Features May 2019 Issue

Fainting as a Sign of Bradycardia

A pacemaker will give your heart the boost it needs.

We don't give the speed of our beating heart much thought unless it goes too fast or too slow. If your heart beats too slowly, you'll need a pacemaker. However, you may not know you have a slow rhythm-a condition called bradycardia-until you pass out.

"Fainting is often the first clue someone has bradycardia," says Cleveland Clinic cardiologist Bruce Wilkoff, MD.

Your episode may have come out of the blue, but some people experience unusual symptoms that they didn't think were serious. Perhaps you haven't felt well lately, or you felt lightheaded or dizzy when you stood up or exerted yourself.

"These are indications your heart isn't delivering enough oxygen and nutrients to your brain and organs," says Dr. Wilkoff. "You need a steady supply of freshly oxygenated blood to move, breathe and think."

A pacemaker can keep your heart beating at the rate it needs for you to function normally. These tiny, implantable computers are designed to prevent a heart from slowing down or stopping.

Why Your Heart Slows Down

ICD

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A pacemaker ensures the heart never beats slower than a predetermined rate. This prevents bradycardia—and fainting.

Most people who need pacemakers are over age 60. Their slow heart rate often is caused by a malfunction in one of the heart's electrical timers called the sinus node. This node, located in the upper right chamber of the heart, emits electrical pulses that keep the heart beating properly in what's known as sinus rhythm.

A healthy sinus node adjusts the heart rate so the heart pumps enough blood to maintain a normal blood pressure. This ensures that the body has a steady supply of glucose and oxygen. Scars from a heart attack or a malfunctioning sinus node can cause the heart to slow down or even stop for several minutes.

A problem with the atrioventricular (AV) node can also cause the heart to slow down. This node relays pulses from the sinus node to the heart's lower chambers (ventricles).

Pacemaker to the Rescue

Pacemakers take over the electrical signaling function and tell the heart when to beat. They are inserted under the skin in the chest near the shoulder. Wires (called leads) are run from the device to the heart muscle through the veins.

Most basic pacemakers are about the size of a tablespoon. Their batteries last seven to 10 years.

Pacemakers collect and transmit data on the patient's heartbeat and how well the device is functioning. The physician uses this information to adjust the device using a special computer. This ensures the pacemaker always provides the right heart rate to meet the patient's needs.

About 200,000 pacemakers are implanted in the U.S. every year. One thing is sure: They work."If you have symptomatic bradycardia, a pacemaker will help you feel and function much better," says Dr.Wilkoff.

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