Neurocardiogenic syncope

I have been diagnosed with Neurocardiogenic syncope (NCS) and a I had a PM implanted 1-18-07 to prevent me from blacking out. My condition is rate drop, beta blockers are not an option because I’m an asthmatic. On an average I have 15 to 20 rate drop episodes daily. The parameters of my setup is a rate drop of 40 bpm in 15 seconds or less with the pacemaker intervention then raising my heart rate to 90 bpm for two minutes. During the day my low limit rate is 60 bpm & at night when in sleep mode it is 45 bpm. This worked for a few months but the other day I blacked out at a traffic light.
My EP raised my low limit to 70 bpm and intervention rate to 100 and I am now wearing a Cardo-Net Monitor to try to capture what is happening. The PM only stores the last ten events and I had 251 rate drop events in the last 10 days.

I think I have coped with this well up to now but I am wondering if there will ever be a fix for my condition. Does anyone else have this type of problem & can shed some light on what type of setup worked for them.

Thanks,
Joe Correia

5 Comments

N. syncope

by bowlrbob - 2007-04-28 12:04:21

I have exactly that same thing. Not quite so many episodes a day but many. The settings they just put on your pm is what they put on mine the first time. Since putting that setting in I have been blackout free for almost 1 year. I also don't get dizzy anymore either. Fell great. It has been a godsend. Bowlrbob

N.syncope

by bowlrbob - 2007-04-28 12:04:57

Sorry about the spelling forgot to use my spell checker. I used to fell great. Ha! Ha!. But now just feel great. Bowlrbob

Syncopy:

by joec - 2007-04-29 10:04:10

My Syncope was not a problem at night I was always able to sleep great. I had a loop recorder implanted in my chest for 13 months that revealed, like you many events daily and at night usually around 3 to 5 am.. My resting heart rate for most of my adult life was 44 bbm but I suffer from hypertension. I have kept myself in very good shape I was a runner & kayaker. I started have problems while exercising, shortness of breath dizziness then I started blacking out. I had a positive tilt test also just like yours when I brady down my bp drops but I learned to feel the signs that it was happening and laying down flat for a few minutes until my rate picked up again did the trick. I had no idea that I was having events in my sleep now I wake up almost every night sometimes two or three when my pm responds to the rate drop episodes. I am wearing a Cardio-Net monitor for the next 20 days hopefully that will show what is happening

N. syncope

by bjensensc - 2007-04-29 12:04:07

I had a PM implanted 3 weeks ago to treat bradycardia episodes I had been having on and off for the past 20 years! Sometimes I could go a few years without any symptoms and then I'd have a few and then nothing for awhile. Anyway in the past 2 years they have been happening more and more often, sometimes several times a day. 95% of the time was when I was resting or asleep. They did occur a few times while I was driving, but because they came on gradually, I was able to pull to the side of the road before losing control. I also have low blood pressure, my normal is 100/60, but has dropped as low as 50/30 during tilt-table testing, so my cardio doc put me on meds to raise my BP. My cardio doc did every test there was to try to find out the cause of my LBP and LHR and how often they happened. After several holters, a heart cath, tilt table and a few others, he gave me a loop back monitor to wear that would automatically monitor what my heart was doing over a 30 day period. While wearing this monitor, I would weake up each morning and it would have registered 3 or 4 cardiac episodes each night for almost the entire 30 day period, plus a few during the day. Anyway, my doctor told me that the episodes it was reporting was my HR would drop to the low to mid 20's a few times each night, mostly between 4 and 5 AM. And a few times during the day it would drop to the upper 40's to low 50's. Since getting my PM, I haven't had any episodes and have been sleeping through the night finally. I had always wondered why I would get so tired around noon or so, it was because whenever I had an episode, I would wake up because I couln't breathe (no apnea). Anyway from what the PM rep told me, my low setting is 60 and the high end is 140. I don't know much else about the settings, but should know more after my 6 week checkup. I imagine your situation will get better, just keep your doc informed about what is happening each time and the monitor will also be able to let him know what is happening.

Hang in there

by ela-girl - 2007-04-30 02:04:45

Hi, joec!

There is a good handful of us on this site with NCS. So, you are in good company. :) I suffered with this for many years before having my pm implanted via emrgency surgery. I've been blackout free since although I will get a few "weird feeling spells" here and there. My heart used to drop to 6 bpm, so I am very blessed that my pm is doing it's job. Many of us have posted about our NCS lately, so be sure to check the posts. Feel free to message me if you ever need to!

Happy pacing!
ela-girl

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I, too, am feeling tons better since my implant.