Anxiety after pacemaker implant

@kgiery
Per my EP it takes about a year for someone to get used to having a ICD and or Pacemaker. Both physically and mentally. Physically the body will encapsulate the device and it will become less physically feeling.

Mentally it will again take some time to get use to having a foreign device in your body. Too much worry will cause the fright or flight adrenaline build up and most likely the cause (only an opinion based on my past experiences with anxiety/panic attacks.

So normal would not say but can happened yes. Do you have just he pacemaker or a ICD/Pacemaker? Either way the device is implanted to provide you a better quality or life and in many cases like mine insurance (I have a ICD/Pacemaker for 20 years) you own EMS in your body anytime you need an emergency shock to bring your heart back into rhythm or to pulse you out of arrythmias.

If you have only the pacemaker was it done to bring your pulse rate up? Than is common procedure to ensure pulse rate does not get too low which can cause arrythmia in your heart, dizziness, etc.

My heart is paced at 70 bpm. The medications I take Entresto and Coreg brought my BPM into the 50's and even lower. I have a lot of PVCs so my EP experimented with right pacing level to help reduce them. We found 70 bpm was beneficial to reducing PVCS.

The pacemaker or ICD or a dual device is in your body to help you. Accept that, appreciate you have something to help you. See it as a plus versus worrying about having it. See it as something good and beneficial for you. Know that millions and millions of individuals have these devices. I have had one since 2006.

@jc76 Thanks for you contributions....they surely help a lot. I figure, in a philosophical way, that our bodies comprise specialized components with differentiated cells whose roll is to make the organ work to keep the host alive. In a way, the heart is like a mechanical pump that keeps a car's engine turning over, and it delivers more and more fuel when the demand is great(er). We don't think about that never-ceasing function, beat after beat, hour after hour, week after week, and year after year all our long lives. It's only when our car's fuel pump acts up, or the alternator, or the transmission, that we realize something needs attention. It's no different for our hearts. Some car components fail just outside of warranty. We have no such thing, and our hearts can fail or act in ways that make our lives very troubling. An ICD or pacemaker is an engineering gift that precludes having to do an outright replacement, but it can keep that pump ticking over for another 20-30 years...easy. And who wouldn't want to enjoy that for what it is?!?!?

I had a 2 lead PM implanted in January 2025 for second degree AV block. I didn't experience anxiety to the level that you are having, although I'd say I was very hyper- aware of my heart beats and how I was feeling and sent messages and strips to my EP's office s few days after it was implanted.
After I sent the first strip in, I had to go into the device clinic to have some programming changes because of repetitive non-reentrant ventriculoatrial synchrony (RNRVAS)that was picked up .I described it as a flapping sensation in my heart, that almost felt like I was being repeatedly slapped. I later commented to my EP that boy, did I feel that in a big way. It felt like flapping within my heart.
His reactions was "I'll bet you did"
And then a couple of days after that, I began to feel , what seemed to me, to be larger than life SVTs , some of them lasting up to 45 minutes. I would feel so weak, I had to lay down.
I'd had them before the Pacemaker and had been on medication for them, however I had been one of the lucky ones who had not felt them before the PM. And perhaps, my heart was more irritable and so I was having a lot more SVT's.
So I sent in another strip from my PM and that didn't show anything abnormal. The EP said he thought my "tachyarrythmias" were probably not fast enough to be flagged as abnormal by the PM strip, so he then had be wear a MCOT for a week. When he got the results , I was put back on medication.
I also reported being SOB and just not feeling very perky. and so then I had a chest x-ray and a portion of an Echo and some blood work. All of that turned out to be normal and because the results came in on the weekend, he called me at home to tell me the result.
I was lucky that my EP and his nurse didn't dismiss all my complaints. So I didn't go to the ER, but I did have some hand holding from my EP's office.
I have RA and any invasive type of medical procedure usually causes an increase in RA symptoms and so I think those feelings of being short of breath and having no energy probably was the RA and not having anything to do with the PM.
What do they tell you when you've gone to the ER. Do they do an EKG and other tests when you go?
Is your EP aware of this . If so, what are they telling you.

@kgiery Welcome to Connect where you have asked an important question! We are the bionic people with our pacemakers and ICDs and like you, found that there are sometimes "quirks" as we adjust to our new companions. Thank you, @jc76, @gloaming and @missy245 for your clear and informative accounting of your experiences and explanations. I acquired Buddy, my ICD, after experiencing arrythmias (dizzy, giddy and then a couple of syncope) after a septal myectomy for HCM in 2022. I am paced at 60 beats a minute, so far, no shocks. I, too, feel anxious, but I have always been an anxious person, probably part of my personality. My husband said that it has gotten worse - yet it has not prevented me from the activities of regular daily life. Perhaps keeping track of when you are feeling the anxiety and panic attacks (day, time, what you are doing, etc), and having your EP compare the data with the occurrences may point the right direction for further investigation. Perhaps consider meeting with an anxiety professional. I found this study https://pmc.ncbi.nlm.nih.gov/articles/PMC12023003/ Also: https://www.mayoclinicproceedings.org/article/S0025-6196%2811%2961510-3/fulltext Again, welcome to this blog! How did the decision to acquire your device come about?

@walkinggirl I have traditionally had low heart rate and recently developed a-fib. The pacemaker was necessary so I could take Sotalol for the a-fib without lowering my heart rate more since my normal was between 50-55 bpm. I suffer from anxiety from time to time and this has been the worst. I will get better and I am talking with someone. I felt a support group with others who have experienced similar would be beneficial.

@kgiery Yes, we are a support group although we are all individuals and come here with unique experiences. You are the first that posted specifically about anxiety/panic attacks, if any other readers can add to the discussion, they are welcome to chime in! Thank you for posting.

Please talk to your pcp about your anxiety/panic attacks. A good support group like Womenheart (if you are a woman), and the American Heart Association can help tremendously. Your pcp or cardiologist may have access to a good psychologist to help you adjust. Its not easy emotionally to be implanted with a mechanical device so give yourself some grace and be patient. I speak from experience since I have been implanted with an ICD seven years ago. It can be a challenging adjustment.

@deniseheart thank you, I have reached out to my PC and will follow up. Yes, emotionally I’m struggling.