Question:

Should I have a pacemaker?  I am very apprehensive.

I’ve had very poor results taking Lopressor. On 2 occasions I tried with 1/2 of a 25mg pill & my pulse plummeted to low 50s very quickly, so I immediately stopped as I lost most of my energy. My LVEF (left ventricular ejection fraction) is 23. I’m male, 85 years old. Now my cardiologist wants me to have a pacemaker to hold my pulse to 60 as a minimum & try to take Lopressor again. He says it will possibly forestall a stroke or heart attack. I am very apprehensive. Can you give me any advice? Thanks.

Submitted by Gilbert from Metropolitan, Washington, DC on 12/11/2013

Answer:
by Abdi Rasekh, MD

You mention that your EF (ejection fraction) is 23%. If your EF is low you would likely benefit from a defibrillator which is also a pacemaker. It can prevent sudden cardiac death and also prevent slow heart rate. You may also benefit from use of a beta blocker such as Lopressor. Your cardiologist has given you good advice.