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Increased fatigue after bi-v icd implant.

I am a 51 year old female, diagnosed with nonischemic cardiomyopathy in late December 2011. I was put on a low salt diet, and a daily baby aspirin regimen plus 25mg Spirinolactone, 10 mg Lisinopril once a day, and 6.25 mg Carvedilol twice a day.  Echocardiogram in April showed a slight improvement of EF from less than 20% in December, to 25-30%.  I was advised to get a bi-v icd, which was done May 15.  The device has been checked twice since release from hospital, everything is working extremely well, no complications.  However I seem even more fatigued than since before the pacemaker.  I am on a restricted schedule at work of 8 hours/day with breaks every 2 hours (I work in retail).  I have continued mild exercise ( walking 2 miles 3 times a week, weights and band stretching) and continue to keep my daily sodium intake to less than 1500 mg, typically around 1300 mg.
My original cardiologist is relocating, and I will not see my new cardiologist. until end of July.  Due to my questions regarding my fatigue the device clinic contacted the office of the new cardiologist, and I was then advised to increase the 10 mg Lisionopril from once a day to twice a day.  Before the pacer implant my blood pressure was typically around 90/65.  Last week my blood pressure in the device clinic was 124/76, which the nurse at the device clinic was pleased with.  Since I will not see my cardiologist for a few more weeks I am wondering what the increase of Lisinopril will do for me, and what I need to watch for with sodium intake. I have been scheduled for lab work next week.  Thank you. SMS
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Avatar universal
Thank you, I appreciate the clarification and advice.  BMP check scheduled for tomorrow.
Have a good day!
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Avatar universal
The fatigue you are experiencing is likely not related to the Bi-V ICD implant, and if the device is working appropriately by interrogation that is reassuring. However, it would be worth evaluating your cardiac function by echo again now post-implant if it hasn't been done previously, to ensure that the pacing function hasn't made your heart pump less (lowered your ejection fraction), which is rare but not impossible.

With nonischemic cardiomyopathy (NICM), lower blood pressure is sometimes better, especially with ejection fraction below 25%, like your pressure of 90/65. Increasing the lisinopril will give further blood pressure reduction. You won't need to change your sodium intake based on this increase in lisinopril. But you will need to have your basic metabolic panel (BMP) checked after a week of the increased dose to ensure that there was change in your kidney function.
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