Brachy & SVT's

I had pm insertion 13.06.07 everything fine then two weeks ago had a few light headed moments. This week have experienced almost fainting a few times,  yesterday started to black out but it stopped as I fell, feet and ankles very swollen I feel exhausted and very pale.  I did have a viral infection then bronchitis for the first 3 wks but still felt so much better than I had for a long while even so.  I have first check up on 27th will it just mean a "tweak" of the timer and I will be fine again or do you think something else is going on? I have 2nd Degree AV node block and right bundle branch block. My heart beat has been all over the place for the last 2/3 days I am so disappointed I thought I would be better straight away.

[Michael J. McWilliams, M.D.]

Hi Arabella,
Have you talked to your doctor?  I would advise my patient to got to the emergency room so we can figure out what is going on.  There are many things that could cause symptoms like this.  I would want to rule out pacemaker lead dislodgement, pacemaker syndrome and perforation from the lead causing a pericardial effusion.  The new leg swelling and near syncope concerns me. That is why I would check it now rather than waiting.  It could be unrelated to the pacemaker and if I was sure I knew your whole history that would be easier to assess.  From what you have said above I would want a chest xray, echocardiogram, and pacemaker device check today.

If you don't mind, please provide some follow up when you what is going on.  Thanks for the post.

[Arabella]

Hello Doc, I went to my GP on monday my bm was 220/140 and she did ecg and was concerned and said I should go to hosp and be admitted she rang the cardiac dept but they said as I was seeing tech on thursday to take it easy and go home. It was the bottom line on the ecg that caused most concern she did not actually say though what. I saw tech yesterday, I do feel much better now but have had lightheaded moments, he said I had been throwing quite a few extra heartbeats but could see nothing which would relate to the symptoms I experienced but next time go straight to hosp for ecg. He was not concerned so I suppose I just have to expect it to happen every now and then. I did have 1st dual pm insertion in Feb but the wire went throu skin of vein and wedged in heart it took 3 hrs to remove but 2cms broke off the end as it now lodged in my left cartoid artery I did experience problems with my arm but that has stopped now.  I still get an ache in left side of chest which is like a muscle cramp and goes around my back.  I feel like I have wasted everyones time.  I am so sorry to have wasted yours.  I will just get used to it sorry to have bothered  you.  Thanks you Arabella