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Fatigue worse after Pacemaker
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Fatigue worse after Pacemaker

Dear Dr.

My 83 year old father had a pacemaker put in last Fall, in Oct. 3 due to a. fib that had become unresponsive to medication and cardioversion.  At that time he was quite able to walk on his own, although somewhat weaker that previously, due to several months of chemo and radiation following a parotidectomy.  Quite soon after, he became so weak and sometimes disoriented that he fell several times, and at the beginning of Nov. was placed in a nursing home to protect him from this danger.  He has not regained his strength and is still unable to walk unassisted.   How normal or expected is it for someone to decline in such a fashion after receiving a pacemaker?  His Dr. says that the pacemaker is working.  

Very concerned,

Miss Becky
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I would be more concerned about the chemo and radiation causing his decline rather than the pacemaker.  Of course, you have to rule out infection especially that he is at high risk due to his cancer and older age.  His pacemaker should also be interrogated to make sure that it is working.  There are certain conditions, such as heart failure where pacing can actually make the symptoms worse by causing, what we refer to as dyssynchrony.  
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