question for Frank.

So I am older than you by 4 months. Turned 83 February 2. Have a question about rate response. Saw cardiologist on Monday because my heart rate has been 115-125 while resting. Obviously not good. He says I won't die from it, but it is a nuisance. Duh, yeah. In some responses you have given, you mentioned you had rate response turned off. Mine is on and just wonder if my coughing or breathing or getting engrossed in a tv show, or even just walking around the house and then sitting and taking pulse might be triggering rate response. Doctor increased atenolol to 75 mg from 50 to see if that solves problem. I just have a feeling that the rate response is contributing. Just wondered what your experience was. I am not inactive but not like some of these fantastic sports enthusiasts here. I work around house, go to store, water my garden, chase the dog but do read and write a lot, just so you won't think I am a real couch bunny. Thanks for any info.

1 Comments

Tachycardia at rest

by golden_snitch - 2013-03-06 03:03:57

Hi!

What does the ECG at rest show? Is the 115-125 bpm even a paced rhythm or is it some sort of atrial rhythm? If your doctor increases the betablocker, I'd guess that this is not a pacemaker rhythm, because a betablocker wouldn't help, if you had a pacemaker induced tachycardia. So, if it's an atrial rhythm, then it cannot be triggered by the rate response. Any atrial/ventricular rhythm that's faster then what the pacemaker is programmed at will just inhibit the pacemaker, so that it can only watch, but not really interfere.

The only thing I could imagine that has the pacemaker involved in your high resting heart rate, is a pacemaker mediated tachycardia. For that to happen you'd need to have an AV-node that can conduct from the ventricles to the atria (retrograde conduction); normally it only conducts from the atria down to the ventricles. If you have that retrograde conduction, what can happen is that the impulse coming from the atria arrives in the ventricles, stimulates them, then travels backwards to the atria again, down to the ventricles - a reentrant circuit is created, and you'll end up with your heart racing. But that's something your doctor would see in your ECG. Did he ever mention anything like this? A betablocker might help in case of pacemaker mediated tachycardia as it slows the retrograde conduction down or even blocks it.

Inga

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