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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Dizziness With Tingling Sensation

In late July I was hospitalized after reporting to the ER with dizziness/faintness, tingling, etc. I was tested for Lyme and thoroughly screened for stroke (I am in my early 40 s, BMI of 22, healthy eater, relatively active...but not disciplined with daily exercise, non-smoker, weekly drinker of wine/beer while cooking or with dinner). I was admitted for observation to the cardiac unit and underwent EKG, Echocardiogram, MRI, chest x-ray, and connected to a heart monitor. ( I was injected with heparin and remained in bed during the two night stay.) All test were within normal range and I was schedule for discharge. When the nurse removed the IV from the back of my hand ( in the bed, laying upright) I experienced vasovegal syncope and asystole for 10.67 seconds (heart monitor was still in place to capture the event). Recovery took place without intervention beyond verbal & touch stimulation. I am prone to elevated feelings of anxiety with needles, heights, hospitals, medical stuff, ). After five more days in hospital waiting for surgeon to return from vacation, a dual lead pacemaker was implanted. Multiple post op complications occurred including pericarditis, a lead perforation and 7 weeks out infection of the surgical site due to a lack of wound check & surgical glue still in place allowing for bacteria to grow. A referral to an electro physiologist cardiologist took place at week 8 post op and at week 9 post op it was determined the pacemaker would be removed. The explant surgery happened in a day surgery and I have been home for 2 plus weeks without device. My current doctor s approach is one of assessment, with my increasing my fluid intake, adding salt to my diet (blood pressure now averaging 105/69) and wearing an event monitor to capture events. My anxiety is huge and I am just beginning CBT counseling to help. I have not returned to work or any normal routine as I fear experiencing an episode. Logically I know I fainted due to the IV being withdrawn, however experiencing the heart stop has me feeling a real lack of confidence. How common is vasovagal syncope with asystole heart response and was a pacemaker absolutely necessary? I only wish the second approach had come first, as the fear level would not be conditioned into my thought process.
Wed, 27 May 2015
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Cardiologist 's  Response
Hello,first of all let me congratulateyou for giving such excellent description of your history .I personally feel you had simple vasovagal syncope .regarding pacemaker implantation and its removal I can't give opinion on either side without seeing your ECGs and record of monitoring.
Interestingly you are fine without pace maker.
And now more or less you have anxiety.It is uncommon to have asystole in vaso vagal syncope,but it is known .This event is not indication of pace maker.
I would suggest to overcome fear and you should join your work.
You may get 48 hrs holter monitor and if that is normal ,go to your work with full confidence.
My best wishes.
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Suggest Treatment For Dizziness With Tingling Sensation

Hello,first of all let me congratulateyou for giving such excellent description of your history .I personally feel you had simple vasovagal syncope .regarding pacemaker implantation and its removal I can t give opinion on either side without seeing your ECGs and record of monitoring. Interestingly you are fine without pace maker. And now more or less you have anxiety.It is uncommon to have asystole in vaso vagal syncope,but it is known .This event is not indication of pace maker. I would suggest to overcome fear and you should join your work. You may get 48 hrs holter monitor and if that is normal ,go to your work with full confidence. My best wishes.