Pacemaker Rate Question

I understood that my pacemaker was set to pace if HR went below 60 bpm. Recently had dental surgery and was hooked up to a HR monitor and EKG machine. While waiting for the surgeon (about five minutes) and prior to sedation, my heart rate was 55-57. I had found the same readings with my home heart rate monitor and BP machine but thought maybe they were off. At last ICD check up was told I am paced less than 1%.

Question - is there a time lag from when the heart rate goes down and the pacemaker kicks in? Thank you for any responses.

4 Comments

Hi Marie........

by Tattoo Man - 2014-10-13 02:10:08


..........I was only discussing this with my Cardiologist...Andrew Houghton..a few days ago...this is my take on the matter..pretty well echoing Ingas comment.

Most PMs are factory set at 60 bpm, as in, a default setting. At your first PM Interrogation this is likely to be reviewed, along with other settings...but not neccesarily changed.

Many settings, as I see it, are made to satisfy both your own medical needs and also with the aim to reduce battery demand if possible.

If your setting is 60 bpm its very unlikely that your PM will do anything until your heart dips below a pre planned threshold for a pre planned duration....this is , again to preserve battery life..as in..the PM " Keeps its eye on you" and does not, neccesarily, respond immediately.

Andrew Houghton told me that many young Cardios would call him at home because they saw a sub-60 with no PM response, thinking that the device was malfunctioning..he agreed with me that they were " Better safe than sorry"

I once experimented with my PM by lying totally doggo on the sofa ( couch ) with a Heart Monitor and deliberately reduced my cardio / vasc activity to get under 60bpm ( not easy ). At 58 bpm there was no PM response...the device was more clever than me (Electric Frank would have been proud !! )

Marie, I think that your question is a very good one. As ever I can only speak for my own experience..there may well be others whose settings respond more expediently to a bpm drop.

Check with your Cardio / Tecchie so you feel ok with this.

Best wishes Tattoo Man

Sounds a bit high...

by Lurch - 2014-10-13 09:10:37

In my very limited experience a minimum of 60 sounds a little high. For example, my minimum is set at 40 bpm.

Hopefully, someone with more experience will be by to comment...

pacemaker rate

by lhogue - 2014-10-13 10:10:35

Hi,
my PM is set to 50 and I pace over 60% of the time. At the hospital I would watch it hit 48. At home with my Garmin and my blood pressure machine it would also drop below 50. It was explained to me that it never gets close to 50 and it has to do with the timing between beats. It's measured a little different and much more accurately than a BP machine. I just assume that it's off a few bpm and didn't worry until I saw 38 consistently. I thought I pulled my leads but I didn't. I had a house call. Then I bought a new HR strap. =)
Take care!

Lower rate limit

by golden_snitch - 2014-10-13 11:10:42

Hi!

In some pacemakers you can program a so called "rate hysteresis" which is designed to promote the intrinsic (your own) rhythm. This setting basically allows the rate to drop a little below the lower rate limit, for instance five or ten beats per minute lower. Also, even without a programmed rate hysteresis many pacemakers allow the rate to drop a bit below the lower rate limit or exceed the upper rate limit a bit. My pacemaker tolerates +/- 1.5 bpm, so it can drop from 60 to 59 or 58, and it can go a little bit higher than 160bpm.

So, if you are programmed at 60bpm, and your rate sometimes drops to 55 or 57 that should be okay. I'd start worrying, if it drops 10 or 20 bpm below the lower rate limit, but not when it's only 3-5 bpm.

Best wishes

Inga

You know you're wired when...

You have a maintenance schedule just like your car.

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