Post pm loss of consciousness

Hi, i am 71y/m.  i had an episode of loss of consciousness 4 days after surgery. Is it normal?? Dis anyone else face this. No cardiac event was discovered on pacemaker. Doctor told probably its vascular or neurological event.


Loss of Consciousness (LOC)

by Gemita - 2023-03-19 09:52:59

Tapas, there are so many potential causes for loss of consciousness (LOC).  My husband and I both intermittently suffered from LOC (syncope spells) due to our arrhythmias and other conditions before our pacemaker implants (we both have pacemakers now) but after pacemaker implant, these were better controlled and we now only have “pre-syncope” spells which rarely lead to a total LOC.

LOC is never normal and if you have been checked for a potential cardiac event and none was found, while that is reassuring, you still need to be assessed by your general doctor for other causes.  LOC can lead to dangerous falls and worse, car accidents should you be driving, so you really need answers and quickly.

Unfortunately the pacemaker cannot treat a drop in blood pressure as it can treat a fall in your heart rate, so that may be one problem that we all have to face.  Perhaps you have hypotension from medication?  I have periods of hypotension and my blood pressure can fall to low levels, making me feel unstable.  Perhaps this is happening to you, too?

I have confirmed swallow syncope which is a vasovagal condition (neurally mediated) and it can certainly cause not only pre-syncope, but bradycardia and changes in blood pressure (falls and increases) leading to sudden onset of my Atrial Fibrillation and then down I might go!

What you are experiencing is not normal in this pacemaker community and you should be followed up by your general doctor who might carry out a range of simple tests first, followed by referral to a specialist for advice if indicated.  In the meantime, stay well hydrated, ask for a check of your electrolytes and take extra care.

I wish you well and hope that you will remain safe Tapas.

Checking your blood pressure?

by Persephone - 2023-03-19 11:19:55

Not clear if you got checked after the LOC or just had a phone consult. Low blood pressure and dehydration could be factors

Loss of consciousness never "normal"

by Gotrhythm - 2023-03-19 15:34:06

Even after a pacemaker. And the fact that No event was recorded by the pacemaker really doesn't prove anything. The pacemaker only records what it is programmed to record.

I once was having episodes of heart block with near-syncope spells without a peep from my pacemaker. The pacemaker wasn't wrong. It wasn't configured in a way that it could record heart block even when it happened.

Don't let the doctor shrug you off with "probably vascular or neurological event." Follow up with him/her. LOC is serious, never normal. This is the health of your brain we're talking about. It could be something that by treating it now, you can prevent more problems later.

You're 72? Well, I'm 80. You look young to me. You've got a lot of living still to do.


by Lavender - 2023-03-19 16:14:27

I had no complete loss of consciousness after getting my pacemaker but I did have a couple woozy spells. It had to do with being outdoors in the heat and water intake. Make sure you are well hydrated. You need more water than you used to take in. Your heart is pumping more and you're healing. 

Your doctor doesn't sound concerned. You might want to keep a log of your blood pressure at different times of the day for a week or so to see if it's leveling. 

hope you feel better soon!👋🏼

Loss of consciousness

by AgentX86 - 2023-03-19 17:49:39

I had an LOC about nine months after my PM implant.  I had a siezure, apparently caused my a micro-stroke or two at some point before.  These "micro-infarcts" are often caused by undiagnosed/treated Afib, which could have been from four years before that.

You should probably consult with a neurologist.  A neurologist is unlikely to find anything.  They're good at pushing pills at this point and not so good at finding root causes.  They're fine for neurological diseases, like Parkinson's, but not so great at acute neurological issues.  Yes, he did put me on an anti-convulsive (lamotrigine).  It took a pretty large dose but it seems to work.


by piglet22 - 2023-03-20 06:55:24

Yes, you put your finger on that.

I had all the GP syncope, vago-vascular event stuff.

This particular GP was a cider vinegar and honey man where it should really have been antibiotics.

When I went along knowing that something wasn't right his answer was "rub your neck" and stimulate the vagus nerve.

On one occasion when things were getting really bad and I was getting episodes of 30-40 bpm in exercise, I suggested he checked me after walking up and down their stairs.

Even that was declined. I don't understand why they think they always know best.

Eventually, it did sink in and I got a referral. It took the consulant about 5 minutes to diagnose.

You know you're wired when...

You have a new body part.

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