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Pace Maker


JAQUIROUIN
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Lopressor (metoprolol) is a beta blocker. It's the same active agent as in Toprol-XL. The purpose of the beta blocker in the management of POTS is to slow down the racing heartbeat. A pacemaker could also slow down your heartbeat. But before you can make an informed decision about what to do, you need a lot more information.

Do you have POTS, or do you have something else? The three most important steps in managing any illness are diagnosis, diagnosis, and diagnosis. Have you had a tilt-table test? If you do have POTS, have you tried all of the "conservative" (i.e., nonprescription) measures first? Salt and water loading, pressure stockings, vitamin supplements, etc.? They help enormously. Have you tried fludrocortisone and midodrine (which are prescription drugs)? These things are far cheaper and less of a hassle than a pacemaker. Plus, a pacemaker has to be implanted surgically. Ouch!

My doctors have been of the opinion that my fast heartbeat is physiologic--that my heart is compensating for hypovolemia and beating really fast to keep adequate amounts of blood going to my brain. If we expand my blood volume enough, the heart will slow down on its own--without starving my brain of oxygen.

I've known people who have gotten a lot of benefit from pacemakers, but they didn't have POTS. I don't know of anyone with POTS who has gotten benefit from a pacemaker. I guess it all comes down to what your diagnosis is.

Best of luck

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I agree with lthomas. I think pacemakers are more common for NCS, another form of dysautonomia, than for POTS. In NCS, the heart may stop or be too slow. In POTS our main problem is that our hearts beat too fast. Although it can help with both, I think the pacemaker helps more with the slow/stopping heart.

There are also some people with POTS who have a pacemaker because they had a failed ablation. Other than that I think it is pretty rare. Unless your doctor is telling you that a pacemaker is required, I would definitely try all of the medical options first. If your beta blocker is not working for you, you could try a different one or a different type of medicine.

You may find some more useful info on this topic if you do a search on the forum -- it has come up before.

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Hello, I just wanted to give you my option. I have a pacemaker, and I would do anything to go back and not had my 1st ablation. Due to my 2nd ablation they needed to but a pacemaker in. In fact I am going back on April 27, and the are talking about a new pacer, and to go in and clean up scare tissue in my heart. To top it off I have felt worse since we started all of this. I would get all the options, and make sure you have tired everything before you try a pacer if you have POTS. I am not trying to scare you, I just am giving you my option, if I could change things I would.

I wish you the best of luck.

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Proceed with caution: re: pacemaker.

I have NCS and have heard "pacemaker" twice from two different cardiologists, so I understand in my case, it may really be warranted. I have low BP, and a slow HR, naturally so. I inherited this from my father, as well as arrythmias -- bradycardia, in particular. In my particular case, the cardiologists theorize that if all 3 occur together, ie. BP is low, HR is slow, and the arrythmia kicks in, I bottom out. This seems to be a "classic" dx for a pacemaker; however, everything I read -- even from the "experts" -- contends pacemaker therapy, even for NCS, is hit-or-miss and studies have been inconclusive. Some benefit from one; others don't.

I have heard from more people who, initially benefitted from the implant of a pacemaker, but later still needed medication(s) and were pretty much in the same boat when it came to trying to stay off the floor. I am hesitant to pursue a pacemaker, myself, as long as there are other options.

I also understand pacemakers accomplish nothing for POTS patients, so I might question why a cardiologist suggested one for you, if a cardiologist indicated it might help you. Leaving yourself as many options for treatment may prove more prudent.

I'm sorry this may not be what you wanted to hear, but I would encourage you to make an informed decision. All of these dysautonomias are perplexing and frustrating, but I don't think you'd want to do something now that won't work for you down the road.

Good luck.

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Guest Belinda

Someone with viable experience told me that if a pacemaker was an option for me or something that was insisted upon..I had ablation in 2001. To make sure that I have a rreputable cardiac thoracic surgeon put it in otherwsise you have to deal with scar tissue and other issues also. Also pacers aren't meant to be put in younger patients which enhances the theory of having difficulty with scar tissue formation.

Good Luck..Belinda

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Of course I don't know your whole medical history but if you are going to have a pace maker put in only for the POTS, then I personally would NOT do it. I have talked to numerous cardiologists and they do not think is it a good treatment for POTS, well at least for me. My PCP has an older patient with POTS and she had a pace maker put in a while back and her POTS is alot worse off and harder to treat now....Just make sure you get a second opinion or a third, etc. until you belive you have sufficient info to go on.

Goodluck!

Jacquie

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I have a pacer to correct the bradycardia that I developed after a sinus node ablation. At that time, I had both bradycardia and tachycardia. A Pacemaker cannot help with tachycardia. It does help correct a slow or irregular heart beat. I had gotten "pauses" due to the ablation. Whatever you do, don't get an ablation if you have POTS!

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I have a pacemaker but it's not for the treatment of POTS. It was for NCS and the extreme bradycardia I get.

I have both NCS & POTS and the pacemaker has helped eliminate some episodes of syncope however, I still have syncope due to bp drops and I still have horrendous tachycardia.

The other thing most EP cardiologists will tell you is that having the pacemaker is no guarantee that you will be able to get off the beta blockers. Our bodies are all different and some people can get off of them and some cannot.

I was able to get off all meds after implantation of pacemaker but then about 5 yrs. later I had to start back on the bb's.

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