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2nd degree heartblock, slow rate at night


Hi to everyone here....this is my first post......getting anxious as I am about to have a pacemaker implanted next week, but feel great and always have!

I am nearly 52 and 22 years ago halfway through pregnancy I felt faint (that day was the one and only time though!) and I had irregular heartbeat. But they never gave me any treatment and tests after my baby was born showed I had 2nd degree heartblock type 1 (London professor wasn't concerned as I was asymptomatic).

Over the years I would sometimes get irregular heartbeat either with anxiety (and tight chest) or occasionally after eating, or all those together!

A few months ago I had what I now think to be a bad case of anxiety for 10 days but went to doctor anyhow.

They think my heart has got 'worse' and tests showed some Wenckebach (but thats still type 1 second degree heartblock!) but my heart rate at night is about 33bpm (it's always been about 60bpm during the day). I am still asymptomatic.

* I still need to ask why the hurry for a pacer?
* Am I close to possibly feeling faint or blacking out?
* Wouldn't feeling tired come first though?
* How long could I have been so 'slow' at night?
* Are they sure it could get worse in the very near future (if at all) and would 'worse' mean 2nd degree type 2, or third degree?
* When my heart is irregular (for me I feel it's due to anxiety and/or after eating) is this of any importance or something that's harmless? 

Has anyone any experience of similar heart problems?

Re the pacemaker, my main concern (apart from lung puncture, heart bleeding, blood clots...) is infection!!!

Best regards from Julie
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Avatar universal
Hi Julie,

I will try and answer some of your questions however I  am, a patient, not a doctor.

1) I still need to ask why the hurry for a pacer?  That is a great Q for your dr and remember, if you feel uncomfortable with the decision do seek another opinion.  My assumption is that the concern is with your HR dropping to 33 bpm during the night.  This is a very low rate and If HR drops too low or is low for a long time then oxygen delivery to organs is reduced which could cause problems.

2) Am I Close to feeling faint or blacking out?  "Most" people don't start having symptoms from a low HR until it gets below 50 and you say our resting HR is 60.  When heart block is occurring, blood pressure tends to drop so depending on what your BP is during the episodes would determine the answer to this q.

3) wouldn't feeling tired come first?  Not necessarily.  Some people feel tired, others feel dizzy, etc.

4) how long could I have been slow at night?  Impossible to answer but if you noticed worsening of symptoms during the day, that "may" have been when things got worse at night too.

5) are they sure it could get worse during the near future?  Only your dr can answer this  based on your medical history.  Again, if you have any concerns bring these up with your dr or seek a second opinion.  "if" your HB progressed you would need a pacer but it sounds like your symptoms now are concerning enough that a pacer is needed.

6) when my heart is irregular is this if importance?  Yes, this could signify a HB episode but you might be having ectopic beats - the only way to know would be to capture on a monitor.

Did your dr say what caused your HB?

7) has anyone experienced any similar heart problems?  Yes!  I am 37 and was diagnosed with second degree HB type 1 earlier this year after experiencing palpations for almost 20 years.  When I have episodes of HB, during the day, my heart rate slows to about 50 and BP drops and I feel very uneasy and sometimes dizzy and can feel the regular pattern of the irregular beats.  I was told my HB is caused by a strong vagal tone and it tends to kick in a few hours after drinking caffeine, when I haven't eaten in awhile, and after strenuous activities.  My average heart rate at night is 45. Based on my symptoms, my EP told me that I didn't need treatment and a follow up for this condition would only be needed if my symptoms got worse or occurred  during exercise.

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Avatar universal
Thanks for your useful words....and I had the pacemaker implanted 3 days ago!

I am just glad I have it BEFORE I ever felt tired or faint or worse!

It's not good you feel dizzy but at least you know what you've got and hopefully it will never get worse.

Maybe I have had first degree heartblock all my life (as my adult heart rate has always been on thd low side at about 60bpm) then halfway through my pregnancy 22 years ago when I was 29 I felt a bit faint (the one and only time) and my heart was irregular. I had caesarean under general, so docs could be in control, I even went in the scary 3rd degree full heart block on delivery day! But I got slowly better.

Long story short, I have felt fine ever since but was found to have 2nd degree heart block (benign type 1).

I have heart irregularities now and then, sometimes after eating, with burping too which is annoying and brings my average heart rate down (I think maybe anxiety can do this too?)

Then recently I had all that continually for 10 days but even though I thought it was due to anxiety I was glad I got checked out as that's when I found my heart had got 'worse' and was sometimes going slow at night, even down to 27bpm!

It's not good you feel dizzy but at least you know what you've got and hopefully it will never get worse. But if you have any fainting or odd irregular beats you can have a 24hr monitor and get checked out again.

I hear so many stories of people who have been fainting regularly for years before its found to be caused by too slow heart rate! Someone even blacked out at wheel of his car and his wife steered them to safety!

Anyway, all the best to you (and the lovely baby - I am a postnatal doula helping mums and new babies!)

Best regards, Julie
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