u/Delicious-Ad6134

Hi everyone,

I'm 31 and was diagnosed with congenital third-degree (complete) heart block. After extensive testing (normal cardiac MRI, normal blood work, etc.), my cardiologists believe it's congenital, and I'm scheduled to receive a pacemaker—I'm currently just waiting for my insurance to approve the procedure.

My concern is that my resting heart rate isn't extremely low. It's usually around 47–50 bpm. Most of the stories I've read are from people whose heart rates were in the 30s or who had dizziness or fainting, and they experienced dramatic improvements after getting a pacemaker.

I don't have dizziness or syncope. My main symptoms are lifelong fatigue, brain fog, poor concentration, low motivation, and very poor exercise tolerance. As long as I can remember—even as a child—I would get exhausted very quickly with exercise, hit a wall almost immediately, and have to stop to catch my breath. My stress test also showed my heart rate only increased to about 80 bpm.

I'm trying to keep realistic expectations because I'm worried my symptoms may not improve as much as I hope. Has anyone here with congenital complete heart block and a resting heart rate in the high 40s had similar symptoms and noticed a meaningful improvement after getting a pacemaker? I'd really appreciate hearing your experience.

Hi everyone,

I'm 31 years old and have been diagnosed with third-degree (complete) heart block, which two cardiologists believe is most likely congenital.

I've had a thorough workup:

• Comprehensive blood work (normal)
• Thyroid tests (normal)
• Cardiac MRI (normal, no structural heart disease)
• Stress test, where my heart rate only reached about 80 bpm during exertion
• Resting heart rate is usually around 47–50 bpm

I'm currently waiting for insurance approval for a pacemaker.

The reason I'm posting is that I've only recently started connecting my diagnosis to how I've actually felt my whole life.

Looking back, I've always tired out before everyone else. During soccer or any physical activity, I'd hit a wall very quickly and need to stop to catch my breath. Over the years, I unconsciously adapted by avoiding stairs, walking less, and generally avoiding exertion without really realizing it. I always assumed I was just out of shape or had low stamina.

I've also struggled with chronic fatigue, brain fog, and generally low energy for as long as I can remember. The strange part is that I never thought of these as symptoms because they've always been my normal. When I was first diagnosed in 2021, I honestly thought, "My heart is beating, so I guess I'm okay." It never occurred to me that the heart block might explain how I'd been feeling.

Now I'm hopeful that the pacemaker might make a real difference, but I'm also nervous about getting my hopes up too much. I've spent years trying to fix my fatigue with better sleep, exercise, diet, vitamins, stress reduction, and nothing ever really changed. Part of me worries this will just be another thing that doesn't help.

One thing I've also been wondering about: when I read stories from people who felt dramatically better after a pacemaker, many seem to describe dizziness, fainting, or extremely low heart rates. I don't have dizziness and I've never fainted. My main issues are fatigue, brain fog, and exercise intolerance. I'm wondering if anyone with a similar symptom pattern noticed significant improvement after getting paced.

If your situation was similar to mine, I'd love to hear:

• Did you have fatigue and brain fog before your pacemaker?
• Did you feel like you'd been living with it for so long that you didn't realize it wasn't normal?
• How much did your energy and exercise tolerance improve?
• Was the improvement immediate, or did it take weeks or months?
• Did the pacemaker change your day-to-day life more than you expected, or less?

I know everyone's experience is different, and I'm not looking for guarantees. I think I'm just trying to understand what life might be like if my heart is finally able to respond normally.

Thanks to anyone willing to share their experience.