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Dual Pacemaker
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Dual Pacemaker

  I have had transpositional of the greater vessels when I was a baby, about a year later I had a pacemaker implanted.  The pacemaker is in my abdomen area and up until about half a year ago I have had no problems (I am twenty now).  Around last April I noticed I was more fatigued and when I laid down at night it felt like my heart would start beating fast.  I went to my cardiologist a few months ago and he ran an ECHO, EKG, and the holter test.  I am not sure of the reason he suggested (he gave several possibilities)and he sent me to a ped. cardiologist to determine what exactly was causing it.  The ped. card. put me on Lanoxin(.25) and Vasotec(2.5) and changed some settings on my pacemaker.  I do know that my pacemaker is a single pacing which paces the bottom of my heart. The "adult" card. thought there were extra heart beats while the pediatric card. does not.  The children's card. said it was caused by the heart normally starting the beat at the top of the heart while the pacemaker paces the bottom and they "meet" in the middle which causes the irregular feeling.  In December, I going to have surgery where they are going to put a lead to the top part of my heart to synchonize the beating. Both doctors are in agreement in the surgery.  I do not know if you can answer my questions without detailed information.  But do you think the dual pacing pacemaker will cause me to be more energetic and not feel the racing heart beat?  With two doctors saying different things I am not sure what is going on and what to beleive. With the pacemaker in the present location will I be able to carry children?  Also, while being on the Lanoxin and Vasotec I have lost a little weight(I only weighed about 105-110 before) and have felt nauseated frequently and have even vomited several times; do you suppose this is caused by the medicine or maybe just stress?  One more question, lately my right hand feel numb or shakey (shaky) from time to time.  Do you know if it has any thing to do with my heart?  I haven't brought it up to my other doctors because I am kinda scared it might, I just wanted to check first.  Thank you so much for you time and intelligence and I hope you can answer any of my questions!
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Dear Kara,
You are in a unique group of patients termed 'adult congenital heart disease' that is made up of patients who survived their congenital heart disease and are now adults with a varying degree of long term effects of the treatment provided them as a child.
In being a member of this group per se, you need special attention by cardiologist (pediatric or adult) who specialize in the treatment and follow-up of adult congenital heart patients, I can not stress this point enough.  These particular cardiologists are found at major university hospitals mostly and really are your best advocates.
ANY new symptoms, regardless of their seemingly unimportance, should be reported to your physician asap.  I can not imagine that a pregnancy would be affected by the pacemaker being in your subcutaneous tissue of your abdomen, however that is an assumption on my part and your best bet is to have your specialist-cardiologist refer you to the appropriate OB/GYN physician BEFORE you get pregnant.  
I would not feel comfortable if I did not at least tell you that you need a full evaluation by a congenital cardilologist BEFORE you get pregnant as this can be life-threatening in some adult congenital patients, most especially in those who do not have a full evaluation PRIOR to getting pregnant.
The dual chamber pacemaker is a higher quality device and better in general simply because it is the best mimic so to speak of the natural heart rhythm.
Now whether or not the dual pacemaker will 'cure' your symptoms is beyond the scope of this forum, although I can say it is likely to make anyone feel better than when they had their single lead pacemaker alone.
Good Luck. Please feel free to write back with more questions as needed.
If you would like an opinion from one of the congenital cardiologists at the Cleveland Clinic, simply call 1-800-CCF-CARE for an appointment with one of the
physicians at Desk M41, namely Dr.Murphy, Dr.Sterba, Dr.Moody, etc.
Information provided in the heart forum is intended for general medical informational purposes only, actual diagnosis and treatment
can only be made by your physician(s).

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