Eleven months ago former England junior squash champion had a pacemaker fitted after his heart stopped for a few seconds during a health check up.

The patient

During a routine health check at work in July last year the doctor noticed that I had a slightly irregular heartbeat.  When I told her that I had been feeling giddy while playing squash or football she told me to get it checked out by my GP.

At the insistence of my girlfriend, Laura, I went to my GP who referred me to a BUPA heart specialist at Redhill, Surrey.  I claimed this on my health insurance through my work.

The specialist did a 24-hour electrocardiogram (ECG) on me, and put me on a drug, Atenolol, to slow down my heart rate.

My ECG showed irregular rhythms and that part of my heart was too big.  He told me that this could be because of an abnormality – or because of my sports history.  I was the England junior squash champion and continued playing to a high level until the age of 19.

I was then referred to Professor William McKenna at St George’s Hospital, Tooting, South London.  I went along to St George’s for an echo-cardiogram, a way of electrically recording your heartbeat, and I had to do an exercise test.

During that test I had to pedal as hard as I could on an exercise bike rigged up to heart monitors.  I felt fine until I finished the test.  Suddenly, I felt very giddy.  The next thing I remember was coming round on the floor.

A crash team – doctors, nurses and a resuscitation officer who deal with people who have collapsed suddenly – rushed down and I was told to lie flat on my back and not move.  My heart had stopped for several seconds and then restarted on its own.  I was told I would just need to say overnight for observation.  By this time I was on NHS treatment because my collapse was an emergency.  The next morning I was told I needed a pacemaker.

I was informed that there was no way of knowing if my heart would suddenly stop again.  Worse still, my resting heartbeat was just 38 beats per minute – the average is 70.

On October 1 last year I had an operation.  Amazingly, it lasted just one and a half hours and they used only a local anaesthetic.  I looked the other way because I didn’t want to see what they were doing, but I could feel sensations where they were cutting.

The registrar who performed the operation, Dr Mark Sopher, said it was more difficult to fit my pacemaker because my muscles were bigger and more developed than those of elderly patients.

Throughout the operation I was surprisingly relaxed, mainly because I knew that if I panicked my heart rate would go mad.

The anaesthetic began to wear off, so I could feel pain while I was being stitched up.  I was allowed to go home the next day, and I went back to work after two weeks.

But after a month I started getting panic attacks.  The more I thought about my condition the more worried I became.  Laura found a nearby support group – Cardiac Risk in the Young (CRY) – based in Tadworth, Surrey.  I have been to one of their meetings and found it very helpful.

Pacemakers last for around 10 years and I have annual appointments where they check the battery and read the information about my heartbeat that is stored within it.

I have recently been for a bike ride, which is progress considering I wouldn’t even run up the stairs when I came out of hospital.  I have also started swimming.  For the first few months after my operation I was too scared to go out in the evenings, but I am gradually getting my life back.

The Physician

Dr Mark Sopher is a specialist registrar in cardiology at St George’s Hospital in London.

When Paul collapsed after the exercise test, it was clear he had a form of heart disease.  The likely outcome if he did not receive a pacemaker was episodes of light headedness and blackouts with potential risk of injury.  He would not have died, but there was an overwhelming case for implanting a pacemaker.

The device monitors the heart rhythm and is set so that if Paul’s heartbeat goes below 55 beats a minute, it will pace the heart at 60 beats per minute.  He also takes a beta-blocker to suppress any extra beats.

In the operation I made a cut under the collarbone on the chest, about 4cm long, then created a pocket on top of the muscle but beneath the fat.  The pacemaker is coated in titanium to prevent rejection.  Once the device was in the pocket, I needed to pass the polyurethane covered leads to the heart.  I used a hollow needle-like tube to find a vein and pierced it.  When blood came through, I put a fine wire through the hollow centre of the tube, which is then removed.  I then passed a plastic tube over the wire and inserted the leads through that tube and into the heart via the vein.

Paul had two leads, each with an electrode at the tip, one which went into the right atrium of the heart and the other into the right ventricle.  Over time they will become attached to the muscle.

We then tested the current to make sure electricity was passing through from the pacemaker.