Complications from pacemaker

I received my medtronic pm in July 2018 and felt great within minutes after coming out of the anesthetic. I couldn't believe how good I was feeling after so many years of feeling crapy. But about a year ago I just wasn't my "new" self. By January I was feeling really tired again. I thought it was my thyroid because several of the symptoms matched along with the weight gain and hair loss. Called my GP for an appointment and went for blood tests. Sure enough everything was out of wack he put me on 2 thyroid meds and was going to have be back in a month. Things got really worse, gained 25 pounds, nasea, chest pain, heaviness, after several months of working with my meds not sure where we are heading with it and still don't have a complete diagnosis. In the mean time I just had my annual check-in with my Cardiologist and with some of the symptoms I discribed he suspects that I may be having Pace Maker induced Conjestive Heart Failure. He has ordered an Echo to confirm. I only have one lead and that is into the right atrium. The PM was to compensate for the SSS, bradycardia and arrythmias I was having but now it is causing this problem. Has anyone else had this issue after a device implant? I have been reading about bi-ventricular pacing - does anyone have this type of pacing? Has it been successful? Several of the medical research sites I have been on says that the one lead Atria wiring, like the one that I have, has the highest failure rate and the most prone to CHF - have you guys found that to be true too. I feel worse than I did before, I can't even sleep normally anymore. Half the time I wake several times in the night feeling like I'm smothering and that's the nights I can fall asleep before 3am. I have to sleep in a recliner because laying down also makes me feel like I'm smothering.  I am at a loss of where to go from here.


Get to an EP ASAP1

by arentas80 - 2020-10-20 01:55:56

Cardiologists can only determine so much but it's more the mechanical side of the heart. You need to see an Electrophysiologist regarding your pacemaker. They can decide if you need two leads. I would also have them give you a 14 day zio patch to see if you are having any funky arrhythmia's. I have issues as well but sometimes we need to stay in their face to get the results we need. Don't lose hope and don't give up. Also make sure you don't have sleep apnea either because that's another issue that could cause serious issues. I'm living proof of that! May god bless you and get you back to normal ASAP!


I hope for the very best for you

by Gemita - 2020-10-20 02:19:20

Victoria, I'm so sorry to hear about your difficulties when you were doing so well.   I hope you get a diagnosis quickly following your echocardiogram and other tests so that the right treatment can be started.  

It seems as though you have a few things going on though from a continuing thyroid problem to potential pacing difficulties and I see you also have arrhythmias which certainly won't be helping.

Where to go from here?  I would start with the thyroid problem which can quickly cause worsening symptoms, and I wouldn't assume this to be 100% pacemaker related until you have confirmation.  An Endocrinologist might be helpful to see for your thyroid and the sooner your thyroid is stabilised, the better.  I would also check with your GP whether any of your medication could be making your symptoms worse.  Some meds can make congestive heart failure (CHF) worse.

If this turns out to be a pacemaker induced problem they might be able to make some pacing adjustments or suggest a pacemaker upgrade known as CRT (cardiac resynchronization therapy).  This can be a very effectiive therapy although it doesn't work for everyone and can take some time to improve symptoms.

My EP explained that the action of pacing - stimulating one or two of the heart's right chambers to contract when my heart beat slows - does have certain risks.  It doesn't allow the four chambers of the heart to beat in the same order as a healthy heart, so this out-of-sync beating can put extra stress on the heart's main pumping chamber, the left ventricle, which could result in heart failure symptoms over time. 

I was always under the impression that a high degree of right ventricular pacing was mainly associated with congestive heart failure (CHF) but clearly pacing in other areas like the right atrium can also increase this risk.

My EP (electrophysiologist) reassured me that if I should ever develop symptoms of heart failure from pacing, a pacemaker system that stimulates both the lower heart chambers may help the heart pump blood more efficiently and limit fluid buildup in the body.  He confirmed though that most patients do very well with dual chamber pacing (right atrium/right ventricle) or single chamber pacing (right atrium or right ventricle) and never show any signs of heart failure.  You have been very unlucky but CRT should really help. 

A good EP will have more experience dealing with pacing difficulties and electrical heart issues like arrhythmias than will a Cardiologist, although the latter can be both a good cardiologist and a good EP too (mine certainly is).  You may need both these specialists to treat you in the future.

I do hope you find a solution and relief from your symptoms very soon Victoria

Thank you

by Victoria99 - 2020-10-20 21:00:42

I also have an EP, but that appointment isn't until dec. He was the one the implanted my PM. I am only on thyroid meds for now.  Thank God I don't have to take any thing else at least not yet. I think that is another reason my doctors are so surprisedat all the conditions I have but only on 1 medication. Well now a diuretic to help with the conjestion, but so far it has had no affect. I am having an Echo on Friday, then we will see what the Doc has to say. Maybe I will have to see the EP sooner than scheduled. Thanks again for the support.

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