Minimum heart rate

I have had my device for 3 days now. It is a Boston Scientific Advantio series. I turn 50 tomorrow. :-) Prior to installation, my resting heart rate was mid to high 40's. I am very active, enjoying workouts in the gym and cycling. My question revolves around the minimum heart rate setting from my doctor. He set it at 70. This both sounds and feels too high for me. Resting in a chair or trying to sleep at night, it feels like my heart is beating too fast. Is it prudent to request it be reduced to say 60, or should I just be patient and try and adjust? Other than this issue, everything else seems fine so far.

13 Comments

Sounds reasonable

by Galadriel - 2013-10-07 02:10:04

Hi, I am almost 6 weeks post op now and had a pre rhr of 40s when doing ok and below when not. I am also very active, running by choice. My initial lower setting was 60 and 50 for night time. I felt 60 was a bit high for me, although I must admit I have adapted more as time has passed. However, I had my first pm check today and after talking to the technician we went for a 50 lower setting with 45 for night time. He also upped my rate responsive top setting from 150 to 170 which will only be supplied if my motion needs it. From what people say on this great forum, it can take a few goes at tweaking settings to get it just right but bearing in mind your hr was in the 40s, 70 seem a big leap. Incidentally, I turned 50 in July. Happy birthday!

Hope this helps

Cath

Sleep Mode

by ebfox - 2013-10-07 02:10:11

I am pretty sure the Medtronic has a sleep mode, which reduces your minimum during a set schedule. You will have to go back in for an interrogation to set that up.

You may wish to discuss lowering your minimum rate; it could be that he wants it higher than your intrinsic junctional rate, that is just a guess. It is not unusual to play around with the settings at the beginning.

Good luck,

E. B.

Does or have a Rest rate?

by lbdina - 2013-10-07 02:10:26

I'm new to this world, so I can't offer a lot of advice. My PM has a maximum rate, a basic rate AND a rest rate. My basic rate is set to 70, and the rest rate is set to 60, apparently to help with sleep when my body's needs are reduced. I mention this because I originally thought my PM was set to an absolute minimum of 70, and was concerned when taking my pulse and measuring low 60s. I thought perhaps my PM wasn't working properly. I wonder if yours also has both basic and rest rates?

FWIW, I seem to sleep fairly well at a rest rate of 60. I say 'fairly well' because I am a light sleeper and have never been very good at sleeping a full 8 hours, especially if I get up in the night for a bathroom break.

wait

by cropduster - 2013-10-07 03:10:52

From my experience, I would wait & see how you feel. We are similar ages & pre pm my heart rate was about the same as yours. I too am active.
I had mine set to 60 initially, 24/7. I felt great for about 3 weeks then started to feel ill again. They put it up to 70, again 24/7 & turned on rate response & I felt great again.

Like an idiot I went back a few weeks later as I couldn't sleep very well & persuaded them to put it to 60 at night. I too could feel my heart as I lay there trying to sleep.

60 is too slow for me, going out at the weekend, driving home late meant driving when I was at 60bpm. Not high enough. Plus I realised if I go on holiday, to another time zone, I will be at 60 during the day potentially.

So I had them put it back to 70 24/7.

After a few weeks I settled down, I don't notice it now.

IMO, give it time.

Initial settings only?

by SaraTB - 2013-10-07 04:10:24

Bear in mind that when you first get your PM, they tend to set it at 'factory default' settings, adjusting it more precisely to your needs at your follow-up appointment. 70 does seem high - as Tracey says, 60 is more common, but they may have a good reason for it. As she says, ask them to see you if you don't feel good: my initial settings made me feel terrible, could hardly exert myself. It's not uncommon, particularly with us younger patients, for it to take several adjustments to get it set up to your personal requirements, so be prepared to persevere and keep telling your doctor if it doesn't feel right.
I had my first PM at 43 - it took 6 months or so to get it fine tuned. These things have such a complexity of settings that it's not easy.
Good luck and let us know how you get on.

why

by Tracey_E - 2013-10-07 04:10:30

Why did he set it so high? 60 is more common but sometimes they have a reason for keeping it higher than that. If you don 't feel good, call and ask to be seen. It does take a while to get used to the higher rate, whatever it is. My rate went from low 40's to high 70's (on my own, not paced) so I felt like I was mainlining coffee for months. Now it feels right.

Settings

by Grateful Heart - 2013-10-07 05:10:07

3 days is early but if you are very uncomfortable, you can ask to have an adjustment for your lower setting.

Chances are you may need another adjustment or two as your device settles in, the swelling subsides and you become more active again.

Happy Birthday and welcome to the club!

Grateful Heart

Happy B-Day!

by ohiolaura - 2013-10-07 09:10:36

Im not real experienced either,I got my PM last year at 49 1/2,and it was set however the surgeon and EP set it.
After 10 days,I wasn't feeling the way I thought I should,and felt like crap basically,ended up in the ER overnight,had a local Cardio see me,the Pacer visited,and changed a setting to 60,and ever since been going strong.I hit 50 this year,and am very active,the settings I have seem to be good for me now.
If you don't feel right,speak up,its your health!!
Bet its a easy fix,good luck and welcome to the 50 club!
Laura

comfortable heart rates

by LuCas - 2013-10-07 10:10:08

Hello,
It is observable that everyone here has requested different settings, more comfortable heart rates. Well I too have asked my cardiologist to change it since the very beginning. It was initially set to 80bpm. I could not sleep. I asked to lower a bit and the doctor set it to 70, base rate and 55bpm during rest. We both thought that I would get 55bpm only after 11pm and the cardiologist even called a colleague because he could not set it properly. His colleague told him it was ok. I was a St. Jude model and the characteristic is that it is automatic. When I get moveless for certain time, my hr goes down to 55bpm. The cardiologist was used to Biotronik, which allows the rest rate begin at a certain time. However, both brands (systems) have advantages and disadvantages. If you are driving late at night, and being moveless inside car, you may automatically go to rest rate, if you have Saint Jude.

However, for people who have had AV node ablation, doctors set the heart rate to 85bpm during at least 3 months to avoid the secondary appearance of something they call Torsades de pointes.
Lucio Castro

Advocate for yourself!

by HoneyBadger - 2013-10-07 10:10:22

I am 54 and had my pacemaker operation this past July 15th for heart block. When I came home from the hospital, I felt very anxious, paced a lot, and couldn't sleep well. The initial settings were not good for me. I think I too have always had a low heart rate. Initially they had me set at 60 with the rate response set on. I went back in to the cardiologist and he lowered it to 40 and turned off the rate response (he said the rep never should have left RR on for my condition). I'm feeling better now and pacing less than 1% in the atrium and 1.8 in the ventricle. With my original settings, I was pacing 36% in the ventricle- I feel much better now. As everyone seems to say, it takes a while to get the settings just right, so don't be afraid to speak up!

Mines set to 40

by Ravenflight - 2013-10-08 03:10:43

I am 44. Mine is set to 40 then will pace at 60 if hr falls below 40. A second setting looks for a sudden drop to less than 20 then paces at 100- that's to compensate for any vagal episodes. I am not sure that it really works to keep me conscious though. I'm thinking of having both settings raised- I get very tired and sleepy since the pacemaker was put in. Also I had a number of vagal episodes triggered by extreme pain right after a recent hernia surgery and the 100 bpm vagal setting did a rather poor job of keeping me conscious. On the plus side I sleep very very well after the pm was put in. The quality of my sleep has vastly improved.

You left out...

by donr - 2013-10-09 09:10:11

...ONE itty-bitty detail that just might help those of us who cannot read minds from afar!!!!!

What was your resting HR BEFORE you got "Sick" & needed a PM? You mentioned 40 BPM, but not when that occurred.

WHOOPS! Make that TWO details - What is the reason for the PM? Your diagnosis, in other words?

Lemme give you a F'rinstance: Before PM, my resting HR was 72 - all my adult life. I rec'd my PM for SSS - (Sick Sinus Syndrome), so they could not see what my REAL HR was & I came out of surgery w/ my Lower Rate set at 80.

Big deal, only 8 BPM too high. BUT - that extra 8 BPM made me feel like my heart was always beating too fast. I was always "Hyper alert." Agitated while resting. At the end of three weks of this, at a routine check up I had them drop it to 75 BPM from 80. In 15 min I could feel the difference.

The Amateur Cardio in me says you have a gripe, but I have NO IDEA how much of one because you left out a couple details.

Don

answer to Don and follow up...

by gennings - 2013-10-11 09:10:59

First to Don...My resting heart rate has always been in the 40's. My diagnosis was chronotropic incompetence. My max heart rate was in the 130's.

Now, follow up to my post: I went to the doctor and had my minimum heart rate lowered from 70 to 60. WOW! What a tremendous difference! I feel better throughout the day and am sleeping like a rock at night. At my next follow up visit I'm going to ask about this "sleep mode". I'm not sure if my PM has one, but I'll find out! ;-)

Thank you for all of your replies. It's comforting knowing there are people going through the same thing as me, but even better is that you care enough about others to help a stranger in need. Blessings to each of you!

John

You know you're wired when...

You can hear your heartbeat in your cell phone.

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