LIght headedness

In the last two nights, when arising and going to the kitchen to get a glass of water I was light-headed. They told me I wouldn't have that anymore after having the PM placed. Is this something I should be concerned about? Thanks. 



by Gemita - 2020-03-29 06:07:23

Hello Tim,

Lightheadedness has many different causes, so even though a pacemaker may have addressed one particular cause, another cause may still be present.  In the past SOME of the following situations have caused lightheadedness for me personally and these causes still remain and are not helped by my pacemaker:

Dehydration which may lead to electrolyte disturbances - I was told to keep water by my bedside and to take a sip BEFORE rising 

Postural changes like getting up too quickly from a lying down position

Medication may cause lightheadedness especially some blood pressure meds which may lower blood pressure too quickly or cause dehydration from excessive urination (like a diuretic)

Blood pressure changes, especially if sudden (low/high) and fluctuating - pacemaker will only prevent HEART RATE from falling below set minimum.  It cannot prevent our BLOOD PRESSURE from falling 

Arrhythmia is my NUMBER 1 cause for sudden lightheadedness - a pacemaker will not stop an arrhythmia or prevent a sudden spike in heart rate caused by an arrhythmia.  I have had fainting/near fainting episodes after pacemaker implant due to a sudden increase in heart rate at the start of an arrhythmia.  Remember pacemaker can only prevent sudden drops in heart rate.  It cannot prevent sudden increases in heart rate which may need to be controlled by medication and/or an ablation.

Diabetics can experience low blood glucose levels causing sudden lightheadedness which may be quickly relieved by drinking something sweet.  Frequent monitoring of  blood glucose levels may be necessary especially if someone is insulin dependent or is a type 2 diabetic on medication which may need adjusting.  

More serious conditions like a stroke or heart attack can also cause lightheadedness as one of its symptoms, so if it doesnt go away quickly, it may need assessing.  

Other possible causes include hidden blood loss, infection . . . and the list goes on!

I know it is disappointing that your symptom of lightheadedness is not presently relieved by your pacemaker.  I can remember my doctors telling me they have to be really certain that my syncope/lightheadedness could be significantly relieved by a pacemaker and/or an ablation before they could recommend these treatments.  However, even though my lightheadedness is not “always” helped by my pacemaker (due my arrhythmias), my low heart rates (bradycardia) and long pauses have certainly been successfully addressed/treated and I feel so much better now.  I would speak to your doctors if you are at all concerned and your lightheadedness continues.  I wish you well


by TimMcCoy - 2020-03-29 15:06:32

Thank you, your response is most informative. 

I have a pacemaker for bradycardia. I also have arrhythmias but was told the pm is for the bradycardia. 

I noticed that both times I experienced the lightheadedness was after rising from a sitting position in a recliner. So that may be the cause. I will monitor and report to the doctor if it persists. 

Thanks again, 



by AgentX86 - 2020-03-29 15:15:21

By all means, ask your cardiologist.  They want to know this sort of thing.  However, expect the answer "don't do that".  Meaning, don't get up quickly.  Take a few seconds to get out of bed, or even a chair if that bothers you.  This isn't uncommon at all, though as Gemita says, there is a small chance that it might be more serious.  Your cardiologist or EP should know about it.


by Graham M - 2020-03-29 16:14:04

Hi Tim,

I also have bradycardia due to Type II AV block and PM implanted in August 19.

For the first 3 months, I had episodes of lightheadedness on and off for the first 3 months.  It wasn't as bad as the feeling I had before my PM, but was a bit concerning at the time.  It all seems OK now, and I think it just takes the body several months to adapt to having a PM.

Hope this helps,




by Bigdan - 2020-03-29 18:04:32

thats a releif to hear graham, i was thinking of posting the same question as tim so have been watching the replies with interest.

i'm 5 week post implant and often have mild lightheadedness especially in the mornings while walikng the dog. i was thinking of asking for a pacemaker check to make sure everything is still connected but its not the best time to start pestering thr nhs currently!

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