Sick Sinus Syndrome

Been dealing with fatigue and light headedness with onset of nausea, for several years. It comes & goes, some episodes last, days, weeks, months. All doctors and tests suggested allergies since they really couldn't pinpoint the cause. A month & a half ago I had a serious blood pressure drop, 80/50 pulse 40, nauseaus, really dizzy, and extreme fatigue. Went to cardio doc first time in 5 years, wore heart monitor and the diagnosis was Sick Sinus Syndrome & A-Fib. Waiting for pacemaker implant to be scheduled. 

1) Will the PM take care of my symptoms / if so how long after implant.

2) I have read that some of the BP medications (beta-blockers) I have been taking since my stent implants 10 years ago could cause this condition, why would they prescribe these if they know this. 

3) How restrictive will I have to be with my left arm after the procedure. 

4) I have serious anxiety, it's really freaking me out, I live alone so I have no one to talk to about this. 

Any input or reassurance would be greatly appreciated. 

Thanks


5 Comments

Questions, Questions

by AgentX86 - 2022-05-14 00:14:58

Hi Don. Welcome to the club. Too bad you're here but I hope that we can help you in some way.

1) Yes, Maybe. If SSS/Bradycardia is your only problem,  your pacemaker will take care of it. There may be something else going on that SSS was covering up. If there is something messing with your blood pressure,  for instance,  that'll have to be  addressed too.

If you're lucky, you'll feel better before your feet hit the floor (I did). Depending on how badly your sinus node is damaged, it may take some tweaking of the pacemakers settings to tune everything in. SSS is positively the easiest arrhythmia for a pacemaker to fix. That's what they were designed to do.

2)Beta blockers causing SSS? I've never heard such a thing. Some drugs can, particularly antiarrhythmics (sotalol got mine). Beta blockers do reduce heart rate but that's what they're supposed to do. You pacemaker will keep that from happening. You'll probably stay on the beta blocker, perhaps even a higher dose. Don't worry,  your PM will make sure your heart rate doesn't fall too far.

3) For four to six weeks you shouldn't raise your hand above your shoulder,  behind your back,  or fully extended forward. No full golf swings or tennis serves for three to six months. Listen to your doctor's. They'll give you a full set of restrictions.  After that,  live your life.

4) I understand your anxiety but know that you'll be fine. This really is a simple procedure and you'll feel better than ever. If you have trouble adjusting, see your PCP get a referral to the best behavioral therapist you can find.

Drop by here anytime you have a question or need a hand to hold.. there are a wide range of people who are here to help.. You're going to be fine.

 

Hello AgentX86

by Dond59 - 2022-05-14 14:10:51

I really appreciate the reply and positive outlook on my procedure. Actually my preliminary findings were SSS, Afib / Flutter 22.81% Burden / VT / SVT / Heart Pause. I am hoping for the same results as you and hoping to feel better right away, though I know it's not a guarantee. Just to feel normal and have some energy without being lightheadded is something I look forward to. Seems like this episode I am experiencing now is lasting the longest so I can't wait until they schedule my procedure. 

Thanks again and I will do a follow up post after the procedure. 

Sick Sinus Syndrome (SSS) and Afib Here Too

by Marybird - 2022-05-14 14:51:14

Agent's advice and information is spot on, so I'll just add my two cents here.

I  have SSS too, and a long history of atrial tachyarrhythms, to which a diagnosis of A-fib was added about a year ago. I felt the symptoms you mention, the lightheadedness, fatigue, the brain fog, etc. I'm sure you know both a low heart rate for any length of time, as well as the tachyarrhythms ( afib- flutter) can make you feel these symptoms. They're due to lack of perfusion or blood flow to your brain, and other vital organs. 

I can't even begin to describe the improvement in the way I felt after my pacemaker implant close to three years ago. Though I did feel better after the implant, it wasn't until my 6 week post-implant checkup when the EP/pacer tech turned on the pacemaker's rate response function that I really noticed a difference in the way I felt pre-vs.-post pacemaker, and that has continued to this day. The reason for this is like many people with SSS, my heart rate would not increase to the appropriate level when my activity increased- so I chronically felt like an 18 wheeler being powered by a lawn mower engine. I don't think I was even aware of this until I noticed a difference in my heart rate after the pacemaker with even moderate activity ( 70's-80's vs low 50's at the highest for the same activity) but I sure knew I felt better. This is called chronotropic incompetence. I just mention it as it's possible that chronotropic incompetence might play a part in your SSS too, just something to know about.

That's a pretty significant amount of afib/aflutter you mention as well. I don't know what's been discussed with you in regards to getting that under control. Having a pacemaker would allow you to take enough medication, hopefully, to get the afib/flutter under control without the medication causing your heart rate to tank. I take a fairly high dose of both metoprolol ( beta blocker) and diltiazem ( calcium channel blocker) )to control my tachyarrhythmias, and feel much better for it- have taken them long enough the side effects have disappeared. There are other options for afib/flutter management, but that's a conversation to have with your doctors.

But I can reassure you that a pacemaker will improve things for you in the long run!

Best of luck.

AF/AFL

by AgentX86 - 2022-05-14 15:26:43

That's a whole different kettle o' fish. A pacemaker won't help and a 20+ burden rate is really bad. A pacemaker will allow more drug options to try to control it. If you're asymptomatic there really isn't much needed, just anticoagulation and rate control.  After that it's a quality of life thing. Drugs might work or perhaps an ablation but at a 22% burden it may be too late for that. There are more serious tools in an EP's toolbox but you have to try the simpler weapons before committing to the a-bomb.

Thanks Marybird

by Dond59 - 2022-05-19 13:55:34

That really gives me a lot of confidence that this will fix my fatigue & lightheadedness, How long did you have to wait for your procedure, mine is in 2 weeks but my symptoms are unrelenting even though all my readings are normal. 

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