Passing out on treadmill

Hi,
I am a 38 year old with a dual chamber pacemaker. I had it recently put in back in September and then had an ablation for junctional tachycardia. They were able to fix the junctional tachycardia with the ablation. I am very active and work out a lot. I ran on the treadmill this morning and ended up blacking out about 20 minutes into my run and got some nasty abrasions, luckily nothing worse. I've noticed that my heart goes into this fluttery, rapid feeling and then I lose my energy to continue. My muscles get weak and I have nothing left. I had a exercise stress test last month and all was good with the electrical signals. Initially I only had a single chamber atrial pacemaker, but had an upgrade a few months ago, due to the junctional tachycardia ablation. I am paced in dddr mode about 96% atrial and 30% ventirical. I have an appt. with my ep next week. I think the interrogation will probably show nothing, and don't really know what else to do? Stop running? It's frustrating when you go in and it doesn't show up on the pacemaker checks and you feel like an idiot. It doesn't help that I don't like to complain and play the "tough girl" act.


5 Comments

Keep nagging your doctors!

by Spunky_1 - 2015-01-02 10:01:34

Definitely keep looking for answers! You went through this so you could feel well - not pass out!!

I have a similar situation going on w/ me. I got my pacemaker in July for SSS/CI and sinus pauses. I had a single wire atrial PM put in. I've passed out 8 times in 5.5 months 5 times lying down, once exercising and once rising from a seated position. My (ever unhelpful) pacemaker shows nothing wrong. I do have tachy episodes and when I pass out I feel a weird tachy rate, like my heart is hunting for gears), but it is below my threshold so no capture as of yet.

I too am going in for an upgrade - mine is scheduled for this Tuesday. I hope that this will fix whatever is going on, but I am also hoping there will at least be some sort of a window into what is happening in the ventricles if something does happen.

Keep pushing until you feel well - you're supposed to feel better with this and be able to live life. Don't give up - we're pulling for you -

Spunky_1

pacing

by Tracey_E - 2015-01-02 10:01:48

When you get the fluttery feeling and lose your energy, have you checked your pulse? There is a mode that is intended to help with afib by putting us into an artificial 2:1 block. Only problem is sometimes we are just going fast because we are working out, not from afib, and the pm is fooled and drops our rate in half. That means if you are cruising along at 180 it suddenly paces at 90. I didn't black out when that happened, but I sure felt like I was going to and my arms and legs turned to lead in the blink of an eye.

I've also had that feeling, but not nearly as bad, when my atrial rate got higher than the pm could pace the ventricle. Atria doing 200+, ventricles only paced at 180 because that's as fast as it can go. That's only going to happen if you are in av block.

Don't stop running, but maybe cut back some and don't push it until you get some answers. Give them the day and time you blacked out, hopefully something shows up.

Have you had a tilt test? Wondering if bp is a factor, that would not show up on the interrogation.

Good luck!!

Thanks for the insight!

by JaneJ - 2015-01-02 11:01:31

I appreciate the support and insight from you all. Tracey, it has crossed my mind that it is something with pacemaker settings or possibly an a fib issue. I'm not sure what my heart rate was. One second I was feeling great, like I could run forever, and the next I woke up with my lower back slammed against the treadmill behind me. What a way to celebrate New Year's Day 😊. When I feel that fluttery sensation I really tend to feel it in my throat area. It's really strange. I love the way running makes me feel, but am hesitant until they figure it out. My husband and I will be having a conversation with my ep next week about what happened. I always tend to minimalize my symptoms when I see him, but this time my husband will be there and.that will help.I also do wonder if I have vasovagal episodes and it causes a plummet in my bp. My ep has told me to eat lots of salt and drink more fluids. I guess they will maybe do a holter, because the pacemaker doesn't always show everything. Or maybe another stress test with me actually running might be good. Thanks for all the help and support everyone!

Hi Jane

by IAN MC - 2015-01-02 11:01:40

Exercise-induced fainting needs to be taken very seriously so insist that your Drs get to the bottom of it and find a definitive cause . There are many possible causes :-

- it can be caused by some structural problem of the heart

- it may be an electrical problem of the heart which the PM is not preventing e.g. exercise induced atrial fibrillation

- it may be caused by the PM settings e.g. a PM-induced block

- there may be a non-cardiac cause

Years ago , when training for a marathon, I blacked out at 20 miles during a run. The eventual diagnosis in my case was exercise-induced hypotension . My cardiologist told me to increase my salt intake and to keep REALLY REALLY hydrated when I run and fortunately that solved the problem for me.

Don't give up without getting an answer

Best of luck

Ian

stress tests

by Tracey_E - 2015-01-04 09:01:20

Stress tests are a great tool! Let them see exactly what happens rather than guessing at it. If you were in afib, the pm should have recorded it. A tilt test will confirm if it's bp/vasovagal.

Great decision to take your husband. Two brains to remember what to ask, two to remember what they tell you. And your husband to stop you if you minimize ;) I tend to do that too. I don't want to be a whiner, but sometimes we have to be very honest if we are going to get the answers we need.

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