Apical wall hypokinesis

[kellylevicky]

I'm a 34 yr old female & I have a pacemaker for congenital complete heart block. I had it replaced for the first time 5 weeks ago. A recent echo showed severe hypokinesis of the apical wall. Ejection fraction is 50%. My dr said this could be due to wear my lead is at. I returned to work a 2 weeks ago after being off for a month after my surgery. I'm a prep cook & my job is pretty easy. I'm on my feet all day but I've been doing the same work for years. Ever since I returned I've been exhausted, I'm sleeping 12+ hours a day & still feel tired. I don't think this is a normal for a pacemaker  replacement surgery 5 weeks out.  Is it possible that even if my pacemaker lead is causing the hypokinesis in the apical wall that it is doing damage to my heart? Or could that be why I'm suddenly so tired? All of my blood work, including thyroid, is normal.  I'm  very frustrated with the fatigue I'm experiencing. Any info would be appreciated!

[Flycaster305]

It took me quite a while to get my pacer set right.  Most large hospitals also have Manufacturer reps who can make sure the pacer is working correctly and help the pacer docs correctly set it.  Don't be shy about contacting the manufacturer with any questions.  I had the same symptoms as you have.  

[ed34]

I wouldn't worry, tell your cardiologist because it may be that the pacemaker needs some adjustment. It could even have a fault. Your EF of 50% is fine because an echo is usually 10% out making your EF 55% which is perfectly normal.

[Ger57]

I dont know if the lead can cause such effects, but hypokinesis is sometimes reversible. It depends on whether heart cells are dead or hibernating. It of course negatively influences ejection fraction (depending on position in heart), which can make you feel tired. In time, things still can improve. I understand your frustration. I personally would try to keep exercising us much as possible to stimulate the heart function and overall condition and see if improvement sets in (give it time) and then perhaps get an echo at a later stage to check for improvement.