not run 5 miles without walking. Things had started to change, but I was in denial. Finally went to the EP and my ejection fraction had dropped dramatically and after exercise, my heart rate was bottoming out significantly. Had my CRT-P placed 2 months ago, and it was like someone turned the lights back on. I felt so good I went home immediately from the recovery room. Am already running/walking 4-5 miles (albeit very slowly) but have hope for the future now. Did get an ID band with my type of pacer on it, so if I crash on the bike and don't have ID--they will know all about my medical marvel. Good luck and have faith. Medtronix rocks!!!

syncope results

by chasj - 2015-03-28 07:03:47

When the doctors waited for me to have a bad result from irregular heart beat after all the tests, my ef was 65% at that time, it happened while I was waiting for a table for 40 minutes one sat night at the roadhouse steak house right in front of the place you ask for a table reservation. I went from standing to face first ion the floor, my friend said it sounded like someone dropped a watermelon. I broke my nose and the front of my face. I woke up on the floor. When the emts got there thay said my hr was 33. I had nose and face surgery after the three week wait for the pacemaker. imagine my wife following me around the place for three weeks waiting for the pm surgery and riding with me in the car.

Listen to you!

by Bean19 - 2015-03-28 09:03:03

I am still fairly new to this as well seeing as I received my pm late November 2014. I turned 40 early January and am a fit healthy PE teacher. I was diagnosed with bradycardia and high vagal tone. It was my choice to get the pm and it is set strictly to keep me from passing out. I use it less than 1% of the time. My decision came easily to me because I look at the pm as a solution to a problem as well as a safety blanket.

Like you I have bradycardia, always have. I remember in fifth grade we were doing pulse things and I was sent to the nurse because of my slow pulse. During the day I am consistently in the low 50's high 40's, and at night low 30's. I exercise multiple times a week doing many varying activities. I did prior to the pm and post pm too.

Unlike you I did pass out, about once a month for four months. I was not passing out during warmup or recovery of exercise at all though, the common time for vasal-vagel syncope. I passed out while playing a board game with my kids, taking a shower, being a passenger (thankfully) in a car. My heart monitor captured a 15 second pause/flatline that completely freaked out my husband and myself.

There is too much to live for to be upset that your heart needs a little help at the age you're at. At least we have warning symptoms that an episode is about to happen. My pm does not stop the symptoms but it keeps me conscious. It is set to go off around thirty and kicks me to ninety for one minute. It is amazing how quickly I feel better after it kicks in-it is just about instantaneously. Listen to yourself and EP 2. Passing out is peaceful but NOT safe.

Take care of you and keep us posted.

You know you're wired when...

You can shop longer than the Energizer Bunny.

Member Quotes

I am 100% pacemaker dependant and have been all my life. I try not to think about how a little metal box keeps me alive - it would drive me crazy. So I lead a very active life.