I had a pacemaker implanted on July 4th, and now I am questioning if I
really needed it. I am an American expat living in France, and
because of the language difficulties, I really don't comprehend what
the cardiologist told me.
Breifly, I am a 51 year old male with a history of coronary artery
disease, and variant angina caused by vasospasms. I had a stent in
the right coronary artery in August 2002, and due to restenosis, I had
2 new stents (one in the right and the other in the left coronary
artery) in May 2003. After the 2nd stent procedure, I began to have
some strange palipations. They always began in the morning and lasted
anywhere from 2 to 3 hours nonstop. It felt like someone came up
behind me and frightened me. During these palpitations, my BP
readings were, on average, 93/63 with a pulse rate in the 60s.
My doctor put me on atenolol 25mg, and when the palpations did not
stop, he increased it to 50mg. (I also take Cardizem 240mg, Imdur
60mg, and Plavix). On my 4th day at this dosage, while walking down
the street, I felt horrible palpatations and was extremely dizzy. I
leaned against a building, then passed out. I must of hit the
pavement hard, because my face was a mess. In the ambulance, my EKG
readings showed a heart rate in the low 30s and they gave me IVs to
stabilize me.
At the hospital, outside of 1 EKG, the cardiologist at the hospital
did not even examine me. He informed he that I had sinus node
dysfunction and needed a pacemaker. I asked if my problem was perhaps
not caused by induced bradycardia from the atenolol plus the cardizem.
He said that the atenolol only exposed the problem, but did not cause
it. That sounds so strange to me.
Ironically, I had taken the Holter test a few weeks before. At the
time that this test was taken, I was not experiencing any palipations.
The reason for this test was due to chest discomfort and numerous
episodes of PCV or 'dropping" sensations while at rest. Neither the
cardiologist at the hospital nor myself had seen the results. I
finally got the results today which were "absence of trouble in
ventriculaire rhythm; absence of significant modification in the ST
segment; number of episodes of bradycardia 'sinusale' of no major
significance.
Well, I have a pacemaker now and I am absolutely unsure if I really
have sinus node dysfunction or drug induced bradycardia. And was the
emergency cardiologist correct in that the atenol only exposed the
problem and did not cause it? Or was I just fed a line? Any thoughts
or comments most welcome.
Thanks