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Pacemaker & Bradycardia
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sue664 posted:
My roommate is not yet 40 and has had to have 3 stints in the last year. Now the Cardiaologists are saying that he needs a pacemaker and most likely was born with Bradycardia. What exactly is Bradycardia and are we looking at a not so good prognosis for his future? Isn't he somewhat young to be needing a pacemaker and what if the pacemaker does not have the expected result? What is the next step?
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BillH99 responded:
Bradycardia just means a heart rate of less than 60. That in itself is not a problem.

The problem is when it is not beat fast enough to keep up with demand.

Here is some information on the causes and treatment.

http://www.mayoclinic.com/health/bradycardia/DS00947

http://www.webmd.com/heart-disease/tc/bradycardia-slow-heart-rate-overview
 
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James Beckerman, MD, FACC responded:
Bradycardia means a low heart rate, usually less than 60 beats per minute.

A pacemaker can be recommended when bradycardia is symptomatic, or if there is another underlying electrical problem with the heart that increases the risk of the heart slowing even more or even stopping. Pacemakers work very well in general because they sense the heart beating (or not) and then provide an electrical stimulus to make the heart beat if it isn't producing its own heart beat.
 
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An_193072 replied to James Beckerman, MD, FACC's response:
Dear Dr. Beckerman, My mother is 73 years old, and had a pacemaker placed 2 years ago at the, Mayo Clinic. She is doctoring in her home town now. They are having trouble contoling her comidon levels, it has been 2 weeks now, and still do not have the levels controled. Is this unusual to have it take so long to adjust her levels?
 
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sue664 replied to James Beckerman, MD, FACC's response:
Thanks for your reply. One more question. How does all of this associate with the stints and I forgot to mention that my friend has had two heart attacks this past year. Can we possibly look forward to my friend having a long and somewhat healthy life if the pacemaker and his new medication, Coreg, do what they are supposed to do? I realize that I am asking you to look into a crystal ball, but surely you have an educated guess?
 
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James Beckerman, MD, FACC replied to An_193072's response:
It can definitely be difficult sometimes to find the exact right dosing of coumadin for some people. This sometimes happens after a recent hospitalization, or when there are changes in diet or even other medical conditions. It's a challenge with this medication. You may be familiar with the newer anticoagulant, Pradaxa, which is taken twice a day and does not require monitoring. It's more expensive for most people however.
 
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James Beckerman, MD, FACC replied to sue664's response:
I wish I had a crystal ball! There are lots of factors to consider when guessing about a prognosis - I wouldn't feel comfortable doing so without caring directly for your friend - I'm sorry!
 
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sue664 replied to James Beckerman, MD, FACC's response:
I can appreciate your hesitation on a prognosis for my friend. I guess we will expect the worst and hope for the best. Thanks for your time.


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