Bradycardia with Pauses

[HuskyHendrix]

My cardiologist is recommending a pacemaker, as I've had two 5 sec. pause episodes in the past 30 days. My resting heart rate is typically in the low 50's, but lately it has been as low as 45-47 on a consistent basis. Without treatment will this trend continue. I'm attempting to decide if I should get the pacer, as I've only had two lengthy pause episodes, without symptoms, and one was while sleeping.

Thanks,

[BobD Volunteer]

I guess it depends on what medication you are already on. If your heart is being slowed by drugs then maybe the solution is obvious. Depending on your fitness your rate is not really that low anyway. and typical in athletes. I once met a chap who was perfectly healthy with a HR of 36. Ex lifeboat man with nerves of steel.

If you are in UK mind I would not expect a PM to be recommended if not needed as they cost a fair bit each. Maybe ethics are quite not so good where NHS care not available.

[realdon]

I had a pacemaker fitted in similar circumstances. My AF was originally diagnosed after I had started having occasional dizzy spells and brief fainting episodes. A seven day halter revealed that when I was coming out of AF, my heart was pausing for between 3 and 10 seconds. At that time I was having about one AF episode every 10 days or so, with only occasional dizziness, but this was serious and in the UK any dizziness or fainting must be notified to the DVLA and is likely to mean you cannot drive until it has been fixed. A pacemaker was implanted and I have not had any dizziness since. This was 6 years ago. I continue to have AF which has been treated in various ways. One advantage of the pacemaker (apart from eliminating the dizzy spells) is that it records the number of AF events and the percentage of time spent in AF, and in the case of people with a low heart rate leading to bradycardia, the heart rate can be set higher (in my case my pre- AF heart rate was around 50 bpm and is now set at 70 bpm). Being over 70 I have to renew my driving licence every 3 years and have just done so with no problem having made the appropriate declarations.

[Hidden]

I’m afraid I can’t help you, but I would be very interested to hear what your cardiologist said was likely to happen over time if you did not have the PM.

I have been symptomatic with 3 second pauses, with definite presyncope or feeling faint. With a 5 second pause, I would expect to be on the floor, but I’m sure my circulation at 70 is not as good as yours.

[Tallgirl]

I had a pacemaker fitted in 2013 when I was 52. Until then I had never had a serious illness and considered myself to be reasonably fit and well. I went to the gp feeling like I had flu only to be rushed into hospital with fast AF. Only on day 7 of a 10 stay did they manage to bring my heart rate down and I was sent home on bisoprolol. It was four days later that I had my first of five 13 second pauses within five hours, the first one happened at home and thankfully the rest in hospital after a blue light ride to get there. I was quickly transferred to Papworth hospital and a pacemaker was fitted immediately. Needless to say it all happened in a whirlwind that didn’t allow time to think I just knew I wanted to stay alive! There was definitely a sense of urgency around their actions and I felt time was of an essence.

I went on to have 3 ablations for the AF and luckily I no longer have AF or take any medication, just the pacemaker, but it is reassuring that it is there to catch me if I fall (heart wise). As to whether things will progressively get worse for you, who knows, but if they are offering you a pacemaker they wouldn’t do that lightly.

[quanglewangle]

Hello

First - a bit of background; I had a AF for a while but some faints prompted the insertion of a monitor for a year.When time came for a check-up they said everything was FINE - but I asked what showed on the record for some dates I remembered? and they said...Oh! your heart stopped then for 10 seconds! and that time for 14 seconds!!, etc....I said but why did you not call me in? It turned out that the reporting machine was in the wrong place and they had no reports at all for the whole year! Apparently the protocol was that they only call you in if something abnormal shows but 'no report' was not considered abnormal so nothing was done! Having established what the true situation was, they scheduled me for a PM in three days!! Mine is set to cut in if my HR drops below my resting heart rate of 60bpm - result no more syncope fainting turns and life carries on!! (and so does the AF of course, but without the fear of collapse...) Hopefully the protocol has been updated!!!!

Based solely on my experience I would say that if a PM is offered then go for it - and up to 10 years of peace of mind.