Slow heart, and chest pain, help please

I do not have a pacemaker yet, but my heart rate at rest is often in the 40s and dips into the upper 30s at night.  I am not an athlete, but fairly active.  I have sinus rhythm, but have had a slow heart for 10 years, was told it is Sick Sinus Syndrome.  I haven't had any significant symptoms until now.  I have chest pain (angina?) often, everyday, and I read that can be from untreated slow heart, bradycardia.  My cardiologist is holding off putting in a pacemaker.  But the chest pain is uncomfortable and hurts more on the heart beats.  Has anyone had anything similar?  And how low a heart rate is too low?  Doesn't the 40's seem too low?  I am sick with worry, so any response would be welcome.


7 Comments

get another opinion

by Tracey_E - 2019-08-16 21:59:30

I don't know why some doctors hold off. If you are borderline and not symptomatic, sure. But if you are borderline and don't feel well, if you can't do what you want to do,if it's affecting your ability to enjoy life, why put off something fairly simple that can fix it?? I would get another opinion. When was your last holter?

Under 60 is bradycardia. Under 50 means it's time to think about pacing. 

Hold off on pacemaker--why?

by Gotrhythm - 2019-08-17 15:25:21

Ditto everything ar-vin and Tracey said.

But finding a new cardiologist is not as easy as ordering from Amazon. if you're not quite ready to ditch this cardiologist, you at least need to understand his thinking so that you know for sure if what he thinks is important is tnhe same as what you think is important. 

One way to get information from a doctor is not to ask direct questions like "do I need a pacemaker or don't I?"  Instead ask him to tell you how he sees the the pros and cons of "holding off" vs installing pacemaker now.

Of course, if he doesn't want to discuss it with you...reread Tracey and Ar-vin's answers.

And recognize that you may have to travel to find the EP/cardiologist you need.

Delay Pacemaker?

by AgentX86 - 2019-08-18 00:06:26

That's nuts.  Angina is a very strong warning sign.  IMO, there is no excuse for a cardiologist to delay treatment for angina.  It's your body's warning that your heart is starving for oxygen.  There's no guarantee that a PM is the fix but you cardiologist should be finding a fix - now!  As the others have said, there is no reason to delay a PM, if that's the fix, either.

Thank you and more questions!

by Pondreef - 2019-08-18 16:00:22

Thank you everyone for responding!  I feel better just from that.  I now have an appointment with an EP this coming week and have a better idea what questions to ask now.  If I need a PM, I am ready to get one.  Has anyone had angina go away after PM installation?  What type PM do they use for SSS?  Will I be on drugs too?  

pacing

by Tracey_E - 2019-08-18 16:22:09

Any pacer will work for SSS, but depending on your activities some types of rate response might be a better choice than others. Rate response is when it senses that you are moving and raises your rate for you if it doesn't go up on its own. Some use motion ( accelerometer), some use breathing (minute ventilation) and some use Closed Loop Stimulation which I don't really understand. It learns you and is the most sophisticated. If you like to ride a bike, the one with the motion only is not a good choice because it won't pick up on the movement. This is a discussion to have with your doctor. You also want one that your doctor knows inside and out, because they are only as good as the programming. 

If all you have is a slow heart rate, you will not need any drugs. If you also have racing or afib, then they will prescribe meds to go with the pacing, but just a slow heart you shouldn't need anything else. 

Everyone is different, but I'd felt so bad for so long that I was practically giddy when I got the pacer. I suddenly felt normal and it was wonderful. I was awake and alert and not dizzy.  I've never looked back. My doctor put it off because of my age, which is why that's a giant pet peeve of mine now. If it will fix the problem, just do it. Why wait? Good luck. If you have more questions, don't be shy. 

More questions

by Pondreef - 2019-08-21 22:15:24

I can't thank you all enough for all the information everyone has provided.  It is a great comfort to me.  I live in Alaska and flew to the Cleveland Clinic.  The EP I saw ordered an ECHO/STRESS test for me.  The test showed that the pumping part of my heart was good.  However, the upper left chamber of my heart is severely dilated.  He said that puts me at a high likelihood of developing Afib.  He doesn't know why it is stretched, because I have always had normal blood pressure.  As far as the chest pain/angina, he wants a Holter test to help determine what is going on.   I'm assuming that will show PVCs and ectopic beats.  Does anyone know if having a pacemaker implanted increases the risk of Afib?  Either during the procedure or anytime afterwards?

PM's and AFIB

by charlene - 2019-09-21 00:09:42

I had a PM implanted on July 5 of this year. 

I have a history of SSS and AFIB.  My Cardiologist has put me on Sotalol to help, along with the PM, to keep the HR in "line".  I also take Lipitor and Xarelto.

Thus far, I had one small episode the day following surgery because I had just changed to Sotalol and didn't have enough of the med in my body.

At this point, I can say that all has been going much better than I expected and I feel like my old self again.  There was an adjustment period, of course; however, the meds and PM have been working well together and there hasn't been so much as a hint of AFIB. I can always tell when an episode is about to occur.

That's my story. Hope it helps.

You know you're wired when...

Bad hair days can be blamed on your device shorting out.

Member Quotes

I'm 43 and have had my pacemaker four weeks today. I'm looking forward to living another 50 years and this marvelous device inside me will help me do that.