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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Medical
Satisfied Customers: 10341
Experience:  14 years experience in the field of Family Practice
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My question is about av block. I'm a 30 yr female with a 3

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Hi my question is about av block.I'm a 30 yr female with a 3 yr hx of sudden collapse with loc for about 3-10 mins. After having an internal heart monitor inserted for a few months i was diagnosed with ac block and pauses of up to 8 secs I had a single lead pacemaker inserted in feb. before my pacemaker I mainly had a resting hr of 120/130 but now I have both bradycardia and tachycardia all the time. My question is could the insertion of a pacemaker cause this change in my heart rate as now I suffer a lot from dizziness and the suddenly a racing heart rate
Anthony Bray MD : Hello!
Anthony Bray MD : With your history it sounds that you need further follow up with your cardiologist and possibly evaluation by a cardiology sub specialist in electrophysiology of the heart ....
Anthony Bray MD : The pacemaker SHOULD be protecting you from bradycardia...
Anthony Bray MD : Your history sounds like you may have sick sinus syndrome which is a possible cause of tachy- Brady syndrome...
Anthony Bray MD : medication can usually control the episodes of tachycardia.... The pacemaker should be protective against bradycardia...
Anthony Bray MD : Your pacemaker should be checked and I realize that it probably checked on a regular basis ... Still I recommend that you start with a follow up with your cardiologist...
Anthony Bray MD : The details of findings on rhythm monitoring and of the heart' s electrical physiology will determine the best treatment path for you....
Anthony Bray MD : I hope this information is helpful for you. Let me know if you have further questions/ information/ discussion... I will be happy to get back with you!
Anthony Bray MD : If my answers have been helpful and to your satisfaction then please remember to leave positive feedback. That would be very much appreciated!! Thank you and best regards ,
Anthony Bray MD : Anthony Bray MD
Anthony Bray MD : PS your electrolytes and thyroid function should also be checked ...
Customer: Had review with my cardiologist who did a 7 day event monitor which found I had resting heart rate if about 38/40 and a heart rte of about 130/40 with any exertion. If I sit for about 10 mins then it drops really low again :( one suggestion is that I change from an on demand pacemaker to a permanent pacemaker though I'm not sure this is a good idea as I'm so young ill need lots of box changes this lots more complications and scares
Customer: Full bloods done have a high white cell count continuously for about 3 months otherwise all normal
Anthony Bray MD : Well with your heart rate dropping so low it looks to me that you may need some change in your pacemaker...... I don't know if some adjustment in yours may be feasible ??? Or a different pacemaker may be needed...
Anthony Bray MD : You have the marked highs and lows !! The high rate may benefit from a beta blocker potentially but the minimum rate needs to be addressed first....
Anthony Bray MD : Other arrhythmia MEDS might be of help....
Anthony Bray MD : How high is the white cell count?? I would worry about subacute bacterial endocarditis as a potential with the combination of problems noted...have you had any fever! Chills?? Abnormal fatigue??any chest discomfort??
Customer: Last result 3 days ago was 18.4 lab range 8-10. Have been really exhausted for about a month literally go to work for 8hrs and its home and bed
Customer: pacemaker settings are set to 35 as a minimum so no changes able there
Anthony Bray MD : I would recommend that you ask your doctor about this-- recommend blood culture x 3 to check for infection in the blood stream--- ultrasound of heart to check interior and valves--- these would help to rule out SBE( subacute bacterial endocarditis ) as a possible cause.... Also rule out viral myocarditis--- echo--12 lead EKG--serum titers to coxsackie virus---ck-mb, troop in...other tests to be considered but I think that you need to have this checked...
Anthony Bray MD : I think it very important for your doctors to chase after the high white count to find the reason for this!!
Anthony Bray MD : I hope this helps! Let me know if you have further questions and I will be happy to get back with you!!
Anthony Bray MD : If my answers have been helpful and to your satisfaction then please remember to leave positive feedback. That would be very much appreciated! Thank you and best regards,
Anthony Bray MD : Anthony Bray MD
Customer: Thanks ill contact them Monday when they open and get onto it as I feel really poorly today and just need something done :(
Anthony Bray MD : Yes I agree that you need artention promptly with these issues....ok to call doctor on Monday on presumption that you do not have SBE....BUT WATCH FOR SIGNS OF CONCERN AND GO TO ER IF YOU HAVE FEVER, CHILLS, CHEST PAIN, SHORTNESS OF BREATH.....good luck to you! I hope that you get good care and feel better soon!!
Anthony Bray MD : Let me know if you have further questions now or later and I will be happy to get back with you!!
Anthony Bray MD : Do follow up on the high white cell count as what you reported is concerning --- it might drop back to normal with no cause identified...if so then that is ok but it should be investigated further if it remains that high!
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