Extreme fatigue

Hello everyone! I am a 70 year old male implanted 3 days ago with a biventricular pacemaker/ defibrillator. my EF rate is 20% and I was diagnosed with a left bundle branch block 5 years ago. I also had a quadruple bypass 2 years ago. my cardiologist started me on Entresto 3 months ago along with a small dose of Correg. My bp is low (95/60) and I believe this is caused by the Entresto.  Has anyone had to stop Entresto because of this issue? If so what did you switch to? I literally can sleep 20 Hrs. a day.



by Julros - 2023-02-27 00:31:27

Hello Dover, I hope you are healing after your implant. Blood pressure can be low for many reasons, and yes, medication can be responsible. However, Enstresto has been shown to actually improve heart function. Often times, people with reduced ejection fraction have a low blood pressure, due to the heart not being able to push out as much blood as a normal heart. Reducing the pressure that the heart must pump against reduces the workload. Cardiologists and heart failure patients thus walk a narrow line between a BP that allows to us to feel well, and reducing the workload of the heart. Now that you have a Biventricular pacer, your heart function should improve and you should feel better. It will take some time. Your doctor is likely closely monitoring your symptoms and blood pressure. Unless your are having severe symptoms like passing out or nearly passing out, you are likely on the best meds. 

Heart Failure

by Gemita - 2023-02-27 04:49:36

Dover45, both my sister and husband are heart failure patients.  My sister had an EF of 16% just over a year ago, so I do understand what you are facing and the difficulties you will be having with your meds.  

My feeling though is that it is early days with your biventricular pacemaker and if you need to sleep 20 hours a day, perhaps it is nature’s way of trying to help you while you recover from implant surgery and to allow your EF to improve naturally.   As you get stronger and your EF hopefully recovers, you will be able to do more and to feel less tired.  Experience has taught me not to change too much too quickly, to step back sometimes and to be patient.

Of course I am not suggesting that we as patients should tolerate symptoms that are clearly intolerable or that make us feel “unstable”.  If this is the case, then I would let your Cardiologist know, or at least speak to your GP about your difficulties.

I do agree with Julros’ comments.  Entresto was the med of choice given to my sister also, along with a cocktail of other meds.  My sister’s EF has recovered on medication alone since she was too weak at the time of diagnosis to receive invasive intervention.  She is doing extremely well on meds alone much to the surprise of her cardiac team.  I hope you do very well with a combination of treatments Dover.  I send my best wishes for a good outcome

Hi Class of 70

by Lavender - 2023-02-27 08:55:06

I have a CRT-P. Mine is two years old. I initially had lots of exhaustion and slept all afternoon for about a month. I still take a one hour nap most days. I had to lie down or I fell asleep sitting up. 

My ejection fraction wasn't at low as yours but my blood pressure was. Over time both got to normal. 

I had left bundle branch block since 2010. The pacemaker doesn't care about it. Yours is fixing that problem by overriding it. 

Make sure you put in more liquids. Liquids help with blood pressure and you need more after this surgery so you don't get dehydrated. 

It's early in your body adjusting to your device. You are not your doctor's first rodeo so trust them and what they prescribed for a longer run. 

Stay groovy☮️

Recovery Process

by Angry Sparrow - 2023-03-01 14:17:57

First sleeping after a injury or illness is natures way of speeding up the healing process.  I slept a lot the first two or three weeks after my implant, I had a Stroke a couple of days before the implant, so I was recovering from two trauma events. It is a proven fact human bodies heal during certain stage of sleep.  Give yourself a bit more time, if you are sleeping excessively have a look at what you are eating and do a self check on your emotional status.  

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