sick sinus syndrome

hi. i have sss and will get my pm this week. the doctor aluded to the possiblity of needeing a beta blocker- i dont understand why- at rest my rhr as 48. the sympxotms can start at 70  and the highest its gone with symtoms is 120. i assume the pm will help to increase the rhr and i thought it would also help control the elevated herat rate and encompaning symptoms of racing heart and anddizziness. 

hope this makes sense-can anyone help me understand this.

thanks


5 Comments

Beta blocker

by AgentX86 - 2022-10-14 23:58:02

No, a pacemaker can only increase the heart rate.  It can't lower it and do nothing for irregular heartbeats.  A beta blocker can help (not always) with ectopic beats but will depress the heart rate.  This is probably why they haven't used them already.  Your heart rate is too low and a beta blocker would only make things worse.  Since you'll have a pacemaker, the low heart rate will be taken care of so a high(er) dose of beta blockers can be used.

You are describing more than SSS

by crustyg - 2022-10-15 06:07:34

I think you have something more than just SSS: it sounds a lot as though you are already having tachycardia episodes - and that's what your doc is hoping to control with a beta-blocker.

AFAIK, current thinking about development of atrial tachy-arrhythmias for those with a very low atrial-paced rate is that clumps of cells in the atria start to fire off without waiting for the normal electrical activation from the SA-node (your sinus-node) - which in you is failing.  This starts some disordered rhythm which may stop on its own, or may, eventually, become established either as AFib or AFlut.  Neither of which you want.

There is *some* evidence that pacing the atria to keep the rate up slows down, or even prevents, the development of these atrial tachy-arrhythmias.  But that doesn't mean that you need a very high resting rate.  50BPM or 55BPM may be all that's needed.

Make sure that your EP-doc knows what activities you undertake - there's a world of difference between PM types that really makes a difference for road cycling+swimming.

Hope it all goes well for you.

Use of beta blockers.

by Selwyn - 2022-10-16 12:18:01

A pacemaker will not therapeutically slow down your heart.

~Pacemakers have the following indications for their use:

angina and myocardial infarction.
heart failure
atrial fibrillation  and other fast arrhythmias
hypertension
migraine
anxiety 
tremor
glaucoma – as eyedrops

I would give the BB a try, Laurie

by Persephone - 2022-10-16 17:07:39

Try them out and see how it goes, your PM will protect you from too low of a HR. Most importantly, best wishes to you for a successful surgery and uneventful recovery. 

Selwyn  - may I assume you meant to say "beta blockers" in the second part of your comment? I feel like I'm missing something.

beta blocker

by laurieb03 - 2022-10-16 18:33:11

you are all terrific- thanks so much. i am still in denial even though its happening on tuesday- ive been feeling so good - 

laurie

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