Post PM Implant

It's a common enough presentation

by crustyg - 2021-04-21 17:49:31

Long pauses between heartbeats=>not enough oxygenated blood to the brain, can cause blackouts, fits, 'absences', and while everyone is thinking 'brain problem' the poor old heart can be overlooked.

I recall the first consultant I ever worked for telling us about a lovely 80+ year old gent who was sitting waiting to be seen in outpatients, sent in for his '? fits', had an episode sitting in the chair, quick-thinking nurse felt his pulse =>12-lead ECG => diagnosis made.  Off to the 'Heart Hospital' (long, long time ago) and fitted with a PM.  Sorted.

Post pm implant

by Aberdeen - 2021-04-21 18:17:03

It can be quite a shock to suddenly need a pacemaker. I had been feeling breathless going up any incline or stairs. I went to my doctor and had an electrocardiograph. I was having coffee with friends and received a phone call from my doctor telling me to go to the Cardiology department of my local hospital asap.

My heart rate was 36-40 bpm and they were surprised I was functioning with such a low heart rate . I hadn’t passed out as you had but I had to remain in hospital continually monitored until a pacemaker was implanted on the 5th day.

Just like you prior to this I had good health. I hadn’t had a cold for 3 years and I always felt very well.

You will come to terms with what has happened to you and I am sure you will feel better soon.

Good luck!

Same but different

by AgentX86 - 2021-04-21 19:24:03

I'd had arrhythmias (Afib) for several years but mostly handled by a beta blocker.  The first diagnosis was followed by a cardioversion and I was good for five or six years.  After that, I'd have short episodes but nothing to worry about.  My heart rate didn't rise, just got wonky.

After that five or six years, I started getting exhausted easily.  At first is was kind of random.  Sometimes when I did physical work it was bad, sometimes I could do a lot more.  Thinking it was just my AF acting up I didn't get too concerned.  Then i was working outside.  Digging one little hole to plant a sapling exhausted me to the point where I could barely walk.  I made an appointment with a cardiologist but it took a month to get in.  He set me up for a stress test.  Right after, the cardiologist on duty (not mine) said that he didn't like the results already (I couldn't stop coughing).  I had a heart cath done and a couple of weeks later had had my chest cracked open and a bunch of work done under the hood.

After, my AF was taken care of (a maze procedure while they were replacing the bad plumbing) but it was replaced with flutter, which wasn't a good trade.  After three ablations and a lot of drugs, I started having pauses much like you.  That bought me the pacemaker.  The difference, in my case, is that my EP had been discussing a PM as a way to treat the flutter.  Not that the PM would do anything by itself but it would allow different/more drugs to be used trying to control the flutter.  ...or I could have an AV ablation and stop it altogether.  Kind a bridge too far. 

After the long sinus pauses were discovered (shorter ones had been found by Holter tests) a PM was inevitable (immediate), so I went all the way to the AV ablation at the same time. 

So, while my pacemaker wasn't much of a surprise, the start of the whole process was.  Once the ball got rolling, it sped up fast.  The pacemaker pretty much put an end to the misery.  I felt 100% better before I was even wheeled to my room (kept overnight because I was now dependent on the PM).  It's been comparitive roses ever since.  I walk 10mi before breakfast every morning (unless there is a downpour). The difference is nothing short of amazing.  I hope you find your long-term results just as good as mine. 

Interesting variety of stories

by TLee - 2021-04-21 21:32:55

It seems we all get here in slightly (or very) different ways, but mostly end up better for it. I was having worsening shortness of breath for years. I was very bad about going to doctors, but tried every over-the-counter or herbal treatment for the shortness of breath, which I self-diagnosed as asthma. I would also occasionally feel odd, sort of skippy heartbeats, which I blamed on too much caffiene.

Then fate stepped in with a vengeance. I was pet-sitting for my daughter's animals, which included a very cute spotted rat. I was cleaning the cage & had an asthma attack that very soon became so severe that my husband called emergency services. I woke up 2 days later, after having been placed on a ventilator. That got me diagnosed with COPD and asthma, and I now have a very good pulmonary doctor.

While I was still in the hospital, I was sitting reading the morning paper when several nurses ran into the room to tell me that my monitor showed my heart was in a-fib. News to me! That started treatment with a cardiologist--various meds, cardioversion, ablation--no luck. Then I started getting spells that felt like I was near to passing out. I don't think I ever completely lost consciousness, but my head would spin, my vision would begin to close in & I'd become mostly unaware of my surroundings. I can certainly relate to feeling this coming on enough to be able to say, "Here it comes again!". I would usually manage to get out a swear word! 

After wearing a monitor for a month, I was told that my heart was getting "confused" when it tried to go from a-fib back to normal rhythm, and that it would therefore pause. So my poor, confused heart needed a pacemaker, because pauses are definitely not good! An added bonus is that I can take medication for a-fib that would normally resut in too slow a heart rate. Now I also have fewer & less severe symptoms of arrhythmia,

Sometimes I can't believe all that I've been through in just the last 2 years, but I do think that it was a lucky turn of fate that got me the treatments I needed--all thanks to a rat that nearly killed me!

Post PM Implant

by Dixie Chick 65 - 2021-04-21 22:15:56

May 28th will be one year since I got my " surprise" pacemaker. I never get tired of reading about the various ways, yet sometimes quite similar, the members of this forum came to have a pacemaker. This group has helped me tremendously this past year. Like you, I have had trouble processing that my heart now has an assistant. Sitting there in my chest, doing it's thing ! I consider myself fairly well versed in different medical conditions but all I knew about a PM was that it helped your heart. I didn't know how it got there. What are leads ? A temporary pacemaker ?? OK, I said. Didn't have a clue what it was. Like you I had 2 episodes of " almost " fainting. Now I know it's called pre syncope. About a week before I got my PM I noticed fatigue and shortness of breath ( SOB) I've learned it's called ! The almost fainting episodes felt like I was suddenly weightless from the neck up. Very strange feeling. I knew I had a regular appointment coming up with my PCP so when I saw him he ordered an EKG. He called my cardiologist/EP and I saw him the next day, May 28, 2020. I had a heart cath at 3:30 and PM implant at 9:00. When doc came in to talk with me after the cath I was still somewhat loopy and I think, in a state of shock. I asked no questions. I just said, OK, OK, OK. I assure you it is a traumatic experience any way you look at it. When I went in a month after implant for my device check I asked to see my X-ray. I asked because I had read on this forum to ASK. It helped me to see it. I also took a picture so I have it on my phone. Again, all these steps helped me come to an understanding of how I got here. Plus all of last year, from June onward, I was researched all about PM's online. In the process I became very grateful for my doctor ( team) and the care I received when I needed it.

As in just about everything, knowledge, understanding and TIME will help you a lot.

All the best,

DC65

I had to wait a bit

by Julros - 2021-04-22 11:28:54

I went to my primary when I noticed my pulse was 44. I had been feeling tired would become SOB with the slightest exhertion. She did an ECG that showed atrial flutter and I was referred to cardiology. I waited 2 weeks for that appointment and started taking aspirin. Got the initial cardio consult, then scheduled for echo and stress test, then had EP consult. Pacer was implanted 3 months after original ECG. 

As a fairly new cardiac nurse I saw a patient come to our unit from ED admitted for syncope, third degree block. He had passed out in the elevator and again when tranfered into bed. He had no pulse so we started compressions and he woke up and yelled at us to stop. So we did and he passed out again. We kept trying to do compressions until we could apply an external pacer, and then rush him to the EP lab. He had been experienced ventricular standstill, not technically asystole(flatline), because he had atrial contractions (per ECG), followed by long pauses of no ventricular contractions. I felt so bad for his poor wife who had accompanied him. Chest compressions are brutal. Lifesaving, but brutal. 

I can relate!

by KatieG - 2021-04-23 05:28:06

Beatingheart, I'm also a newbie. Had my PM fitted a week ago today. It's all been a bit of a whirlwind! My story is very similar to Aberdeen's. I'm 54, female, active, usually enjoying life to the full. Pre-Covid, I was travelling often with my husband to play at various folk music events. I play clarinet, guitar and I sing. I'm also asthmatic, so feeling tired and breathless can happen at times.

Anyway, we bought a Border Collie at the end of September last year and started walking more regularly as a result. This pooch doesn't do 'slow'...I was finding it hard to keep up with him and hubby, and getting dizzy when I did try. One day we'd just left the house for a walk, when I had a sudden violent dizzy spell which resulted in me having to sit on the street before I fell over. I felt so awful after that i had to come home and rest. It shook me up. Previous to that, I'd been having occasional dizziness but I'm prone to low BP so put it down to that. I'd also noticed I was struggling on inclines and stairs, was finding cycling difficult even on the level, and for a couple of weeks prior to being hospitalised, i was getting breathless playing Clarinet and singing. We look after our 2 young grandkids once a week and it took me most of the weekend to recover. I was also tearful, irritable and feeling like I had 'brain fog'. I didn't want to make decisions, go anywhere or do much at all. My get-up-and-go had got-up-and-went!! I just felt generally rubbish. I made an appointment to speak to my GP (I'm in Scotland) and she asked me to go to the surgery that afternoon. During that day I was having weird episodes of detachment and dream-like states, which made me feel faint and unwell. I had one whilst I was at the doc's and she said I went very grey and quiet. She was able to do a heart trace with a phone app (!!) and it showed a 2:1 block. The signal just wasn't getting as far as my ventricles. My pulse was no higher than 45 bpm and dropping lower at times. So she sent me straight to hospital to be assessed (thankfully we live 5 minutes away). My poor hubby was wondering what in earth was going on! 

They put me in an assessment unit overnight and monitored me. At times my heart rate dropped to 35. I didn't realise at this point just how dangerous that was. The next day I was transferred to the cardiology ward and a consultant came to tell me that I would need a PM fitted with dual leads. I wasn't altogether surprised, as I'd been reading up on heart arrhythmia when my mum was diagnosed with AF a couple of years ago. My hubby, however, was gobsmacked! I think I was possibly in a bit of shock anyway, it had all happened so fast. The reality of my situation didn't kick in until after the PM was fitted, and I realised all the 'what ifs' and just what a close call I'd had. I can't believe how much better I feel, with more energy, being clear headed and with a much more positive outlook. I'd actually wondered if I was suffering from depression but I think it was lack of oxygen! It's taking a bit of getting used to, having the device, but I'm grateful to still be here...and i can't wait to get back to playing music and doing lots of fun things! Onwards and upwards...and good luck! 

Getting used to new PM

by sfp1 - 2021-04-24 23:22:11

Hi Beating Heart,

We are around the same age. I send you many good thoughts.

I was always active (dancing, singing, cycling, hiking, etc.). I also used to do some pretty heavy gardening. I had started gaining a bit of weight and eventually learned that I had pre-diabetes...so I attributed my fatigue, weight gain, etc. to the pre-d.

For about a year, I felt progressively worse; mostly having trouble breathing. One day I was out digging in the garden and almost passed out. No one was around. Still I didn't call my doctor. 

Some time after that I had a strange swelling in my face that I thought was an allergic reaction...being a single mother I'm used to doing everything myself. As I write this I know I should have called an ambulence. I got my son and made him sit in the car with me while I drove mysel to the hospital!  See the crazy things we do when we are not getting enough oxygen to our brain!  ;)

I barely made it in time. My face was so swollen one of the viisting nurses was taking pictures of me to share with others...I was so out of it I couldn't ask her to stop. My son was confused and not sure what to do.

One of the nurses was smart enough to hook me up to an EKG...THANK GOD!!! She immediately called a cardiologist who was fortunatley on-site that night. They asked me so many questions while I was woozey from the Benedryl they gave me to stop the swelling in my face.  

The next morning they tried to have me to a treadmill stress test but I couldn't get through it. I almost passed out.

The cardiologist ordered an emergency PM to be implanted.

Intellectually I've dealt with it. I'm so lucky they found out and saved my life. Emotionally, it's still hard to talk about that night even though it was several years ago.

Most of my friends are compassionate but they don't really know or understand all I went through. My son wanted me to be ok, but also wanted things to be "normal" again.

I'm back on the site because it definitely helps to talk to others who understand. I wish you all the best with adjusting. Glad that you are reaching out. 

Susan

Different experience

by dwelch - 2021-04-26 21:42:26

You may not find my story interesting.  I was a pre-teen.  Pediatrician heard a murmur or something so I went to a cardiologist.  This was over 30 years ago, mind you, not as much equipment as today.  I was hooked up to an EKG and complete heart block is trivial to see, only takes a few seconds...He watched me for several years, had a primitive ultrasound/sonograp type thing that could see the thickness of the heart muscle which was his concern.  My normal awake rate was in the 40s and sleep likely in the 30s (certainly my last night before a pacer where I spent the night before and was on a monitor).  Very active at that time.   

Survival of CCHB before pacemakers was not good, survival into adulthood was not rare, but you didnt have a good life expectancy.  I was not really warned of the danger and even then I may have just ignored them anyway.  I stopped a number of activities but then simply switched to other activities, that should have killed me.  I simply stopped telling the doc what I was doing rather than not doing them.  This was the period of time where parents just let their kids go out and play, not like today.

When I was 19 my heart was pretty big, you could see it beat between my ribs, and he basically said it was time it is getting too big and the muscle too thick.  Thats what I remember as a teen at an age where adults are stupid and we are smart.  No doubt there were converstations with my parents as well...Probably had been for years.

I noticed the change immediately.  Pre-pacer I could feel and hear every single heart beat, it was normal.  Post pacer, disturbing silence, it took months if not the first year to get over that change.  

I literally would not be here, it is that simple, even if mine was not an emergency it was no less required.  I technically had lots of time to prepare, but I was a kid, kids are immortal or dont think about such things.  I didnt object because we had just lost a 15 year old relative to a car accident and I saw what that did to the family, and I was moving into adulthood and didnt know anything about insurance or how I would pay for such a thing myself, so I figured I had better get it while my folks were paying (well in hindsight their insurance).  That was literally my thought process at the time.

I am on device number five, perhaps half-way through...34 years with devices.  Before long I will be 2/3rds of my life with a device.

Welcome.  And glad the stars aligned such that you had an event at the right time in the right place such that they could help you.

Having pacemakers is not a bad thing, not a negative thing, not a crippling thing.  Quite the opposite, they make us normal or more normal, not less.