Arrhythmias after pacemaker implant

Hello, I am a new member. I am 60 years old, female and until recently active and healthy. I was born with a heart defect (ASD) and successfully operated 56 years ago in Düsseldorf. I work internationally and live in Italy. In late July, on a flight from Ghana I fainted for the first time. I had several fainting spells in September and finally saw my cardiologist in October, who diagnosed an AV Block II grade (Wenckebach) with 3 minute pause at night. This came as a real shock especially because I had had a thorough check up in May this year, at the same cardiologists’ - when I had been a given a clean bill of health. I am still dumbstruck and simply cannot explain how this could happen.
Following the implant of a Biotronik Ecuro DR in mid-October, I stayed at home for three works before returning to work. I walked daily to get fit again however I noticed one day, after having walked at a fast pace for more than 2 hours and climbed up to my apartment on the 4th floor, that my heart rate was only 70. About 2 weeks ago, while at work, I experienced severe heart arrhythmia for the first time which continued for 4 hours. The medical unit at work sent me to cardiologist who re-set the advice to 70, DDDR and prescribed Atenolol 50 mg/day. After this I continued to experience problems, constant extra systoles which did not calm down and made sleeping difficult. After several days I decided, feeling desperate and depressed, to see my cardiologist in Germany who reset the device to 60 beats/min and prescribed Bisoprolol 1.25 mg/day. He had no explanation for what is happening and has not offered much help other than to say that my condition has worsened as my heart has gone into chronotropic incompetence.
While I currently feel a little better and my arrhythmias seem to have calmed down somewhat, at least while resting or working at my laptop, most types of physical activity, especially walking, appear to call forth another episode of arrhythmia, a tight feeling around my neck and shortness of breath. All things considered, I feel worse than ever and I am worried that I may never return to my old strength and normal life. I feel badly cared for and I have not found a doctor who is ready to help me adjust to and cope with my condition. Any advice that you can give would be much appreciated.

3 Comments

Adjust Medications

by Artist - 2014-12-07 10:12:55

The causes and types of arrhythmias vary and it often takes trial and error to see specifically which medications will help and not cause more problems. All of them have side effects, dizziness and weakness are common side effects. I have been through 4 different medications now and at one point I was feeling almost as weak and bad as I was before my surgery. I have not had a post surgical work up yet but have decided to cut the dosage of one of my medications in half and that seems to help. I now feel "normal" most of the time. On the two occasions that I had strong arrhythmias I just took the half of a pill that I had cut back on and that was a good solution. There is an excellent video at this link that will help you understand the types of arrhythmias and medications that are appropriate for your condition.
https://www.youtube.com/watch?v=LYKj6SFIP3w&feature=youtu.be

I hope that you will obtain an appointment with a cardiologist that will evaluate your medication and make some adjustments that will probably help.

Prescription Medications

by Artist - 2014-12-08 05:12:42

Please consider watching the video at the link that I provided in my previous comment. You should be able to copy and paste that link into your web browser to watch that very informative video. It discusses a variety of medications that are available to treat arrhythmias and which ones are best for treating the different types of arrhythmias. I went through several different prescriptions before they found out the medications that worked for me without making me feel so tired and dizzy. I needed the PM implant so that my already too slow heart rate would not get dangerously slow when I tried to take the medication to control the Afib. The Afib is not entirely gone now, but is much better and I am not so tired since my heart rate is not dipping down in the 30s and 40s anymore.

Adjust medications

by Grete - 2014-12-08 08:12:30

Many thanks for your suggestion. I cannot lower medications so perhaps I should increase but I am afraid that I may end up feeling like a zombie. I am back to work today after a week's rest and have had extra systoles all morning, feeling faint when I get up and move around. Even talking makes me feel weak and vulnerable. I wonder whether I should go off the meds altogether. Have my next doctor's appointment on 19 December, wonder though whether I should try to find another cardiologist locally.

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