Heart Rate Settings

Hi, new member that just had a St. Jude CRT-D device implanted a week ago. This is my 5th device, over the years implanted, so I'm not new to the devices. I have had different brands, last one was a Medtronic ICD unit. I have total heart block and have suffered with V-tach episodes for a long time. That has been taken care of, now I stay in Afib for months at a time. I have had 2 strokes, due to Afib. My question is for anyone that would know why my heart rate was set at 60 in the hospital. I am used to about 85 - 100 heart rate, and feel now that I have !just bottomed out. So tired, no energy at all! Can or will they reset your settings up to a higher heart rate if you just ask them? A simple question that I am very serious about! I would really appreciate any insight into this. Thank you so much

4 Comments

Ask to have it changed

by IAN MC - 2015-11-21 09:11:35

You are now on your 5th PM. I am a little confused . Are you saying that number 4 pacemaker had a higher base rate setting but this one has been set at 60 for some reason and you are now having symptoms.

If this is the case, ask to have the same setting that you had on PM no. 4. It really is a simple job for them to raise it, so have it raised and see if you feel better.

Sometimes they install PM s with straight-from-the-box settings instead of tailoring them to the individual patient and 60 bpm is a very common setting. The higher the setting the more pacing you would get so they may have set it low to avoid unnecessary pacing and to prolong battery life ( but how you feel is more important than that ! ).

The PM doesn't necessarily reduce your resting HR , it simply determines the lowest HR that it will tolerate before it kicks in. So theoretically your heart could beat at 85 - 100 most of the time, but occasionally it may drop below 60 and then you start pacing. It depends on your own heart condition.

The base setting should be no lower than a rate at which you feel comfortable.

The most important thing of all is " how you feel " and it sounds as though 60 bpm base rate may be too low for you.

Let us know how you get on

Ian

Heart Rate Settings

by Leady1 - 2015-11-21 10:11:16

Thank you for your quick response, I really appreciate it! That certainly makes sense to me about the straight from-the-box setting trying to save battery life. That seemed to be a real problem for my 4th device as my battery barely lasted 3 1/2 yrs. Number 4 had a much higher base rate setting which for me worked perfectly. Now I am SOB and extremely tired all the time, of course my CHF is getting worse as well. I am totally PM dependent and have been for about 15 yrs. This all makes better sense now, I will just ask to have it raised and go from there. Thank you for your comment, it really helped!

Leady1

Settings

by Good Dog - 2015-11-21 12:11:55

Yes, the previous post was most likely correct. It just happened to me. I had mine changed over 2 weeks ago. The doc promised (because I asked) to restore my settings from my old PM. Well, they restored some, but not all. My minimum rate was actually higher than it had been. I take my pulse often, so I knew. I went in for my checkup a week after the implant and told the tech that I wanted all of my old settings back. I told her that I was comfortable with them. She said I'll have to ask the doc. I responded by saying that he had assured me he would restore them. She said, yeah, I am sure he will say O.K., but I need to ask. She did and he said O.K.
My point in all of this is that even if they aren't out-of-the-box settings, you need to tell them what is going-on and ask them to restore your old settings.
Sincerely,
David

Unclear

by Cabg Patch - 2015-11-23 09:11:47

Since your post isn't concise, this may not be applicable...
If your natural base heart rate (the rate of your heart not your device) is 85 - 100 bpm, and they set your device for 60 bpm, what they are doing is allowing your natural strong rhythm to drive the pacing of the ventricles.

My St. Jude's Quadra Assura CRT is set to 60 as well but my own heart beats at 65-75 so they allow the atrium to drive the CRT and thereby pacing of my ventricles which is less stressful on the heart and saves battery life.

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I, too, am feeling tons better since my implant.