Hi, I've had a heart monitor fitted since beginning of June this year. The specialist says I've had a couple of 150+ HR events, and one event of no heartbeat for 3 seconds. My resting HR is often 37bpm, blood pressure is just about perfect 120/80. I don't get out of breath, though can get low blood sugar if I overexert myself. I'm now struggling with the request from my cardiologist that I have a two wire pacemaker fitted in 11 days. He says it won't stop the tachycardia I rarely get, but will stop the bradycardia I do get. The bradycardia isn't noticed by myself anymore. When I was younger 25 years ago my resting HR was below 30, and I'd feel a bit faint getting upright quickly, but after a couple of 2 to 3 hour episodes of tachycardia 200+BPM my heart reset itself to a resting HR of just below 40, which is not noticeable. I haven't had any tests or scans for many years, would it be prudent that these are done first?
Oh no, I don't want this š - Atrial Fibrillati...
Oh no, I don't want this š
Take the advice of your cardiologist. He is the expert.
I can understand your dilemma but you are dealing with things which require careful thought and consideration. My knowledge about pacemakers is zippo so I couldnāt help with the detail even if I wanted to. EPās are the experts and if your Cardiologist isnāt one, I would either ask to see one or perhaps, if possible seek a private consultation. I believe a resting heart rate of 37 bpm is potentially quite serious, others who are better informed will correct me if Iām wrong but itās something which needs proper attention sooner than lateā¦ā¦.
My opinion is that you need a Ƨomplete worÄ·Ć¹p from an EP including EKG. Echocardiagram, possibly longer term monitor and blood tests. Treatment would depend on results. If you have heart rate below 40 it seems a Pacemaker would be advisable to prevent potential dire consequences. If there are any structural abnormalities found on the scan they can possibly he mitigated through surgical or drug treatment. This may sound excessive, but it's not like in some instances you would necessarily get a second chance. Discuss this all with an Electrophysiologist. Best etheral
I totally understand your cardiologist wanting you to have a pacemaker. I had one fitted last year due to occasional bradycardia and long pauses. Better than it stopping!
Get the pacemaker. Iāve not lost consciousness since had mine fitted, for similar reasons, about 4 years ago.
Lucky you! I would like to have a pacemaker but not quite bad enough I think so live with the little worry that one day a āfunny turnā will be the last š°
It's a big decision, so reasonable and prudent to speak to one or two experts before deciding. That would be an ep, not a cardiologist. The fact that you've always had a very low heart rate, may or not affect the decision. Good luck and let us know what you decide.
Jim
Hi Jim & jointpain, Just want to mention that all EP's ARE cardiologists who have extra training in how to diagnose and treat arrhythmias etc. using ablation and other hands-on techniques. However, cardiologists who are not EP's seem to be more knowledgeable on a wider range of drug and lifestyle options for handling AF, while EP's are going to promote ablations more heavily. A few years ago, my cardiologist said "You are not a candidate for ablation". Next, an EP said, "You should have an ablation". He had, unfortunately, a rather arrogant personality, and when I said "no, I'd like to try meds first", he stood up and said "then I can't help you", and actually left our appointment! For this reason, I see a cardiologist regularly for meds & questions, but also keep in touch with a different EP cardiologist, just in case I should need him in future. Over 14 years I have really noticed a difference in personality between these two types of cardiologists. And that's OK w/ me, since we want EP's to keep perfecting these technical interventions by (hopefully) doing 1000's of ablations! All good health, Diane S.
Yes, very aware of the distinction, cardiologist vs ep. But when you get into pacemaker and bradycardia territory it is the ep (cardiologist with xtra training in arrhythmia's) that you want to consult with. Nothing against cardiologists without that xtra training and some of your comments are right on. Quite reasonable and often prudent to have both a regular cardiolgoist as well as an ep.
Jim
Jim, I knew you knew the distinction! When you said to see "an ep, not a cardiologist" I made the point for the new readers who might not understand the difference. Of course, if you pop into the regular cardiologist's office w/ bradycardia, needing a pacemaker, etc., any proper cardiologist is going to whisk you off to the EP anyway. Personally, I find regular cardiologists more "friendly" toward the less invasive options for AF. I'd probably feel better if more EP's would educate themselves further on types of mini-maze etc., but most of the EP's I know remind me of Abraham Maslow's comment, "If all you have is a hammer, everything looks like a nail." 
All the best, Diane
Diane, I'm also from the US and indeed the regular cardio's a bit more friendly and more inclined toward less invasive options, however I find their sophistication in matters afib, often lacking.
On the other hand, the ep's here have mostly turned into proceduralists, so unless you already made up your mind to have a catheter ablation, they not much help. GP's, well, they plead ignorance on matters afib and they aren't just playing, they really don't know much, nor do they seem motivated to
This all seems to translate into many cases of afib being either over or under treated and that treatment will depend not so much on what you have, as opposed to who you see
Fortunately, with Medicare, I get as many "second" opinions as I want without needing a referral, which has helped me find the best options, but I understand not everyone has that luxury.
And, yes, don't expect the average ep to recommend a mini maze, or even have a decent understanding of it. If they don't perform them in their hospital, it either doesn't exist, or often gets maligned.
So, if inclined, that to a large extent eaves it up to us to do our own independent research and bring that knowledge to our respective appointments and hope -- really hope -- that the doctor will listen during our often, much too short of a visit.
Well, enough cynicism for one Sunday
Jim
What is it you donāt like the idea of?
Not sure MRI scans would be essential but hopefully you have had or will have an echocardiogram, bloodwork and ECGs and I would have thought a monitor of some sort?
With a pacemaker heart rate meds would control the high HR as rates of 200+ are quite dangerous.
Having said all of that you do need some control and with those sort of ranges and pauses you risk damage to your heart and health so I donāt think doing nothing is an option.
I agree with Etheral - whose has exceptional knowledge & experience.
Best wishes
Definately get the pacemaker fitted, I had mine last December after cardiac arrest, very scary experience, no problems since!
Get a pacemaker. I got one in March. It stopped the bradycardia and the pauses and it has even minimised the number of A Fibs I get. Like you I did not want one but I am so glad I did. Good luck
I echo the sentiments about getting the pacemaker - best thing that ever happened to me after fainting and blackouts due to HR dipping to zero.
hi, this is just personal experience I'm not a doc. Low HR, that seems very low, usually associated with top athletes, even people I know who do marathons and triathlons are not so low, but if it hasn't bothered you ? Beta blockers which they may have considered for the tachy would probably make it go lower. My low HR I thought was cos I was reasonably fit, but it was being caused by badly leaking mitral valve, which needed repairing.
Have you had scans, TOE or angiogram to see if there is any problem, for me it showed my EFR was low cos of the leaky valve.#
Tachy, I had that, horrible bouts that would make me feel sick and faint. They fixed that with an ablation.
Pacemaker, generally controls HR going too low, but I think there are ones that will control HR going too high, maybe ask about those, think they're called ICDs
Thank you for your input and experience! The cardiologist did say that I couldn't go on beta blockers, and the high HR wouldn't harm me. The tachy episodes I have had are normally unnoticed by myself. The fall from my bicycle on 13th January when I was unconscious for 4 days due to skull fracture and subacute brain bleed, made me think when I had a couple of tachycardia events two months after I escaped from Stoke hospital to ask if my heart was ok. As it has a range of nearly 200 BPM between rest and flogging it. I'm beginning to think that I may have fallen due to a low blood sugar event, as I used to feel faint 30ish years ago when my blood sugar would go to 1.7 whatevers.(very low) and I'd drop to the ground for a rest. Then after a while get back up and carry on. Drs said I wasn't diabetic. But didn't notice or test for my celiac, and pernicious anemia for which I abscond from gluten and inject b12. Now I'm 67 I feel sorted health wise except for some brain damage which affects balance if I turn my head too quickly. I can still cycle well but rough roads and potholes will cause my head to ache due to sub dural bleeds according to the last MRI scan.As I now have a lovely young puppy, and my wife needs me to be here too. I think I may postpone the pacemaker for a good while (like 20 years)
What caused you to fall from your bicycle?
An āevent of no heartbeat for 3 secondsā is a serious pause and could cause a blackout.
When I was young I had a low heart rate and I assumed it was because I was very fit - and I was . Although a healthy and athletic person I had the occasional dizzy spell that I ignored. As I got older I started to find long journeys very tiring and occasions I had to stop on the hard shoulder of the motorway. I put that down to overwork and did the same when I passed out on a couple of flights.
Then one very horrible one night after a hike and a flight I was visited by Mr Brad E. Cardia and ended up with a dual lead pacemaker and never looked back - all those symptoms disappeared. Itās a bit tiresome having a battery changed every few years but based on current projected battery life Iāll only need one more - and that will probably be tte new external charge model which will be handy if I live past 93 (Blue tooth to solar panel on lapel / hat / remote stand)
After having been freed from the occasional sluggish heart syndrome and the debilitating symptoms I was diagnosed with PAF 12 years later. Life !
Iām doing my best to be a healthy, athletic older person (with a few āadvisoriesā on my MOT report sheet ) and I wouldnāt be without my pacemakerā¦in fact I donāt think I would still be here without it.
All the best in whatever you decide to do ..
My husband has a similar problem . How long did it take for you to be seen for the operation. My husband has AF which caused a stroke three months ago causing aphasia and vision loss . Weāre still waiting for arrhythmia clinic appointment nearly four months in. Thank you
I have a pacemaker as the beta blockers meant my resting heart rate was low particularly inthe middle of night.It means you wont pass out if the heart rate drops which given your bradycardia is a risk for the future
get it fitted I had mine 4 years ago and got my life back
My wife's uncle had a pacemaker fitted and never looked back - he lived until he was 99 and had the pacemaker for nearly 30 years. He had been blacking out frequently and unable to get out of bed quite a few times. From the day his pacemaker was fitted he was back walking a mile there and a mile back from the supermarket (uphill) from a couple of days afterwards. He even discharged himself from hospital the same day - he should have stayed the night and took a taxi home as he felt so well. I wouldn't think twice about having a pacemaker fitted if I was told I needed one though my wife would miss her induction hob as we have no mains gas in this area so would have to have a bottled gas hob.
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