Possible Complications

Hi everyone 

I am new to the forum & am looking for some advice about my situation.

A little bit about me, I am 38 years old, was diagnosed with AV block 2:1 (Morbitz) & had dual chamber PM fitted last July.

Had chronic anxiety for weeks after the procedure which thankfully has now disappeared.

This was followed by weeks & months of adjustment to living with the PM. Just before my 3 month post procedure check up, became quite dizzy & lightheaded. Presented to my Health Care Provider at the time, test such as ECG etc where preformed & adjustments where made to the PM. 

The dizziness got better, however it does come & go every now and then along with some headaches. However, I have been less bothered by it as my capacity to preform exercise has been greatly increased since the PM, which has filled me with joy & kind of makes me overlook the occasional downsides.

However over the last week or so, I have been having pulsing head aches eminenting from the base of neck particular when I get up quickly or    sometimes when lying down to go to sleep, they seemed to of eased off with time & massages.

Until last night when I was recieving a neck massage from my lovely wife, I proceeded to get up quite quickly and had a massive sudden on set pulsing head ache coupled with a sensation of nearly fainting ( possibly a presyncopal episode ?)

Needless to say it was far from a pleasent experience, I had a pretty rough night sleeping but did managed to get up in the morning a do my normal weights & yoga routine followed by 10 km walk / with 350 m altitude gain with no issues.

However I still feel a bit cagey & headachy certainly not as good as I have been feeling.

Sorry for the length of the post just wanted to give some context.

Any insights would be very much appreciated



by AgentX86 - 2021-02-16 16:55:00

Syncope is nothing to play around with.  You sound like you're on the edge and it needs to be fixed or at least understood, pronto.  Your headaches and pulsing (and pre-syncope) could be causede by a number of things and not necessarily heart related at all.  Sine you're one of us, it's a good place to start, though.  I'd push them hard to get to the bottom of this.  If your PM doesn't record enough information to see what's going on, I'd demand to carry around a Holter or event recorder for some time period (longer than the time between these episodes).  Again, it's entirely possible that it's not heart related (mine wasn't) but at least rule it out so you know to start looking somewhere else.

My thoughts

by Gemita - 2021-02-16 17:47:53

Hello Heartyone, if this strong pulsing feeling goes on with pre syncope and strong headaches I would respectfully ask whether you could have some imaging of your head and neck to rule out any problems like narrowing/obstruction of any of your blood vessels/arteries as a cause for your symptoms.  Your GP or EP may be able to physically examine you also to rule out anything quickly before referring you for imaging.

Your symptoms sound similar to what I was experiencing during my early arrhythmia history.  I got strong pulsing (which I could actually see) on the right side of my neck (above clavicle) and then I kept getting blood flow surges into the head causing sudden headaches so strong I thought my head would split.  It felt like I would get a stroke or that I was having a TIA (transient ischemic attack), so I went to ER/A&E.  They immediately placed me on anticoagulation and confirmed that I had an arrhythmia called Atrial Fibrillation and it was affecting blood flow because of the irregularity of rhythm. 

Your doctors may want to arrange heart monitoring or imaging to rule out anything significant like an arrhythmia or a small blockage.  I wouldn't let these symptoms go on for too long without answers.  It may be nothing but it could potentially be serious and it would be wise to get it checked out for your own peace of mind in any event.  Good luck

Headaches and postural dizziness.

by Selwyn - 2021-02-17 12:39:38

Do your lying blood pressure. Immediately do your standing blood pressure. If there is a significant drop ( eg. >10mmHg) then you have a postural  hypotension - this may relate to a number of  medical conditions, pacemaker etc. I would seek a medical opinion. Postural hypotension is associated with symptoms of dizziness, buzzing in the ears, unsteadiness, and worsening to loss of vision and blackout unconciousness.  

I continue to get a bit of a postural drop after sitting, especially in the warmth, and especially after exercise. This has been helped a little by increasing my lower rate setting by an extra 5 beats per minute. This is a personal thing.

Your headache sounds muscular - called a tension headache. Often starting in the neck and radiating. Helped by massage, heat packs, exercises, and reduction of nervous tension ( often associated with muscular tension). Such headaches are the commonest cause of headache.  Loads of advice on the www. over these. 

Like anything, if they persist,  seek medical help. 



Same sort of feeling

by TLee - 2021-02-17 21:01:37

I have a-fib (like Gemita), and I agree that it causes very similar symptoms. I can get dizzy or lightheaded & often feel a headache along with it. If it is possible to describe levels of dizziness, I was also experiencing pauses (hence the pacemaker), and during a pause I would come very close to passing out--vision would close in, I would become mostly unaware of my surroundings, then go tingley all over. The dizzy spell from the a-fib is brief, as quickly as I can say, Ooops, I'm dizzy, it's gone, although I may get several in a short time. I'll put up with these symptoms if I have to, as overall I do feel more energetic (some days it's still a bit much to take). I was nervous/disappointed to still have such noticeable symptoms, even though I knew the pm would not fix the a-fib. I have come to find out. mostly from this forum, that what I feel is normal & nothing to worry about. However, it never hurts to find out more about what may be going on in your particular case--especially if symptoms are new or much worse. Hope all goes well!

Thanks for all the advise..A

by HeartyOne - 2021-02-19 08:42:44

Hi there,

Firstly thanks for all your time & advice in response to my questions..

So, after the episode detailed above, I went on a big hike 10 Km / 600 m altitude gain. Felt fine for the vast majority then had a what could only be described as heart flutter & then noticed I had a slight reduction in energy & felt a little lethargic.

Got back to our place & packed an overnight hospital bag & went to A&E.

Posted up in A&E for nearly 20 hours in total, had a battery of test done, blood work, X-Ray, CT scan and ECG.

Everything came back fine, finally got to see a Cardiologist who was great. Look over my digital log on the PM, indeed the incident I discussed in the initial post was an episode of Afib, amazingly the incident of what I discussed as heart flutter on the last walk was not present on the log.

We discussed options in terms with therapy but in general wasn’t overly worried about the incident.

I have had a few other incidents since my pm implant, (all of which were very brief & in these cases I hadn’t even realised they had happened) which I must admit were due to me going in a little heavy on the grape & grain. Which I will now be much more respectful towards. 

I have a follow up in 10 days just to make sure everything is going well.

Doc also upped my lower pace setting from 40 up to 60, which I will posted about possible positives / negatives in another post.

Once again thanks for you time

All the best 


You know you're wired when...

You name your daughter “Synchronicity”.

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