Heart rate dropping constantly after pacemaker surgery

Received pacemaker for Vasovagal syncope because of blood drawn I flat lined for 24 seconds; 9 days after surgery the pacemaker data showed 747 episodes of heart rate dropping episodes of at least 25bpm! - For example: 77bpm - within 1 or 2 heartbeats it drops to 44bpm.  

Before pacemaker tests show I had no abnormal arrhythmias or bradycardia. - I wore a holter monitor for a week with positive readings and no signs. 

My doctor and Medtronic Rep have given me NO answers. 
What is going on!!? Someone please help. 

I am 27 years old


4 Comments

Hmmm....

by Czechmate - 2016-07-28 12:14:16

Sounds like you need a new doctor.  I would think that lead connections need to be checked and the device needs thorough testing. 

Bob

Good news!

by Gotrhythm - 2016-07-28 15:21:02

I'm sorry you don't feel like you are getting good information from your doctor and others. I know how frustrating that is. I discovered asking general questions only got me there-there answers, which of course only frustrated me more.

Here are some things you might not know. Vasovagal syncope isn't a problem with the electrical system of the heart, which most of us who have pacemakers have. Vasovagal syncope is a problem with the sympathetic nervous system. Your heart might be--probably is--perfectly healthy, without arrythmias of any kind. But your sympathetic nervous system goes haywire occasionally and tells your heart rate and blood pressure to drop--as you discovered--sometimes to zero.

The PM will not stop or prevent vasovagal attacks. All it can do is make sure your heart rate only drops so far before the PM takes over and keeps your heart rate from falling to a dangerous level. Give the Medtronic rep a break. He or she doesn't know "why" your heart rate drops. The rep can only tell you whether the PM is working the way it is supposeed to.

So good news! Your pacemaker is working! Everytime your heart rate drops, the PM keeps it from going further and possibly stopping. And so, you don't faint, or god forbid, pass out at the wheel. 

As to why you are suddenly having so many episodes now when you didn't before, vasovagal syncope is odd. You can go days, weeks, years between attacks. You can have many episodes over a couple of weeks, and then none for years or even the rest of your life. I would guess somthing has been going on or your doctor wouldn't have ordered the week-long Holtor monitor.

I hope this helps. The main thing to know is that with the PM on board, you are no longer in danger of fainting with no warning, even though sometimes your sympathetic nervous system still may get its signals crossed. 

I have vagus nerve damage/pinch as well

by techiej - 2016-07-28 17:35:19

after a surgery to correct a large hiatal hernia i had numerous pre-syncope episodes where my heart rate would drop from a resting rate of about 50 to low 40's and upper 30's.  In addition, my response rate was almost nill.

I ended up with a PM because of this and it has helped but as Gotrythm said, does not fix the underlying problem.

I still have pre-syncope episodes but they are not as severe.  I have no triggers and they occur an average of about every 6 days with some episodes only a day apart and others as much as 15 days apart.

The PM was a vast improvement for me and I finally found a surgeon who believes he understands what is happening and will be undergoing soem procedures in about 6 weeks.  It took going to multiple Dr's, tests, etc. and having consults with a couple of surgeons before finding one that understood and has dealt with this before.

Prior to the PM I wore a holter for 48 hrs followed by an event monitor for 3 weeks.  Other than seeing my HR drop and not recover they never saw anything else that could explain the episodes I was having.

In my case I have a swelling in my lower esophegous that is likely to be pressing on the vagus nerve and causing my problems.

Don't give up and keep pushing for some answers/solutions!

 

Thank you!

by IIAwareNessII - 2016-07-29 18:32:07

Gotrhythm & techiej  Thank you soo much for your information and experience. I can't believe the thorough responses!! I will definitely be using this knowledge. 

techiej  - can I ask how they did find the swelling in your lower esophegous?- what test? Are you having any other symptoms? Like hiccups?  - I am having regular hiccups...50-60 a day and they have apparently ruled out the pacemaker based on xray and device interrigation. 

Also what procedure is going to happen in 6 weeks?

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