A pacemaker is an electrical device that is placed under the skin in the chest, which helps in controlling the heartbeat. Conditions that can affect the heart rate are arrhythmias, normal aging of the heart, some medicines, and congenital abnormalities of the heart.

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Why does a patient develop weight gain and insomnia after pacemaker implantation?

Query: Hi doctor, The patient is a 38 years old female. She has a medical history of congenital heart disease. Her heart rate usually ranges between 50 and 55 bpm. Before two months, she had a pacemaker implantation. After pacemaker implantation, her heart rate is 70 to 80 bpm. Now, the patient is sufferi...  Read Full »

Dr. Sagar Ramesh Makode

Answer: Hello, Welcome to Is it a single chamber pacemaker or double chamber? It is mostly a pacemaker syndrome if the patient did not exhibit similar kind of symptoms before pacemaker implantation. In treatment, you need to visit her cardiologist for changing the settings of the pac...  Read Full »

Is it normal for the heart to stop for 11 seconds during vasovagal syncope?

Query: Hi doctor,I am a 21-year-old male and take no medications. Four years ago, I started having vasovagal syncope episodes that have increased in frequency over the years, and I have now passed out from it around ten times. My triggers for it are blood, needles, and damage to the wrists. My clinic recom...  Read Full »

Dr. Muhammad Zohaib Siddiq

Answer: Hi, Welcome to Thanks for the query. 1. First thing you should know is that vasovagal syncope is not dangerous. Try to avoid circumstances that lead to syncope. 2. When you feel that you are having syncope (prodrome), escape from that area or scene. Sit down on the floor in a squatt...  Read Full »

What is the role of pacemaker in arrythmia?

Query: Hello doctor, I am 63 years old male. I am a known case of atrial fibrillation 20 years. I had a brain hemorrhage 23 years back. I have a paroxysmal type of afib. Recently its frequency has markedly increased. I am taking Sotalol 80 mg and 80 mg. But now Sotalol increase is required which causes br...  Read Full »

Dr. Muhammad Zohaib Siddiq

Answer: Hi, Welcome to The rate in AF is controlled with beta blockers, calcium channel blocker or Digoxin. You are taking Sotalol which is a beta blocker as well as the anti-arrhythmic drug. The permanent pacemaker is implanted when there is tachy-brady syndrome. It means sometimes there is ...  Read Full »

Do I need a pacemaker for inappropriate sinus tachycardia?

Query: Hi doctor, I had been diagnosed with inappropriate sinus tachycardia nearly two years back. I have dizziness, chest pain, shortness of breath, not able to exercise, and anxiety. I am currently managing my symptoms with Ivabradine 5 mg, once a day, but the quality of life is very poor due to which ...  Read Full »

Dr. Sagar Ramesh Makode

Answer: Hello, Welcome to Firstly, do not get depressed, this is not a life-threatening condition, and may resolve with time. The symptoms may be troublesome for some time. How much are your resting and maximum heart rate? You should get yourself evaluated by a psychiatrist for anxiety and d...  Read Full »

Why is there tachycardia after pacemaker implantation for bradycardia?

Query: Hello doctor, My father's heart rate was low and fainting, syncope occurs twice. The doctor suggested a permanent pacemaker for bradycardia. After pacemaker implantation, he was fine for 45 days but now his pulse rate increases and fluctuate from 70 to 100 rapidly and some chest pain for 1 or 2 min...  Read Full »

Dr. Sagar Ramesh Makode

Answer: Hello, Welcome to This is likely a part of the syndrome called as a tachy-brady syndrome. Here, patients sometimes develop slow heart rate while sometimes a fast heart rate. Slow heart rate is taken care of by pacemaker and for high heart rate needs medicines like Ivabradine. So, usuall...  Read Full »

What are the reasons for tachycardia?

Query: Hi doctor, I am suffering from shortness of breath, and also I have a pacemaker in my heart due to a complete heart block. Can you please tell me about the findings in my EKG?  Read Full »

Dr. Muhammad Zubayer Alam

Answer: Hi, Welcome to I can understand your concern. According to your EKG (electrocardiogram) tracing (attachment removed to protect the patient's identity), it shows tachycardia, which means heart rate is 100 or above 100 BPM. Tachycardia may result from various physiological and pathologi...  Read Full »

My father has recurrent infections after pacemaker placement. Why?

Query: Hi doctor, My dad had undergone pacemaker fitment, and after that, it was removed due to pocket infection and post explanted, again there was an infection, which was cleaned from a plastic surgeon, and now again he is having swelling near the pacemaker fitment site, and previous pus culture reports ...  Read Full »

Dr. Muhammad Zohaib Siddiq

Answer: Hi, Welcome to It is recommended to place a pacemaker generator on another side of the chest after explanting due to infection. If the pacemaker is implanted and there is re-infection, again, the whole hardware should be removed. And after clearance of infection, it should be implanted ...  Read Full »

What does the sinus arrhythmia finding in my ECG report suggest?

Query: Hi doctor, I am a 35 year old male. I had an ECG done early in the morning immediately after waking up from sleep. It was 60 bpm. Later, on the same day, I took another ECG in the hospital and it was 83 bpm. It was mentioned on as a normal sinus rhythm with sinus arrhythmia. What does it mean?  Read Full »

Dr. Vivek S Narayan Pillai

Answer: Hi, Welcome to Sinus arrhythmia is an entirely normal phenomenon. It just means your pacemaker of the heart. The sinus node will react well to everyday stressors and activity. It is natural to have a low heart rate of 60 during early morning and 83 as your activity progresses. Be assur...  Read Full »

Will increased BNP value cause edema and dyspnea?

Query: Hello doctor, I will try to be brief. I am a 49 year old female who has been pacemaker dependent for several years. Due to cardiomyopathy EF of 30 %, BNP of 186, and a cardiac event resulting in high troponin. I eventually was switched to a biventricular pacemaker/defibrillator. I had an echo last ...  Read Full »

Dr. Isaac Gana

Answer: Hello, Welcome to I understand your concern. Although your ejection fraction is now 50%, your BNP (brain natriuretic peptide) value is high which is the reason you are experiencing edema and dyspnea. Increased BNP causes a fluid and pressure increase in your heart, which in turn mani...  Read Full »

When do I need a pacemaker for my low heart rate?

Query: Hello doctor, I get low heart rates of 40 to 45 bpm while sitting or lying down, and when I get up and walk, it will return to 60 and above. I also went for a long walk for about an hour, and my heart rate was between 78 to 90 bpm. I have had this issue for more than eight years. My query is, do ...  Read Full »

Dr. Isaac Gana

Answer: Hello, Welcome to Thanks for reaching out to us. I have gone through the result of your investigations (attachments removed to protect the patient’s identity). Your ECHO (echocardiogram) and ECG (electrocardiogram) are within normal limits and do not show any abnormalit...  Read Full »

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