I have been diagnosed with 3rd degree congenital heart block. I am 38, my heart rate avg is 45, went as low as 35 and can go as high as 109-120 when on a stress treadmill. I have no enlargement of the heart. I have never fainted, but I definitely feel fatigued, occasionally slightly dizzy, and have postural hypotension often. My ep is currently NOT recommending a pacemaker, but would put one in if I chose to anyway...and says he'd like to do echos yearly to watch me close. I have a great deal of respect for my ep and cardiology group...but feel troubled by this decision being placed in my lap - I would rather have had them choose for me. My concerns are mostly due to sudden cardiac death, since I am sort of asymptomatic and not uncomfortable on a daily basis. What is the percentage risk or likelihood of a stokes adams attack in someone like myself? Does that risk increase with age? Will a pacemaker completely eliminate death as a result of a SA attack? I realize that the pacemaker itself is a fairly simple procedure, however, as I am only 38, I will definitely need replacement leads over time, and the risk factor of lead removal surgery has me quite frightened. Most of the data available for CCHB is either old or hard to find. It seems that pacing is suggested in nearly every case especially with increasing age. These days when infants are born with this they are immediately paced...I seem to have been a "lucky" one with no other structural defects and a relatively reliable escape rate. Some data I have found that individuals can survive into their third decade without pacing...hello...I'm almost to my fourth!
I guess to finalize my question, here it is: should I get a pacemaker, and what are the risks with lead removal and how can I lessen that risk, and will getting the pacemaker shorten my lifespan (even with the prevention of SA)?
Thank you for any advice...