Bradycardia

@muhammadirfan I've had a pacemaker for close to 7 years now, and have yet to find an electrical appliance that I couldn't get close to or use normally, with no effects on my pacemaker. I have no restrictions that I know of either. My pacemaker placement was a game-changer, and I am grateful for it every day.

I didn't think I needed it either, but sometimes you just don't realize how bad you felt until after you feel better- in my case getting the pacemaker made that much difference!

@marybird How did you know you needed it? I have been on this LDL journey for 5 years with little success. I am taking a break from Repatha as im pretty sure I had lots of side effect. They did a holter monitor and said that my heart missed a few beats and it doubled a couple of beats but it really was nothing to worry about. My heart rate is rarely higher than 60.

Pace-maker make more sense! If he wants to continue with his current symptoms with bradycardia so be it. When he gets tired of dealing with it, he'll get a Pacer...always a risk that if he gets dizzy he could have a fall then possibly break a bone, or visual changes while driving could cause an accident. Just saying!

@mdeblaey539 I developed bradycardia after many years of taking Metoprolol tartrate for atrial tachycardia. The bradycardia increased over more than two years - along with the tachycardia. My heart rate would go into the 40's and even high 30's at rest, but as long as the heart rate went up appropriately with activity they didn't worry about the bradycardia so much.

They became concerned when the bradycardia became symptomatic ( tiredness, light-headedness, shortness of breath) and my heart rate would not go up appropriately with activity- some days it wouldn't go above 53 no matter what I did, and it would go back into the low 40's or so when I stopped or even paused any activity. Got to where I was either in bradycardia, or when the tachycardia would start, my heart rate would race. No happy medium, it seemed. I had a couple of 14 day monitors during that time that documented the bradycardia, along with the symptoms caused by the bradycardia.

I was referred to an electrophysiologist (EP) who suggested I had sick sinus syndrome, but what the contribution the metoprolol made to the bradycardia was in question. He suggested a pacemaker, but first we had to determine if taking me off the metoprolol would bring my heart rate into a normal range. I had to taper off the metoprolol first ( I was taking 150 mg/day) and then start taking diltiazem, another heart rate control drug to see how well that controlled the tachycardia without lowering the heart rate overly much. Well, we noted ( as I had noted before) that no matter how little metoprolol I took, the bradycardia was still there, the incidence didn't decrease, and as it turned out after a 6 week trial period the diltiazem failed miserably at both controlling the tachycardia and I still had the bradycardia.

We'd talked about the possibility of ablation to get rid of the tachycardia, with a pipe dream of not needing rate control medication after that- though I also have high blood pressure that's hard to control so will always need medication for that. The EP had studied all my monitor reports and history, and informed me that he believed I had atrial tachycardia, which he said is notoriously hard to induce in the cath lab, and if it can't be induced it can't be ablated. As he put it, it doesn't act the same "in nature" and in the cath lab. He said that if it became more frequent, they could ablate it, but I wasn't gung ho on ablation either- told I'd have to be wide awake for this to ensure better chances for inducing the tachycardia.

Anyway, after that medication failure, and knowing that the bradycardia was there to stay with, or without medication, I had a dual chamber pacemaker implanted in June of 2019. I'm back on the 150 mg/day of metoprolol to control my heart rate, with tachycardias that now include the atrial tachycardia, A-fib and sometimes A-flutter. The medication, along with the overdrive pacing by the pacemaker when my A-fib starts up, does a decent job of controlling things. As I mentioned previously, it's been a game changer for me.

And how did I know I needed the pacemaker? Well, I did have my doubts as once you have it, it's yours for life! And I thought maybe I could muddle along at half-mast, so to speak, spending half my life in oblivion, I didn't need no stinkin' pacemaker!!! But the next day after it was implanted and I went into the clinic for my first pacer check, they noted that the pacemaker was pacing the atrial sinus at a rate of 84% ( with the base rate at 60) which indicated that with those settings I needed a jolt from the pacemaker to initiate the heart rate 84% of the time. They thought I looked better too. At my 5 week post implant visit with the EP, the pacing continued to be noted at around 85%. The EP adjusted the settings, lowering the base rate to 55 ( said I didn't need to pace to 60 while I was sleeping), turned on the rate response- which allows the pacemaker to increase the pacing in response to activity. This latter has made all the difference, as during everyday activities my heart rate will rise appropriately to 75-80 or higher as needed, whereas before the pacemaker the highest it would go was to 53. The atrial pacing rate as shown on subsequent reports stays around 90% with some setting adjustments around 20% ventricular pacing.

And the difference in the way I feel is phenomenal. Convinced me that at least for me, the pacemaker was a gamechanger.