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Old 09-24-2006, 03:39 PM   #1
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aloha43 HB User
Sinus Bradycardia

Hello,

For approx 2 months now, my husband has been experiencing fatigue & lightheadedness, off and on, usually bad for 4-5 days, then feels better for a few days, etc.

The Cholesterol and Triglycerides were extremely high...
HDL: 34 LDL: 280 Triglycerides: 586 Ratio: 8.4
Thyroid: OK
Diabetes: No
Potassium: OK
Lyme disease: Negative

After a month of a complete change of diet....no alcohol...Low fat...very low Cholesterol & Omacor fish tabs, he was tested again....
HDL: 29 LDL: 208 Triglycerides: 250 Ratio: 7.0

Then the heart tests....
EKG: slow heart rhythm
Echo: All good except right side slight enlargement-cardiologist says within normal range.
Stress: Bradycardia

His cardiologist/electrophysiologist has come to the conclusion that the Sinus Bradycardia (Sick Sinus Syndrome)is causing the symptoms. We just don't know what is causing the slow rhythm.

The cardiologist said that since he is symptomatic, and sure that the symptoms are coinciding with the slow heartbeat, that he is a candidate for a pacemaker.

My question is.....Does anyone have any ideas as to what might cause Sinus Bradycardia other than what was tested for?

A pacemaker is a big, scary thing, and we don't want to jump into it unless we're totally sure that this is the only option.

Thanks a bunch,

Debbie

 
Old 09-24-2006, 03:45 PM   #2
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Re: Sinus Bradycardia

I forgot to add that my husband is only 46, doesn't smoke, and gets good excercise at work and an excercise bike. Seems quite young for a pacemaker.

 
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Old 09-25-2006, 06:59 AM   #3
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Re: Sinus Bradycardia

What is your husbands resting heart rate? I recenlty had a echo stress and cardiogram conducted. I was told it was all fine. I requested copies of the report for my records and interestingly read on one of the pre treadmill test that I had an abnormal ECG with possible bradycardia and irregular heart rythms. Obviously, the cardiologist didn't seem to think it was anything to worry about since they never called me on it and said this was an issue. I will be calling my cardiologist on this. You would think they would at least tell you of some things that were abnormal, even if they aren't a serious issue (or did they miss something?) I do notice quite a few instances where my heart feels like it skips a beat. Then, THUMP..it's back to it's normal beat again. I've been checking my pulse in the mornings when I wake and it is usually between 56-60 bpms. Which I hear is bradycardia.

 
Old 09-25-2006, 03:52 PM   #4
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Re: Sinus Bradycardia

Normally my husbands resting heart rate has ALWAYS been about 60. Now it is on average 45, and has gotten as low as 36 a few times, and as high as 55.

When it reaches the 50's he feels pretty good, almost normal. But when he gets anywhere into the 40's, it takes all he can do to get off the couch without being lightheaded.

 
Old 09-25-2006, 04:22 PM   #5
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Re: Sinus Bradycardia

To add to the recent questions.....my husband has also been experiencing weird spasm-like feelings in his arms. For instance, while taking his pulse, his hand starts to shake.

Could this be a symptom of something else that might be going on that could be causing the bradycardia? I need help asap, as he does not want to get a pacemaker if it isn't needed.

Thanks again,

Debbie

 
Old 09-25-2006, 05:30 PM   #6
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Re: Sinus Bradycardia

Hi Debbie,

The problem could be idiopathic (cause unknown) or the result of long-term medication (apparently that can be ruled out). The sinus node is malfunctioning and the condition is progressive if it is SSS. There are some serious complications when advanced such as atrial fibrallation, a very slow hr can cause thromboembolic (clots) events, heart failure...

Although it would be comforting to know the cause, the issue is whether there is an indication for permanent pace-maker implantation. There have been very could results with a pace-maker.

From what I understand, the criteria for an implantation are whether or not there are symptoms and the degree of bradycardia. It is recommended if the hr is less than 40 bpm with significant symptoms, or if minimally symptomatic with less than 30 bpm.

Sorry for the circumstances.

 
Old 09-26-2006, 07:55 AM   #7
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Re: Sinus Bradycardia

Dear Debbie,
I know what you are going through..... a pacemaker is a "big scarey thing".
I actually just got off the phone with the Dr.........my 13yr old daugther is now scheduled for pacemaker surgery in late October.
This has been one of the hardest choices we have ever had to make, but this has been an on going problem for years now.
My daugther has had 3 open heart surgeries and has heart block due to her 1st surgery.She has thrived for 13 yrs, but in the last year or 2, she has had symptoms of lightheadedness,dizziness, but the worst symptom is the SOB.
She was hospitalized 2wks ago,as she couldn't catch her breath.That night I stared at the heart monitor............hence our decision was made.
I am more worried about the actual surgery than having the pacemaker for life.
Good luck in your decisions.......I can only imagine what it is like for your husband and my daugther.....they are my heros!!!
Kelly

 
Old 10-16-2006, 07:35 AM   #8
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Re: Sinus Bradycardia

To update on my husband's condition......ALL tests (IE: Liver, Kidney, Thyroid, lyme, anemia, echo, ekg, stress, holter, etc.) came back OK.

He is still feeling fatigue, lightheaded, etc. and the Doctors is unsure of what to do next.

At first, the slower the pulse, the worse he'd feel...now after time, he sometimes feels bad at higher pulse rate, and better with lower rate. This is so confusing.

He feels way better after eating....I don't know if this is a sign of anything.

Last week, the Dr completely took him off his high blood pressure meds (Monopril & Hydrochlorothiazide) and gave him Provigil to take for a week. This med is for sleep disorders. Basically, the meds are "wiring" him up, and raising his pulse off and on. The blood pressure still seems to be ok....considering he completely changed his eating habits and quit drinking, they probably should have lowered it anyway.

Any other ideas from anyone, would be greatly appreciated. This doesn't seem to be "just" sinus bradycardia since his symptoms are changing. but maybe we are wrong......

Help! He doesn't want to go the pacemaker route, unless absolutely sure.

Thanks,

Debbie

 
Old 10-21-2006, 09:01 PM   #9
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Re: Sinus Bradycardia

Hi Debbie,

Sorry to hear about your husband. Hope he's hanging in there okay mentally!

I can't offer much information but wanted to let you know I'm in a similar situation. I'm 43, female and was totally healthy until a year ago. I started having these bradycardia episodes for a few days to a week at a time. I feel tired and weak when I have them and it's quite scary. My cardiologist said my stress test was fine and my echo was fine...so I was fine. I told him I wasnt' fine and that they just didn't catch it. We moved, and I have a new doctor. When I was feeling bad, I walked into his office and he did an ECG. HR was 41 and I was talking and nervous. He said he believes me something is wrong. I wore a halter for 3 weeks and they caught many brady moments. Plus, they caught a SVT moment - a run of 5. Now they are sending me to an Electro doc in a couple days and hopefully she will be able to make me feel better. I'm tired of feeling this way (weak, lethargic) off and on and I'm really tired of being afraid to go to sleep. I always wonder if my heart is going to stop at night since my hr goes so low when I'm relaxed.

By the way, they have no idea why my heart is having these issues. It came on all of a sudden and my ECG is normal otherwise. The only explanation they have mentioned is damage to my vagal nerve. You might want to ask about that. I do have severe costochondritis from a yet to be identified autoimmune arthritis disease, and perhaps the swelling from that pushes on my vagal nerve? I have no idea - just speculating.

Anyway, I'm in a similar boat, scared of the pace maker that the docs are already telling me I need, and wanting to find a reason for this problem before they do that...hopefully to avoid the Pacemaker. Your husband is not alone. He's probably scared but as a guy, probably doesn't show it much. Trust me, it's scary - especially at night. You are so sweet to get on these boards and try to help him. You're a good wife and friend!

I'll try to check back in here to see what comes of his appointments and update you on mine. Maybe we can help each other.

Take care,
Jeanette

Last edited by Sunshine008; 10-21-2006 at 09:04 PM.

 
Old 10-22-2006, 06:07 AM   #10
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Re: Sinus Bradycardia

aloha,

I think the pacemaker might be moving forward (or backwards) a bit too fast.
First off, his blood lipids are horrible and indicative of "metabolic syndrome"...extremetly high triglycerides coupled with miserably low HDL. Doess he carry much of his weight in his belly?

Is his cardiologist SURE he isn't suffereing from heart disease?
You said he passed his stress and echo. It is extremely important that the stress test was a NUCLEAR test to check for ischemia (poor blood flow generally caused by coronary blockages.)
Heart disease is the USUAL cause of sick sinus syndrome.


Bradycardia is common in athletes. Does or did his exercise rise to that level?

I would keep the pacemaker as my Ace-in-the-Hole and get him on statins to get his blood lipids more into line...probably with niacin to boot for the low HDL.

An angiogram, although it may be an extra procedure, might also be wise expecially if there is any doubt about the NUCLEAR stress test results.

What is the maximum sustained rate that he can get with an extended aerobic workout?

 
Old 10-24-2006, 06:57 AM   #11
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Sunshine008 HB User
Re: Sinus Bradycardia

Debbie -

Forgot to mention...my hands shake when I squeeze things with my fingers, too...like when I'm taking my pulse. It's a rhythmic shake - like clonus (sp?). It happens more some days than others, but somehow it's related. Docs just don't know how or what yet. They've ruled out MS and the like.

Best wishes for your husband.

J

Last edited by Sunshine008; 10-24-2006 at 07:02 AM.

 
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