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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Do symptoms of an underlying SVT show up even after having the pacemaker implanted?

Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 6276 Questions

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Posted on Fri, 3 Aug 2018 in General Health
Question: MY ELDERLY MOTHER SUFFERED FROM SVT FOR YEARS AND WAS ON HIGH DOSES OF AMIODARONE. SHE WENT INTO 3RD DEGREE HEARTBLOCK AND HAD TO HAVE A PACEMAKER PUT IN. AT LAST CHECK HER UNDERLYING RHYTHM WAS NOW SR WITH 1 DEGREE BLOCK. SHE IS NO LONGER ON MEDICATION FOR SVT, ONLY HYPERTENSION. SHE HAS BEEN HAVING SUDDEN ONSET INTERMITTENT EPISODES OF EXTREME FATIGUE AND DIZZYNESS AND OCCASIONAL CHESTPAIN (NEW) WHICH IS RELIEVED WITH ONE SPRAY OF NITRO.
IF SHE IS HAVING EPISODES OF UNDERLYING SVT WOULD SHE BECOME SYMPTOMATIC WHILE HAVING A PACEMAKER.
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Answered by Dr. Ilir Sharka 51 minutes later
Brief Answer:
I would explain as folllows:

Detailed Answer:
Hello!

Welcome on HCM!

I passed carefully through your mother's medical history and would like to explain that an implanted pacemaker helps in maintaining an acceptable heart rate per minute when intrinsic heart impulses fail stimulating the contracting muscle, such as in the case of advanced heart block.

But a pacemaker could do nothing in the case of a SVT episode, it doesn't suppress or stop the arrhythmia and in general it is not capable of dealing with high rate arrhythmias.

So, even with an implanted pacemaker, she would experience the same symptoms during a potential SVT as if the pacemaker were off.

From the other side, considering her recent complaints (fatigue, dizziness and chest pain), I recommend discussing with her attending physician on the possibility of optimizing her ongoing therapy (including anti-ischemic drugs) as her clinical symptomatology is suggestive of cardiac ischemia.

Nitrates and potential vasodilators would be beneficial (in case no risk of hypotension is present).

Hope you will find this answer helpful!

In case of any further questions, feel free to ask me again.

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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