The patient exhibited symptoms of pacemaker syndrome, including fatigue, lightheadedness, and exertional dyspnea. Ab = atrial sensed event in postventricular blanking period, AR = atrial sensed event in postventricular refractory period; VS – Ventricular sensed event.
Pacemaker syndrome without pacemaker participation. Displayed are stored data from a dual-chamber pacemaker. The last condition may be unnecessary, and it helps blur the distinction between definition of syndrome and elucidation of cause.
Most people stay overnight in the hospital after they have a pacemaker implanted. But sometimes the surgery is done as an outpatient procedure, which means you do not need to stay overnight in the hospital.
Most people return to normal activities after a few weeks. The procedure to implant a pacemaker is safe, and most people do well afterward.
The combination of decreased cardiac output, loss of atrial contribution to ventricular filling, loss of TPR response, and nonphysiologic pressure waves contributes to symptoms collectively known as pacemaker syndrome.The pacemaker does not treat atrial fibrillation itself.The pacemaker is used to treat a slow heart rate (bradycardia) that happens in some people who have atrial fibrillation. All new pacemakers are rate-response, or physiologic, pacemakers.For several weeks after having a pacemaker implanted, avoid driving or doing vigorous physical activity that involves the upper body. You will see your doctor regularly to check your pacemaker and make sure you don't have any problems. If problems happen during the procedure, doctors can likely fix them right away. Problems after the procedure can be minor, like mild pain, or serious, like an infection. And most people do not have long-term issues with their pacemakers.Some activities and situations can interrupt the signals sent by the pacemaker to the heart. Follow your doctor's specific instructions about care and precautions. Problems include: In rare cases, people feel throbbing in the neck, chest fullness, or lightheadedness when the pacemaker sends out impulses.
Single vs double chamber pacemaker
A recall means that the pacemaker has a problem that needs to be watched closely or fixed.Although pacemakers provide relief from life-threatening arrhythmias and can improve quality of life significantly, they also can function in a nonphysiologic manner, which is accompanied by nontrivial morbidity.Furman redefined pacemaker syndrome in a 1994 editorial in which he included the following elements Ellenbogen and colleagues focused on clinical utility and proposed that "pacemaker syndrome represents the clinical consequences of AV dyssynchrony or suboptimal AV synchrony, regardless of the pacing mode." Recently, most authors have recognized that pacemaker syndrome, which initially was described in patients with ventricular pacemakers, is related to nonphysiologic timing of atrial and ventricular contractions, which may occur in a variety of pacing modes.Some have proposed renaming the syndrome "AV dyssynchrony syndrome," which more specifically reflects the mechanism responsible for symptom production.Several large trials have focused on pacing mode in the setting of sinus node dysfunction as a mechanism of symptom production.
Estimates of atrial contribution to cardiac output vary from 15-25% in healthy hearts at rest.However, in cases of decreased ventricular compliance, atrial "kick" may contribute as much as 50% to cardiac output.Causes of decreased ventricular compliance include diseases such as hypertensive cardiomyopathy, hypertrophic cardiomyopathy, and restrictive cardiomyopathies, and it also occurs in some elderly patients.They can sense when your activity increases and respond by increasing your heart rate.Rate-responsive pacemakers are often the ideal choice for active people.