Is a pacemaker required to deal with syncope episodes?
Patient: I was diagnosed with post-partum cardiomyopathy in May of 2011 with an ejection fracture of 30%.. In January my ejection fracture went back to normal 60% with metoprolol.. Starting in Feb started to feel dizzy and weak, having near syncope episodes. I've been in all kind of holter monitors and none of them really picked up anything besides my heart rate being really high or really low. ( also my blood pressure likes to hang out around the 80's) On the 26th of April,2012 i got an implanted Loop Monitor.  I had a near syncope episode on the 28th and just took note of it. Yesterday May 3,2012 I went for a regular scheduled appointed to download the DATA off the monitor and the Tech saw that my heart had stopped twice, one being 11 seconds and the other one 18 seconds long. This happened around the time that I had the near syncope episode.  My cardiologist scheduled me for a pacemaker implant that same day.  However, right before I got to the hospital my cardiologist called me and told me that he would like to wait on the pacemaker.  I dont know why he would want to wait when they have record that my heart had stopped for 18 seconds. It is still puzzling me and it is really frustrating. I am 24 years old, Do you Doc's have any idea of what might have changed his mind? Doctor: Hello ,Now considering that there was a pause for so long , without doubt It's an indication of pacemaker . Now because As you said that the function have returned to normal , Generally there should not be such episodes . One thing that explains is ongoing inflammation of the heart muscle , but its temporary and may settle down by itself . Lastly I would just like to point out , trust me at 24 years of age if we can avoid a pacemaker it's best , because it stays with you for life and requires care . However if still in future there is evidence of such pauses , it would be safer to put a defibrillator. Let me know if any clarification needed . Regards Dr Priyank Mody