Q. I have DDDR-CLS pacemaker with symptoms of breathlessness. What to do?

Answered by
Dr. Muhammad Zohaib Siddiq
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Jan 15, 2021

Hi doctor,

I have done ECG strip analysis. I have symptoms of breathlessness on climbing stairs. I am having a DDDR-CLS rate-responsive dual-chamber pacemaker. I have type diabetes, hypertension, hypothyroidism, and Parkinson's syndrome.



Welcome to icliniq.com.

Your ECG (electrocardiogram) seems to be normal (attachment removed to protect patient identity). Your rate, rhythm, axis, and everything are within the range. Please mention the reason for having DDDR (dual chamber rate-adaptive pacemaker) implantation and when you did it. Shortness of breath can occur due to many causes. The cardiac cause can be due to heart failure. For this, I would like to see your echocardiography report. Other cause can be due to the lungs. Please mention whether you have a cough and fever. Please say whether your hypothyroidism is under control and the medicines taken for these problems. Please answer all the questions and so that I can guide you properly. Please send your chest X-ray and echocardiography reports.

Thank you doctor,

This pacemaker was implanted when I was diagnosed with sick sinus syndrome where the heart rate falls down suddenly to dangerous levels. I have breathlessness when I do stressful activities like climbing stairs and hypothyroidism is under control. I am attaching the latest ECG report and my consulting cardiologist told me that I have ST-T abnormality. Please give your opinion regarding this and guide me.



Welcome back to icliniq.com.

Your ECG is normal and you do not have arrhythmia and ischemic changes. Sick sinus syndrome occurs in aged peoples above 70 years. It is a permanent condition and it does not resolve. But on your ECG, I can see a normal rhythm and there is no evidence of sick sinus or slow heart rate. Please mention whether you have done a holter monitoring test to diagnose sick sinus syndrome. Regarding breathlessness, please do echocardiography to see for a cardiac cause. For diagnosis, cardiac auscultation is done and lung auscultation is done. Other signs are also seen in patients and it is necessary to do echocardiography in your case to know the cause.

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