Pacemaker Syndrome?

Hi, I've just joined from Sunshine Coast, Qld, Australia because I'm interested in members comments about my problem. I had a single lead pacemaker fitted three years for bradycardia - sick sinus syndrome. I've noticed increasing tiredness and need to regularly take an afternoon nap; I've also had more minor ailments and consider my resistance is not as good as it was.
My family has an Altzheimer's history and I thought my deterioration - I sometimes get befuddled was the cause but I had a CT scan and passed all the tests. My doctor suggested more exercise (I haven't had the energy) but now realise I can't get my pulse higher than 95.
I'm 69 and reasonably fit because of good nutrition and moderate habits but I think I've got pacemaker syndrome (I'm not getting enough oxygenated blood to the brain etc) and may need re-fitting to a dual lead pacemaker.
I have an appointment with my cardiologist later this week so will report back.
Regards,
John.

3 Comments

Unlikely

by golden_snitch - 2015-01-05 02:01:26

Hi John!

Pacemaker syndrome in an AAI(R) pacemaker is not very common. It is more common in VVI pacemakers or dual-chamber pacemakers that are badly programmed. If you have sick sinus only, your AV-node is functioning perfectly fine, and is therefore passing the eletrical impulses, that your atrial lead gives, on to the ventricles in a physiologic way.

I had a pseudo pacemaker syndrome when I had an AAIR pacemaker. It was caused by an accelerated AV-nodal/junctional rhythm that was going faster than the atrial lead was firing. That led to my ventricles beating earlier or at the same time as my atria. It was nothing that could be cured by adding a second lead. I did get one, because I also started to have heart block episodes (caused by the drugs I was on to suppress the junctional rhythm), but adding the ventricular lead made no difference to the pseudo pacemaker syndrome. In the end I had to have an AV-node ablation causing complete heart block.

Do you have the rate response sensor switched on? Most SSS patients do, but if you cannot get your heart rate to exceed 95bpm it sounds like it's either switched off or needs some adjustments. In a Medtronic pacemaker, 95bpm is the standard ADL (=activity daily life) rate. It's a rate response sensor setting. This rate should be reached when you, for instance, walk the stairs or do other daily life activities.

Inga

fantastic

by fantastic - 2015-01-05 05:01:39

Thanks for the reply Inga. Nor sure about the rate response sensor but still don't think I should be so tired and believe my inability to pump more blood when activity is raised causes problems - not enough oxygen to the brain etc. Perhaps the pacemaker can be adjusted without the need for another lead.

Update.

by fantastic - 2015-01-26 08:01:11

I've since had a nuclear stress test and surprised everyone by passing with above average results - 15 minutes extreme at 145 pulse rate. Also had another heart ultrasound which confirmed good heart health.
It seems I've been overly cautious because of my low readings when in fact I've maintained good fitness. The tiredness is probably because of my propensity for late nights and a stressful lifestyle.
I now think I'm a superstar with few limits.

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