Recent chest pains, Pacemaker since 2009

I am 68 and have had a pacemaker for quite a while.  I don’t find the pacemaker as debilitating as the drugs that often go along with it.  My problem is AFIB.  Basically the pacemaker is there to make sure my pulse rate does not go below 60BPM during an attack. I am on Sotalol to limit my pulse rate.  Too high and I go into AFIB.  I believe that limit and the drugs properties limit my energy level. 

With all the drugs, an aging body and a previous heart attack it is difficult to tell what is causing the tiredness I often feel.

Lately I have been having occasional sharp chest pains in the area of the pacemaker.  Sometimes laying on my side can bring them on.  The area can be sore to the touch.  The internist thought it might be the pacemaker.  Take some Advil for inflammation.  I did have a stress test which seemed to indicate my heart is fine.  

Has anyone had similar experience?  Could physical activity cause the irritation?

Incidentally, my stress was stopped in the second stage cause apparently my pacemaker took over making the rest of test useless.  New too me.  I didn’t think it could do that...

Thanks for any comments. D

2 Comments

Beta blockers after a heart attack and PM site pain.

by Selwyn - 2017-11-07 07:53:08

Beta blockers differ. They can cause tiredness.  Your base rate of 60 may be a bit low for you. ( mine is 60, I take a  beta blocker). Have you considered, perhaps, 70 bpm?  It may give you less tiredness. I trust your rate response is switched on ?

You should consider Nebivolol. (I take Nebivolol 5mg.) It dilates coronary arteries. Important if you have coronoary disease.

If your chest pains relate to your position of lying, and relates to the PM site, they are most likely to be due to a bit of tissue stretching or lead irritation. I doubt whether you can do anything except avoid those positions. Otherwise, sharp, transient, chest pains are likely to be muscular in origin. Sometimes anxiety will cause this.

Of course, tiredness has many different causes from anxiety to medical illness. 

Cardiac rehabilitation exercise programmes have been shown to improve prognosis after having a myocardiac infarct, or  heart failure. General levels of fitness will help to improve tiredness and well being. 

A coronary angiogram ( eg. a CT angiogram)  would be useful if your 'heart attack' related to coronary artery disease. An incompete exercise test is not worth anything in terms of predicting your future well being. 

An ablation for AF may in the future give  a beta blocker free existance. An ablation for AF should be considered if you cannot get on with AF medication.

With best wishes,

Selwyn

 

Thanks for your comments Selwyn..

by Parkland - 2017-11-07 20:53:37

I will discuss them with my MD.

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