Initial exam

I'm trying to gather all the info I can. I recently went to a cardiologist for a routine physical. My father died with heart failure at 54 so I'm concerned. I'm 68 and have never had heart problems. I exercise daily and have good health routines. During the exam I was informed of a low pulse rate. My pulse has always been low and I attributed that to exercise. He ordered a EKG with turned out normal. He than suggested a halter monitor for 24 hrs. which I did. I turned it in and a few days later I got a call from the nurse informing the monitor showed my heart rate dropped to 35 at one time 5:30AM during sleep. She said the doctor wanted to place a pacemaker in me. It almost put me through the wall. I couldn't believe I would be notified in that manner. I made another appointment and at that app. he said it wasn't necessary for a PM if my rate went up during activity. He ordered a stress test which was normal, but still insist I need a PM?????

8 Comments

Hi cool cat

by IAN MC - 2014-01-19 04:01:15

I think it is crazy to have a PM just because your HR falls to 35 bpm at 5.30 in the morning IF YOU HAVE NO SYMPTOMS !

Athletes commonly have resting HRs as low as 35 bpm during the day , you may naturally have a low heart rate,it may be normal for you !

If I were you, I would keep a watchful eye on your heart rate , measure your pulse occasionally and only consider a PM if your situation changes.

Keep us informed

Ian


numbers

by Tracey_E - 2014-01-19 04:01:50

Sounds like this dr could use some communication lessons. What is routine to them, and truly your problem is one of the easier they probably deal with in a day, is still a big deal to you and should never be handled lightly with big news given over the phone with no details.

There is no one magic number that screams you need a pm. 35 is very low. The question is, were you at 35 for 5 seconds or 5 minutes or the last 5 years? Under 60 is labeled bradycardia. Most people do fine with a regular heart rate in the 50's, some even the 40's. Once you get lower than that, even if you feel ok it's probably hard on your body. Our organs need oxygen, a heart rate in the 30's is not supplying enough.

Did he mention Sick Sinus Syndrome? It's when the sinus node (nature's pacemaker) gets lazy at rest and our heart rate dips. Once we are active, it kicks in gear and responds normally. Some need a pm, some just need monitored. If you are not getting dangerously low, if you go up appropriately on exertion, if you are able to do whatever you want and feel good, you probably fall in the wait-and-see category.

Do you know if your dad's heart failure was heart attack (plumbing issue) or SCA/cardiac arrest (electrical failure)? A history of SCA in the family is more concern than a heart attack. Slow rates and electrical issues are unrelated to heart attacks, unrelated also to how well we take care of ourselves and our overall health. They often just happen at random, like a short circuit.

One last thought, many of us tought we were getting by pretty well with a low heart rate, but once paced with a normal rate, energy skyrocketed. It was like that for me. After a lifetime of 40's, I'd learned to compensate and get by. I didn't think I felt that bad until I had something to compare it to.

It did it ...

by donr - 2014-01-19 05:01:33

...ONCE. I should think that out of the thousands of beats every day that one episode - length unspecified - isn't enough for a PM. Unless, as Tracey mentioned, it was for 5 minutes.

Getting a PM is an invasive procedure. I'd ask for a longer time w/ the Holter before agreeing to the PM.

BTW: A stress test tells nothing about electrical activity of the heart - UNLESS it is a bicycle or treadmill test where they make a continuous ECG on you. You did not specify which it was.

Sounds like this guy made a decision & is now trying to justify it.

Don

snap cool cat

by nellie - 2014-01-19 05:01:41

Hey huny totally know how you feel..... I got results over the phone and was told I was booked in for a pacemaker.mine is for periods where my heart is stopping for long periods. Then docs did a 2nd check of my results and rang me to say they were very concerned and now ive been brought forward to this thurs. It knocks you flying....you have loadsa questions but no one has the time to explain things to you. Keep strong and dont be afraid to talk to people close to you they will get you through this. Lots of love xx

Heart rate and sleep apnea

by Theknotguy - 2014-01-19 06:01:30

You didn't say if your Dad had sleep apnea nor what kind of heart problems he had. So that's an unanswered question for us on the forum.

I moved 2000 pounds of wood on Thursday, walked the dogs 3 1/2 miles on Friday. Turned the corner for the exit trail with the dogs and woke up six days later from a medically induced coma. Unfortunately physical activity doesn't mean you are exempt from heart problems. If I hadn't been as active I wouldn't have survived the six day medical coma. My problems are on the electrical side.

Went in for my PM check. Doctor told me I'm pacing 23/24 percent of the time. All while I'm sleeping, which makes sense.

During deep sleep my brain shuts down and so does the autonomic nervous system. So I stop breathing and (unknown to me) my heart shuts down too. Surprise, surprise! Wondered why I was getting better sleep with the PM. Guess I would if my heart kept beating. The CPAP keeps me breathing which helps sleep too.

So, like the others said, I'd get some further check outs. But if you're having problems on the electrical side you may need the PM even though you don't feel like it. Get enough information so you can make an intelligent decision. But don't think you're a he-man who can live without a heartbeat.

Please don't do what I did. Collapsing on the trail with a heartbeat of 20. Then my heart stopped in the ambulance. They couldn't get it restarted in the ER until they put in a temporary PM. They waited four days to see if I would live, then put in the permanent PM. I didn't know anything about it until they woke me up six days later. Surprise! You're in the hospital! (I am?) Surprise! You've got a pace maker! (I do?) Surprise! You've got six months of recovery! (I do?)

Life is a lot better with the PM. More energy, better response rate, am warm instead of cold, etc. Plus the best part - I'm alive.

Theknotguy

Don't go for it...

by Duke999 - 2014-01-19 08:01:39

It appears that your doctor is fishing for business.
If you feel fine, everything is OK, and have no symptoms, then go on living WITHOUT the pacemaker. Unless things change as time goes on and you have symptoms, then at that time research thoroughly and make absolutely sure that's what you need before you let anyone put a foreign object in your body. It's a very serious decision to make. Don't let them sell it to you. I wish you luck.

Duke

Thanks

by coolchangecat - 2014-01-19 09:01:06

Thanks all of you for your comments and questions. It means a lot to find people you can discuss this with. I wanted to mention more of my situation in the initial post, but wasn't enough room. I have read everything possible on this subject and watched youtube videos of procedures. As for some of your comments and questions. I am aware that athletes can live with heartbeats of 35 & less. While I exercise regularly I don't believe for any minute that this is my situation. I'm almost 69. I will find out about the situation of how long my rate went to 35. 5 secs. 5 mints. or 5 yrs. I know the last is not correct. Yes, the cardiologists did mention sick sinus. He also mentioned that as long as my heart rate does increase with exercise or activity I probably don't need a PM. But after speaking with his nurse who gave me the results of the stress test which were taken on a treadmill I impressed upon her that I wanted to make certain we were all on the same page. She said she would speak with the doctor and call me back. When I heard from her she said the doctor said I still need a PM. So that is why I am so confused. One second it is monitor it and the next you need PM. I understand thyroid or electrolyte imbalance could be a cause, but none of this was communicated to me. I found this out myself. In the morning I am making two phone calls. One to the original cardiologists and the second to another cardiologists. I am going to tie the first to a chair until he takes the time to explain everything and all my questions. Than I will get all my records and see the second doctor. As for the question about my Dad. I do not know the cause. I was 14 at the time and he died in 1959. My mother also had a PM. She was extremely healthy and active her whole life. I cannot remember how old she was when she had it put in, but she was 92 when she went in for a procedure on the PM. She died about 12 hrs. after the procedure. I can only assume the procedure was to replace the generator, but of course it could have been a lead or something else. By that time she was starting to be frail. And thanks for the comment "theknotguy" I won't try to be a hero and fight it. I just want all the I's dotted and the T's crossed .After all this isn't a matter of "toe fungus". And I do understand from some of the articles I've read that people have felt a lot better after the PM was implanted. However I don't have any of those symptoms. I'll keep ya'll advised as I get more info and make a decision. I'm sure it'll take a week or two. Thanks again.

Tracey has it right...

by MelodyMarch - 2014-01-19 11:01:51

There is no set number. I was not tolerating my bradycardia well when my daytime resting was in the low 50's/upper 40's and dropping to the mid 30's at night with occasional short (usually less than 5 second) pauses, which barely meets criteria for implantation. I also was not increasing HR with exertion however, which is what finally pushed things over.

I would say if you are not symptomatic to wait and watch. They say things are not hereditary with electrical issues, but since your Mother had a pm, I say that genetics is still a very young field and we do not know everything.

I too at this point would tie the doctor and the nurse together to that chair and find out why the answers are conflicting so.

You know you're wired when...

You always run anti-virus software.

Member Quotes

Without this little machine, we would not be here.