Constant no. beats per min

I read Smitty's response wherein he said when a pacemaker is permanent there is no fluctuation in bpm. I am to have an AV ablation next week and this is the first I have heard of that, and I will be dependant on the pacemaker.

Would be pleased if several of those who know firsthand will confirm and let me know what problems that would cause. Like are you then only to move reasonably steadily or resume riding, racing etc.

Many thanks for responses. MT

6 Comments

PM Rate

by clockman1 - 2013-02-15 02:02:18

Just to throw the cat amongst the pigeons..... I have just finished 8 weeks of Cardio Rehab during which time the physio's checked my heart beat rate 4 time's per hour and it was always 80 bpm give or take a couple of beats. I know my settings are 80/160 and I generally feel fine apart from the odd day. (oh yeah I also had a quadruple by pass). I was intrigued myself how consistent the readings were, and it was during some reasonably strenuous excercise that it was checked. Last PM check up I was told I was pacing 95% of the time, so maybe this explains all! Maybe not! Any enlightening comments would be appreciated. Still get ectopic beats quite regularly, actually less so if I eat banana's (for the potassium I believe), still you wanna see me climb trees's, everything has an upside!
Keep warm and vertical.
clockman1

My Comment To Fluzy Suzy

by SMITTY - 2013-02-15 03:02:25


Hello MT,

I misspoke or you misunderstood what I was saying. What I was talking about was when a PM goes into its battery saving mode because the battery power output is getting low. When that happens the pacemaker shifts into a power saving mode known as EOL (End of Life) or into ERM (Elective Replacement Mode) or one called a VVI. In these modes it keeps the heart at a constant 65 BPM.

When my PM shifted into this mode a couple of years ago because my battery was getting weak, I had a very irregular heart beat as the PM didn't check to see if my heart's natural PM was, or was not, sending an impulse to make my heart beat. This led to conflicts between the two which caused the irregular heart beat.

"The AV ablation of the atrioventricular node (or AV node, also called AV junction) is a procedure by which the electrical pathway that connects the upper chambers (atria) to the lower chambers (ventricles) is intentionally disrupted." That was from Stanford Hospital and Clinics. I think this is the PM setting you may be speaking of. May I for suggest that you ignore what goes with what I commented to Fluzy Suzy if this comment is the one you are thinking about. What I said was not intended to have any bearing on what people get after an AV ablation.

Smitty


rate response`

by mtulau - 2013-02-15 05:02:06

many thanks to Robert for above letter. I will check 'rate response' and your given site. MT

That's not my experience

by RobertS - 2013-02-15 05:02:31

It depends on how the pm is set.

I have a permanent pacemaker and rate is set between 60 and 140. The upper limit was 130 but I got them to up it a bit as it wasn't high enough when I was exercising - it might have to be upped again. What this means is that, while the pm is pacing may heart my heart rate won't drop below 60bpm or go above 140 bpm

I also have Rate Response turned on so the pm is responsive to my natural heart beat. So if my heart is doing it for itself the pm 'rests'.

There are many setting for pm's depending on the reason you need it but I had mine as my heart rate got stuck at 35 bpm or so. Now my heart rate goes up and down depending on my activity level. I can be as active as I like. In fact the whole thing has been a blessing.

The pm was put in as an emergency a couple of months ago and I have had not trouble at all. No pain or discomfort for more then two days post op. I don't care about the little scar - just one more! And it is working fine as I am back to a normal active life again.

If you search 'rate response' on this site you'll see lots on the topic and here is an interesting little site that tells you about pm settings and what they do.
http://drgdh.wordpress.com/2011/07/11/pacemaker-emergencies/
There are lots of others.

So I wish you all the best.

Robert

Me Too

by Many Blessings - 2013-02-15 09:02:14

Hi MT,

I have a CRT-P with AV Node ablation. Mine is set at 80 bpm with a range from 80-150 (up to 150 with activity). I have not heard of a one number bpm set PM, but that's not to say it's never happened. I just don't know.

They set your rate response according to your activity level (active, inactive, etc.) but this doesn't always work. Always keep that in mind. I'm super active, but when they set my rate response accordingly, it didn't work for me. I felt like total crap. They changed it back to where it "should" work for an inactive person and I felt great. You really just have to experiment with this to see what works for you. It doesn't always go by what the "text book" says will work. Everyone's body is different.

I have mentioned this before on this site, but I think it's so important to say again in case someone out there is really feeling like crap after or before a setting change; ANY setting change. For me, one bad or good setting change, ESPECIALLY a rate response change can make the difference between me not being able to climb a set of stairs, and being able to jog up several sets. It really does make that much difference. I remember after one bad change, I really didn't think I could even make it across the parking lot at work. They changed it back and I was good to go again. It can change how you feel that much.

I'm with Robert. Do a search on this site regarding settings. You can do a search up on the right hand corner and use setting change as your search word.

Good luck!



Double edged question

by donr - 2013-02-15 09:02:55

MT: You can answer that question at least two ways!

Depends on whether or not the SA node is functioning.

Any normal heart has a varying rate - ALL THE TIME! Watch the pulse as reported on an oxymeter or an ER monitor. It is constantly flicking around. MOF, it varies w/ EVERY beat. That's because even in a normal heart each beat is individually timed & created by the two nodes & their timing is NOT perfect, it varies a small bit - so small that YOU cannot perceive it, but the monitors can, & dutifully report it. That reported variation is on the order of one or two BPM - UNLESS you have a PVC or some other arrhythmia, in which case it cane really be different.

Now, if your SA Node still functions, but your AV Node does NOT, the PM follows the SA Node's timing & you will will still have that small variation beat to beat. IF the SA Node does NOT function, the PM will set the timing & be aided by the RR. Then your beat to beat variation will be much less, unless the RR affects it. The PM is much more accurate than your SA Node when it comes to timing.

Your activity level, as detected by the RR will determine the gross changes necessary in HR. But once the RR sets a HR, the PM will very accurately keep it there till told it needs to change.

Hope I did not muddle you up, but the question could be interpreted two ways.

Don

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