Cluster of Symptoms

[wen]

I had had the same cluster of symptoms that President Bush manifested this weekend - neurocardiogenic syncope, plus a very low resting heart rate. I remember the day before my scheduled imlant an article appeared in the paper which lauded his low resting pulse - 38 bpm.  I actually brought the article to my EP - and asked why he was recommending a PM to me (my resting rate wa 40 - dropping to low 30's at times;  I also run recreationally) - when in Bush it seemed like the low rate was a kind of "trophy"! I am also about the same age as W.  Several doctors recommended a pacemaker implant (which I now have - and which is not difficult to live with!).  I'm just wondering:  would this be recommended for him?   (Or does potential public reaction outweigh the medical advice.)   A Curious Patient.

[wilson-wilson]

"Perhaps you should stay away from Pretzels! ;)"

Maybe I'm wearing off on some here!<G>

wilson-wilson

[wen]

I had thought that a propensity for neurocardiogenic syncope COUPLED with a low heart rate - made for a bad combination;  i.e. with a heart rate already so low it doesn't take much to lose conscousness.    Whether one is truly "symptomatic" is not as clear cut as it sounds.  One may seem excessively tired, cold.  Maybe incoherent syntax could be a warning sign.

I just wonder why my doctors (and I got a second and third independent opinion) were unanimous in recommending the PM.  I had one observed fainting episode, and an accident that in retrospect I attribute to an episode - though I could never be certain.   In any case, not having a full time chauffeur, I figured I better go ahead and do everything to prevent a potentially dangerous incident!

Not a DOC.

[CCF-M.D.-CRC]

Dear wen,

Perhaps you should stay away from Pretzels! ;)  

You are asking about 2 different issues - pacemaker for low heart rate, and pacemaker for neurocardiogenic syncope (NCS).  In regard to the first there is no "lower limit" which determines if someone needs a pacemaker as long as they are symptom free.  If there are symptoms due to the low heart rate then pacing is recommended.  

As far as NCS goes pacing helps some people but not everyone.  In general we like to see multiple fainting episodes and not just one and a failure to respond to lifestyle changes and medications before we recommend pacing.