Just what does it do?

A little knowledge has left me totally confused. Please help. I have a pacemaker that is two months old. I think one thing it is supposed to do is speed up my heart when I am sleeping so I don't have 30HR with pauses. That must mean it speeds it up if I go below the programmed 50 sleep mode.Right? I have RR programmed at 110 but my HR even when climbing stairs or carrying groceries is in the high 60s. And when I watch tv or read at night, my HR is in the 60s.When I make the beds and cook a meal, it is in the 60s. I am stating these figures because I have been taking my pulse during these times. I know from EKGs I also have occasional tachycardia but I am not really aware of when that happens. Does the pacemaker slow down my heart during those fast episodes? And if my HR is going to be in the 60s all the time, should I have RR turned off because I really feel that when I slow down at night, something is not right. I am fine during the day.Today from 9am until 5pm, I felt like 43 instead of 83. Should I maybe extend sleep mode rate of 50 to cover the quiet times when I am relaxing?Sleeping (with 1 gram lunesta) is a delight. I just ignore the pounding that sometimes happens because the doctor has assured me it is not a danger. I don't drive at night so wouldn't be afraid of dozing.I am really convinced that great feeling that I had today could become the norm,but I just don't know the questions I should ask the Medtronic person or my doctor.Don has been so helpful but I am still confused about whether the pacemaker can speed up and slow down the HR. I hope this makes some sense. I am sure I am not phrasing things correctly. Maybe someday soon.....

6 Comments

Pacer...

by dad4dds - 2013-02-04 02:02:32

only keep your heart rate from going below the set rate. They can not slow it down if it is going to fast. If you feel it is off you should call your dr and have the settings checked.

Good luck

Right or wrong Tracey

by magenniskeith - 2013-02-04 03:02:03

Very informative TraceyE. OK If rate goes below 50 (sleep mode rate) PM will kick in. If I extend that from 11-8 to 8-8PM that should take care of that. Now with RR on at 110 and HR only going in 60s regardless of activity, if they make it more sensitive, then will my heart rate increase giving me more stamina on stairs and inclines? If so then actually what the pacemaker does is speed up the heart rate when exercising and speed it up when at rest if it goes below 50. It never slows it down and if needed, medication takes care of that. Am I correct in my assumptions? If not please show me the error of my ways.Many thanks/

Re: Just what does it do ?

by d73 - 2013-02-04 03:02:23


Hi,

New here, but I saw your question. Some of the newer
pacemakers do have what is called a anti- tachycardia
mechanism and it can slow you down a small amount
by no stimulus to the sinus node if it is a normal
rhythm- but not really significant as I understand it. However, the pacemaker cannot break the rhythm of a more intense ventricular rhythm such as V-tach. That would definately require a defibrillator. If your fast heart rate is originating in the Atria- the top chambers of the heart you may be feeling what they call PAC- premature
atrial contractions which are not dangerous.You will tend to feel pretty sluggish if you have a continuous low HR. I would talk with your Dr.- Sometimes it takes awhile to get the right settings. At least it did for me.
Good Luck!

Rate Response

by ebfox - 2013-02-04 03:02:33

I agree with Tracey, I don't think your RR is set right for you. I have heard about people getting on a treadmill hooked up to the device to set the RR correctly. Other people ran up and down stairs; it takes a dedicated pacer tech to do this right. I would wager you that if you get that set right you will feel much better-

EB

pacing

by Tracey_E - 2013-02-04 03:02:48

If your minimum rate is 60, it will never let you get under 60. It's not actually programmed in beats per minute, but per second so it won't let you go a second without a beat. It sits back and watches. If your heart beats normally, it just keeps watching. If it goes a second without a beat, it generates a signal that causes a beat. Rate response is waiting for activity, when it senses movement it raises your rate for you. If your heart goes faster on its own, all the pm will do is watch.

it sounds like maybe your rate response sensitivity needs tweaking. It has quite a few settings, and it can take a few tries to find the balance between shooting up when you move and not going up enough when you need it. If your rate isn't going up enough when you climb the stairs, etc, they can make it more sensitive. OTOH, if you feel good, then leave it alone :)

RR programmed at 110 means the max it will go on exertion is 110. If you aren't getting anywhere close to that, then that number is fine.

stamina

by Tracey_E - 2013-02-04 04:02:33

Yes, if it’s more sensitive, then yes theoretically it will increase your rate on stairs, etc, and give you more stamina. If your rate isn’t going up, then it’s set to a very low sensitivity and it isn’t picking up your movement. As EB said, the treadmill can be a wonderful tool in readjusting this. Walk on the treadmill while hooked up to the pm computer and find the right balance that works for you. They don’t like it to be too sensitive because then things like bumpy roads or sneezing will make it think you are exercising and raise your rate. It’s all about finding the balance, which is different for everyone. The treadmill can cut out some of the trial and error.

I’m not sure how the sleep mode works, I don’t use it and not sure that I would want to know I didn’t have all the bells and whistles on 24 hrs a day. I usually sleep all night the same hours, but for example, last Sat I went out with the girls and was still dancing at midnight, or sometimes I get up with a sick kid or dog at 3am.  I don’t want to feel like Cinderella, gotta be in bed by midnight ;)

My guess would be if you have it on sleep mode in the evenings earlier, you’ll be fine as long as you don’t try to do anything. If you do try to do something, your hr is going to stay low. I guess I don’t understand the point of sleep mode because it won’t raise your rate artificially anyway unless it senses movement so it shouldn’t matter what time of day it is? If you aren’t feeling well at night, maybe ask about trying it without sleep mode?

Correct, medication is the only thing that will slow it down. The pm can’t keep the heart from beating on its own. All it can do is fill in beats when we get too slow, or add beats when it doesn’t go up on its own with activity.

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