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Could Cough And Breathlessness Be Associated With Pacemaker Syndrome?
Question: Recently had dual lead pacemaker implanted for slow HR in 40s and sick sinus syndrome. Atrial lead screw penetrated wall of heart, causing severe pn just to right of spine as soon as I came out of anesthesia and continuing. This was not recognized as a potential problem. Echo showed effusion around heart which pn was ascribed to. Second echo next day showed small amount of fluids around heart, so was discharged from heart hospital with pn meds (vicodin). After one night at home, pn on right side so bad, called 911 after consulting heart hospital I was discharged from. Taken to nearest Medical Center to evaluation. CT
showed 3d imaging of atrial lead penetrating heart wall. Pn presumably caused by screw tip protruding from heart wall poking into pericardium with each heart beat. Waited 5 days for original surgeon to reposition atrial lead. Pn stopped as soon as out of anesthesia. Surgeon found no need to replace atrial lead and repositioned it with same lead and screw. Monitored in hospital
overnight with interrogations of Medtronics pacemaker ("the Bently" of pacemakers), with reports of normal functioning.. Sent home the next day. Shortness of breath and coughing ensued. Could not walk across moderate sized room without severe shortness of breath and severe deep coughing. Had appointment the next week with implanting surgeon. I complained about increasing shortness of breath and coughing. This was disregarded as " not our problem, but your lungs" with the surgeon ordering a "partial" ECHO and a pulmonology function test in a separate part of the medical center with results to be called to us. These are scheduled but not yet done.
I am concerned that these symptoms might represent Sick Sinus Syndrome after pacemaker implantation that is not being recognized or at least seriously considered my my surgeon. From what I read this might be fixable by fine tuning of pacemaker atrial and ventical firing patterns to synchronize them for optimal functioning. The interrogation in the doctor's office showed the pacemaker found a XXXXXXX of 15.1 PVCs/hr and "some Afib of six min., 14 seconds as the longest on the pervious day. I said that was the first time I had been told I had any fib at any time. The surgeon said that afib was serious and could strokes and would have to be monitored. From what I have read, could these symptoms--shortness of breath, cough, and new development of afib all be symptoms of Pacemaker Syndrome--a well known and potentially dangerous condition that needs prompt diagnosis and effective treatment via fine tuning atrial and ventricle synchronization to optimize heart output? If this is Pacemaker Syndrome, I need my surgeon (electrophysiologist) to immediately recognize and promptly treat it before I get any worse or develop any other complications. Thank your for your expertise and kind response.
showed 3d imaging of atrial lead penetrating heart wall. Pn presumably caused by screw tip protruding from heart wall poking into pericardium with each heart beat. Waited 5 days for original surgeon to reposition atrial lead. Pn stopped as soon as out of anesthesia. Surgeon found no need to replace atrial lead and repositioned it with same lead and screw. Monitored in hospital
overnight with interrogations of Medtronics pacemaker ("the Bently" of pacemakers), with reports of normal functioning.. Sent home the next day. Shortness of breath and coughing ensued. Could not walk across moderate sized room without severe shortness of breath and severe deep coughing. Had appointment the next week with implanting surgeon. I complained about increasing shortness of breath and coughing. This was disregarded as " not our problem, but your lungs" with the surgeon ordering a "partial" ECHO and a pulmonology function test in a separate part of the medical center with results to be called to us. These are scheduled but not yet done.
I am concerned that these symptoms might represent Sick Sinus Syndrome after pacemaker implantation that is not being recognized or at least seriously considered my my surgeon. From what I read this might be fixable by fine tuning of pacemaker atrial and ventical firing patterns to synchronize them for optimal functioning. The interrogation in the doctor's office showed the pacemaker found a XXXXXXX of 15.1 PVCs/hr and "some Afib of six min., 14 seconds as the longest on the pervious day. I said that was the first time I had been told I had any fib at any time. The surgeon said that afib was serious and could strokes and would have to be monitored. From what I have read, could these symptoms--shortness of breath, cough, and new development of afib all be symptoms of Pacemaker Syndrome--a well known and potentially dangerous condition that needs prompt diagnosis and effective treatment via fine tuning atrial and ventricle synchronization to optimize heart output? If this is Pacemaker Syndrome, I need my surgeon (electrophysiologist) to immediately recognize and promptly treat it before I get any worse or develop any other complications. Thank your for your expertise and kind response.
Brief Answer:
Can be a pacemaker syndrome
Detailed Answer:
Hello,
There can be multiple causes including cardiac and non cardiac. Cough, shortness of breath are very nonspecific and may occur due to respiratory causes as well. Due to having any fever, cough with expectoration, just to consider the possibility of lower respiratory tract infection.
And in cardiac causes, it can be a pacemaker syndrome, can occur due to a fib and vpcs. So pacemaker interrogation should be done which will clarify the picture. You may request company representative for interrogation. Do you have also have neck pounding or prominent neck pulsations, which may additionally support pacemaker syndrome. And usually, this is not a life threatening condition, but troublesome.
I guess your ejection fraction was normal, and was there any echo done after Shortness of breath ensued to look for pericardial effusion. Also, get your bp and pulse rate checked once.
Hope this helps you and get back if you have any doubts.
Can be a pacemaker syndrome
Detailed Answer:
Hello,
There can be multiple causes including cardiac and non cardiac. Cough, shortness of breath are very nonspecific and may occur due to respiratory causes as well. Due to having any fever, cough with expectoration, just to consider the possibility of lower respiratory tract infection.
And in cardiac causes, it can be a pacemaker syndrome, can occur due to a fib and vpcs. So pacemaker interrogation should be done which will clarify the picture. You may request company representative for interrogation. Do you have also have neck pounding or prominent neck pulsations, which may additionally support pacemaker syndrome. And usually, this is not a life threatening condition, but troublesome.
I guess your ejection fraction was normal, and was there any echo done after Shortness of breath ensued to look for pericardial effusion. Also, get your bp and pulse rate checked once.
Hope this helps you and get back if you have any doubts.
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Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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