a couple questions

Hi! I got my PM Monday. The pacer folks re-set my device from 50 to 60 yesterday. (We can call 50 the prior "minimum" or not, since the pacer folks said the pacer was doing 98% of the work at 50. At 60, I'm guessing the pacer will be setting the pace 100% of the time.) I have a bit more energy now, but still don't feel especially good. Anyway, here are my two questions:

I've had A-fib and flutter for years, so I've gotten used to a (wrist) pulse that's pretty irregular. I timed 60 regular beats at the wrist yesterday. Today, however, I sometimes feel the nice regular beat-beat-beat at the wrist, but other times it's beat-beat-beat-beat-pause-beat. I assume the heart has likely beaten 6 times, not the 5 I can feel at the wrist, but that's one question--and, is it cause for concern.

My second question relates to the minimum setting. Is 60 pretty standard?

TIA for any thoughts on either subject.

6 Comments

Give it some time

by Theknotguy - 2013-12-21 10:12:21

Give your body some time. You may not be feeling the six beats. If you watch the pacemaker on a heart monitor you'll see it doesn't skip a beat. It may not feel that way, but trust the PM to do a regular beat.

On the other hand, if you have a-fib you might be feeling a consistent beat which you haven't had for a long time. After I got my PM I'd go into coughing fits because the PM was telling my heart, "Beat now, beat now, beat now." My heart couldn't just go off willy-nilly as it had been doing. So that was a strange feeling. I'd also get some thumping in my jaw because I was getting a regular, strong beat. But that's all diminished - it took about 60 days but it stopped. I also had a lot of trauma so that may have slowed down my recovery.

I don't know if 60 beats is normal settings or not. Will ask at my next cardiologist visit. I am set at 60 beats.

If they didn't tell you, I'd find out how they have you set. They couldn't control my rhythm so they are controlling my rate. I can still go into a-fib but they are using Metoprolol and Cardizem to control that. The PM keeps my heart from going too slow. Others with a-fib on the PM are rhythm controlled. Which are you? You'll probably want to find out if they haven't already told you.

I have to watch that I don't go into an a-fib session where the heart rate goes faster and faster. If I do I can take extra Metoprolol to slow it down. If the Metoprolol doesn't work I have to punch the button and go in the ER.

What they didn't tell me was that it gets better. I have a strong, consistent beat - that's great. I don't get dizzy when I stand up. I don't have to gasp for air. I can do exercise and feel good when I finish. My memory is sharper.

So, in the meantime, hang in there. It gets better.

Theknotguy

PVC

by Jonny - 2013-12-23 02:12:14

I suspect the "missed" beat is in fact a PVC (pre ventricular contraction). Many of us have these and they aren't a cause for concern. They come and go but don't be alarmed. For more info on this just type in PVC in the Search function at the top right of this page and you'll get loads and loads of info on it. Best of luck. John

it takes time

by GillyC - 2013-12-23 03:12:10

It takes time to trust your pm - I had atrial flutter for so long it was SO weird to have a regularly paced heart and at the beginning I noticed it all the time. What seemed like missed beats and then what seemed like catch up beats. I can only say, three years on, I've learned to trust that my pm is going to do its job regardless of if I'm checking up on it or not. Try to relax a bit and write down any questions you have, so when you do go for pacing, you will be able to be a little more in control ... Happy holidays xxx

Hi, Gilly

by heart925 - 2013-12-23 04:12:34

Thanks for the good advice. It's much appreciated, and I'll take it. Happy holidays to you, as well !!!!!!

Hi, John

by heart925 - 2013-12-23 04:12:41

Thanks very much for your comment. I'll use the search function as you suggest. Sorry for a tardy reply, and thanks again. Happy holidays!

Hi, theknotguy

by heart925 - 2013-12-23 04:12:42

Thanks very much for your detailed comment. I appreciate your helpfulness, and am sorry I've been slow to reply.

I've been coughing, but my cough started (in the hospital) a couple days before the device was implanted. Despite the cough starting a couple days prior to the implant, I'm guessing the two things are related. My HR before the surgery was basically 30 to 33. I'm still coughing.

I think I'm in the same boat--if you can't do the rhythm, settle for the rate--but I'll ask them, as you suggest. I still have the A-fib and flutter sometimes, and still take Cardizem for that.

Punch the button?

I got a very abbreviated exit interview after the procedure, unfortunately. Not a lot of information about what I should expect, or an approximate timetable.

Yeah, I've gotten pretty tired of being dizzy, gasping for air from time to time. I was exercising right up until my lower chamber quit getting any signal from its pal upstairs. Then my HR dropped right to 30-35, and stayed there. Next morning went to the ER, three days later the PM. I only hope I recover the energy I had before the HR's (rather) sudden plunge.

I'm feeling a lot better than I was two days ago when I made the post. I think I was really struggling with the PM set at 50. Raising it to 60 helped.

Thanks again!

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