Dr. Sagar Ramesh Makode
Cardiology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's 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 I am suffering from depression and anxiety disorders. Sometimes, I feel better and can work off the medicines, but as soon as I try strenuous exercises, all the symptoms return. Please apologize for my words, but I cannot even masturbate. My questions to you are, should I consider for ablation? If yes, then what are the risks and success rate? If I have to undergo pacemaker implantation, then what may be the complications and success rate and will I be able to perform strenuous exercises with a pacemaker? Should I consider going for a pacemaker at 21 years of age? Lastly, should I continue with medicines, if there is a possibility of self-healing in the future?
Hello,
Welcome to icliniq.com.
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 depression, which I think is causing your poor quality of life. I assume all other causes are ruled out like thyroid, low hemoglobin, and postural orthostatic tachycardia syndrome. The echocardiogram is also normal I guess. In treatment, it is better to continue medicines, because results of ablation are not very good and it may give rise to a need for a permanent pacemaker. A pacemaker is also not a good option in your age group, as strenuous activities and heavy sports need to be restricted after this. Besides, regular surgeries to replace batteries may be troublesome. So, I think you should continue with medicine. I suggest taking beta blockers like Metoprolol 25 mg, once a day or Ciplar LA (Propranolol) 20 mg, once a day. This should be tried rather than Ivabradine. Consult your specialist doctor, discuss with him or her and start taking the medicine after their consent. Hope this helps you, and get back if you have any doubts.
Patient's Query
Hi doctor,
Thank you for replying. Why do some doctors claim that one can resume exercise after some period of pacemaker implantation?
Hi,
Welcome back to icliniq.com.
One can perform moderate activities. In heavy activities and competitive sports, there is a risk of injury to the pacemaker, which may lead to fracture or dislodged. The heart rate may not sufficiently increase with heavy exercise. So, there is risk involved and better to avoid heavy activities in patients with pacemakers.
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Cardiology
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