New to this forum

Hi I am new to this forum. 49 years old and my Zio holter showed advanced grade second degree block with a few pauses (3-5 secs). I am completely asymptomatic, they picked this up incidentally because duting covid of 2020, I got anxious at night and reported palpitations. The EP test revealed no conduction disorder in fall of 2020. But the zio that I wore for the last 2 weeks picked up intermittent blocks, mostly at night but a few during the day. I have my consultation with my EP on Thursday but my cardilogist feels a PM would be the best insurance. It will only trigger if necessary. Wanted to check a) do any of you have PMs that trigger only when necessary and typically how long were you told they would last without replacement?

b) i have a travel planned for Spring Break in the next 2 weeks. Not sure I would be assured if my EP tells me its ok to wait :) No clue how quickly these pauses progress to syncope for folks who have no symptoms. Any data/stats?

I am thankful I joined this forum. So many of your responses are so sane, unilike may hyperreactionary ones on the internet.

3 Comments

Asymptomatic?

by BOBTHOM - 2022-03-23 16:16:55

First I'll start by saying that I am NOT a doctor or medical profesional of any kind.  I do NOT know what I'm talking about.  I do NOT know your exact medical history or condition.

If it were me, I would do nothing but monitor.  Once the device is in it only comes out to be replaced by a bigger and better one.  There is risk of death which I'm sure every doctor would point to, which is why they suggest doing it.  Face it, if they don't recommend it and something happens they could be liable and could face a law suit.  So, remember that as you plan you steps.  I delayed having and ICD (which is what I think your talking about) implanted for 12 years and in hindsight I think I should have waited longer.  But that's just me and my unique situation.  Good luck with your choice!

Again, just a reminder, you should not listen to me as I am not a medical professional.

Thank you

by DBan - 2022-03-23 21:05:01

Thank you for your reply. Gives me some perspective. Will chat with my EP at length tomorrow. Very new to all this, never had any health issue and this is really nerve wracking.

When to pace?

by Julros - 2022-03-23 22:38:27

Most of us have pacers that pace only when needed. But of course, there are several reasons to be paced. 

I don't it is easy to predict how long it takes for a heart block in increase in frequency, part of that would depend again, on the cause. And sometimes there is no obvious cause. 

I disagree that you are asymptomatic because you did report palpitations. This feeling can occur when there is a delay between beats, the ventricles have more time to fill, and the resulting beat feels stronger. And you may be having subtle symptoms that are not that noticable. I know for me, I know I was tired as I walked around with a heart rate of 45, but I didn't notice the brain fog until my pulse was up to 60! 

I think most pacers last between 10-14 years, depending on the type and indication. 

I understand why you are concerned. Hopefully the EP has good answers. 

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