Heart stopped over 15 seconds during test

Question

Hi All,
I had the tilt table test after my cardiologist felt I needed some clarity for my problem.  I found that when going to the gym I was getting dizzy each session.  I wasn't over doing it, just regular exercise. I'm a runner and pretty fit but never got dizzy running.  I do get dizzy cycling or doing activity when off level (no straight up or laying down).
My heart test were all good as well as blood pressure.
When I had my test I passed out almost right away.  At that time, my heart stopped for more than 15 seconds.  When I was going to the gym, I would start to get dizzy then in between sets  I would see my heart rate monitor start climbing while I was resting (assuming thats to correct my dropping blood pressure at this point).  The cardiologist who did the test told me he thinks I should have a pace maker.  Any thoughts?
Anyone have similar diagnosis?

kr25 · Answer

Hi, 
I stumbled upon this thread after doing some research for my own purposes. I had the tilt table test done a couple days ago and my heart stopped for 20 seconds.
I am also a runner (since 2014) and have done three half marathons last year and was training for a full marathon this spring.
It was recommended that I get a PM as well. I am wondering if you decided to get one and how your experience has been.
I am 25 and rather nervous how this is going to affect me, and don't know what to expect, although I must do what is best for my health. Any advice is welcome.

ancasterguy · Answer

I have good blood pressure except when the vaso vagal kicks in.  Then it drops, heart rate goes up to compensate and then I get seriously dizzy.  It comes on with warning so far and I haven't actually passed out since I usually lose my vision (seeing black spots etc.) prior to passing out.  I stop what I'm doing and then after some time I start to feel better (usually makes me feel really sick).  I asked the cardiologist about salt and was told to load salt and that's it.  I guess since it's not causing me to drop suddenly they aren't as concerned.  I'll ask about the beta blockers though.  I drink gatorade all the time when I run to make sure I don't lower my salt during runs.

DodyRosy · Answer

I know a couple of people with vasal vagal syncope and they treat it with betablockers and increased salt intake. My son has postural orthostatic tachycardia syndrome which is similar. He has problems when he stands still or stands up quickly. It causes him to faint and was diagnosed with a tilt table but no heart pauses that we know of. I have orthostatic hypotension which is also similar. I have to drink gatorade all day to keep my blood pressure up and heart rate down. I have never heard of pauses related to these conditions but I have never really researched that. Good luck.

ancasterguy · Answer

No surgery, in fact I'm very fit (running half marathons). My heart tests (2 stress tests, sonograms etc.) all came out all very positive with the exception of the vasal vagal synscope problem and that's when the heart stopped briefly. If suggested by the cardiologist I think I'll get the pacemaker. I'm just a bit concerned about it interferring with my running although I'm told they adjust them for excercise.

DodyRosy · Answer

If your heart is in fact pausing and you didn't recently have heart surgery then you need a pacemaker. Do you have heart block? That's where you av node does not fire and send electrical signals to ventricles. Heart pausing can be very dangerous and 15 seconds is a long time and would cause strong symptoms I would think. I had pauses after heart surgery due to complete heart block (av node injury) and it was AWFUL. Had a temporary pacemaker or it could had been deadly.

ancasterguy · Answer

I remember them lowering me from the tilted position and talking around me then blanking out. I'm sure I had passed out before then. It was as if I was dreaming the whole thing. Very weird indeed. When I did wake up to their voices I remember thinking ..where am I.

GreatBird · Answer

I suppose it's possible for the probes to come lose, but there's no question that in my case my heart stopped. I was terribly sick afterwards. They hospitalized me. I was sick to my stomach, clammy all over, and couldn't raise my head for several hours, plus my whole digestion and elimination system was messed up for several days; my endocrine system shut down and gave me a several-month mini-menopause (not confirmed by a cardiologist but by an ob/gyn). It's amazing that in 23 seconds a body can start turning off systems so fast.

If you didn't feel really ill afterwards, then maybe your heart did not really stop? Def. worth looking into.

Oh--I also got the white light for a bit. It was very weird.

ancasterguy · Answer

The weird thing is also that now my internist friend says that I should get a second opinion. He said to have a heart rate monitor halter test done or a loop test for a couple days. He also said often in the tilt tests it's not unknow for the probes to come lose a little and then it shows no heart beat. I'm not sure if that happened as I definately remember them yanking them off well after I recovered from passing out.

GreatBird · Answer

That happened to me in 2000. I had a tilt table test and after 32 minutes my heart stopped for 23 seconds. My experience is that cardiologists find this alarming. :)

Mine practically insisted I get a pacemaker. Prior to this I had three (or four?) incidents of fainting in my whole life (I was 46 when I got the PM) going back to when I was 17. Unfortunately, the last two had been rather dramatic where I'd woken in the middle of the night feeling unwell, went into the bathroom and passed out on the floor. On one occasion I thwacked my noise on the way down and thought I might have broken it. 

I didn't want the pacemaker, but agreed to it. My electrocardiologist is one of the best on the west coast and I realized that my heart had probably stopped the last time I'd fainted (based on how awful I felt afterwords--just like after the tilt-table test).

So . . . I've had an on-demand pacemaker where they have an upper and lower threshhold set for nine years now and it hasn't been a big deal. No fainting during this time. A few uncomfortable vasovagal moments, but I'm better at managing them too (I lie down). I've never been certain that it was the right decision, but it surely wasn't the wrong decision. 

And the interesting thing is that when I go for  my checkups and ask, it turns out that the PM kicks in while I'm sleeping. Never during the day. Not even when I was in a car accident. 

Your situation seems a bit different because of what kicks in your dizziness and I'm not clear on whether you actually fainted. It wouldn't hurt to get a second opinion, but my guess is any heart doctor would want you to get a PM.

Jerry_NJ · Answer

Of course give the cardiologist recommendation all consideration, but as a PM is a big step, I think it worth a second opinion.  

If you heart has any tendency to stop, a PM may be the only way to be sure... I think they can install a PM that lets you heart run the "timing show" but if it stops the PM takes over.