Ask Dr. Zipes
Pacemaker Problem
By Douglas Zipes, M.D.
From the September/October 2005 Issue
Reader: My husband's lead (on the left ventricular side) of his nearly three-month-old pacemaker came out of his heart. It made him vibrate as it was hitting his diaphragm. How could the lead come out after three months?Dr. Zipes: Pacemaker leads, particularly those placed on the left ventricular side, can dislodge days, weeks, and sometimes months after they have been implanted. The rate for the left ventricular lead is probably 5 percent or more and usually occurs in the first 30 days but can happen later. It may be nothing that your husband or the doctor did wrong. It just happens in some people. I am sure the doctor repositioned the lead and, hopefully, it will not happen again.Statins and Memory Loss Reader: I have been taking Lipitor for many years and recently experienced an episode of memory loss. I heard that extended use of statins can accelerate short-term memory loss. Can you shed any light on this subject?Dr. Zipes: There is a great deal of debate as to whether "statins," the drugs most commonly used to lower lipids, affect brain function. The jury is not in on this, by any means, but much of the information suggests that they do not affect cognitive brain activity. I would recommend that you continue taking the Lipitor, as its benefits have been well established, and its safety profile well characterized. If you have another spell of memory loss, discuss it with your doctor, and tell him/her about what you have read. Then, you both can assess how important the statin is to your health, and make an appropriate decision about whether to stop taking it.Aging and Heart Health Reader: I had the surprise of my life a few months back when I wound up with a pacemaker. How could this happen to me? I have been eating heart healthy for all my adult life--basically vegetarian-based meals--playing tennis and remaining physically active. Until this happened, my only physical problem was high blood pressure. It took me by surprise when the doctor told me I had atrial fibrillation. To complicate matters, the medical establishment has dismembered the Food Pyramid, research on vitamin E has been maligned, and eggs are "in" where for decades we have been advised differently.Dr. Zipes: Lifestyle is important, without question. And it sounds like you are doing the right things. However, age can cause changes in the heart's conduction system, regardless of other considerations, that can result in dangerously low heart rates. A heart rate that gets too low can cause a blackout spell, or worse. It sounds like your doctor has implanted the pacemaker on a "prophylactic" basis, that is, before symptoms arose, in order to prevent them in the future. The nice thing about devices like the pacemaker is that they are made to be forgotten. By that I mean you should go about your daily activities without a thought that you have a pacemaker. Once it has been in place for several months, and is functioning normally (check with your doctor), there really are no or very few restrictions for you. Keep up with the tennis! Regarding your questions about diets and vitamins, you are right. Guidelines have been confusing and contradictory. As we learn more, we need to change the recommendations.Tired On Beta-blocker Reader: My cardiologist has me taking a beta-blocker, atenolol, for high blood pressure. My problem is that atenolol slows my heart rate. I cannot even get it up to 100 when exercising. The slower heart rate makes me feel tired. This seems counterproductive.Dr. Zipes: Drugs like atenolol, a so-called beta-blocker, block some of the adrenaline-like actions on the heart, and that can cause fatigue. However, numerous studies have shown that the adrenaline-like effects can be harmful in certain individuals having certain heart problems, leading to increased mortality. In these situations, the beta-blockers improve survival. Often, starting at lower dose and gradually increasing it over time can avoid the fatigue. Beta-blockers can be combined with an ACE inhibitor. Do not suddenly stop taking the beta-blocker without telling your doctor, as that can be harmful.
E-mail Print Discuss Text Size:
Highlighted Articles
Is there a simple and better incentive to increase organ donations?
A behind the scenes look at the safari of a lifetime in a Kenyan game reserve.
Learn to manage diabetes without sacrificing great taste with savory and healthy soulutions.
Efficient use of body physics has made Tiger Woods' drive the most powerful in golf.
Museum Gift Shoppe
E-mail 
Print 
Discuss | Text Size: 
