At what heart rate is a pacemaker recommended?

Hi Gang,

From your experience, when did you know you had to opt for a pacemaker?

My heart rate has been declining steadily for three years now that I'm aware.  I'm wondering when I should know to make the decision?  My electrophysiologist has said I'm ready, and I'm resisting. I just don't want to concede I need it, I suppose. His response was telling: you'll decide when you're uncomfortable enough. 

I'm an active 63 year old male, on my feet long days and enjoy working and athletics, but dealing with a darn failing sa node.  In 2015 my hr was bottoming out in the mid 50's  in 2016 I was in the mid 40's.  Now, at night, I'm often at 40, some nights dropping occasionally to as low as 38. During the day, when I'm inactive, like working at my desk, reading, etc, I often feel weary, heavy, unmotivated.  Some mornings I wake up wishing I could just go back to bed.  So I wonder, how much is my age playing a part in this, am I just feeling age appropriate tiredness?  Or can I expect a significant improvement from taking the plunge?

I should add that I started experiencing pvc's this summer, which led me to investigate my heart issues.  They are intermittent, sometimes just for a few seconds, sometimes for 20 seconds or so. Some days I don't have any, so from what I can tell they are not severe, but they are scary, stop me in my tracks!

I'd be grateful for your guidance.

kind regards,

JP

 

12 Comments

The signal may be very clear

by MartyP - 2017-09-13 23:42:03

If you suddenly faint and wake up, you need it.

If you faint and wake up and you've wrecked your car, and maybe killed someone it's too late.

If you faint and don't wake up it won't much matter.

If it was me, and IT WAS ME THIS PAST MAY 27, IT WAS A NO BRAINER!  No question, no hesitation, 4 hours later  I got my "Sparky" 

"When in doubt, there is no doubt"

No brainer

by jp - 2017-09-13 23:49:05

Thanks Marty. I haven't felt faint, or dizzy, or anything like that. I try to work out 5 days a week, cardio, light weights.  I tell my wife I'm a world class athlete. ;) She thinks I should get the PM as she knows I'm just a regular joe. 

Did you pass out?

Out like a light at breakfast with my wife at our local diner.

by MartyP - 2017-09-13 23:57:16

Let me add this and you can read one of my earlier posts.

Your heart is now compromised, it is not going to heal itself, over time as you now know, it will only get worse.

Do it now when it's not emergency.  The actual operation is quick, mine was 30 minutes.

Full recovery in 2 to 3 months. I work from home so I didn't miss any work, and I went back to weight training 3 weeks ago.

I was "superwoman", I didn't need no kicker to keep my heart going I said as I fainted

by Miss Emily - 2017-09-14 00:50:55


Actually I felt more like superwoman after having it installed. At first I was apprehensive, but as I got use to my new friend I started feeling better. Yes, there are times when I felt it kick in and I learned to just take it easy for awhile (used the excuse for a day and got by with it). Today I have joined the "100% paced" level and am feeling some apprehension because it is new to me (I have been at the 30 to 35% level for 5 years) and to know that now the PM is kick starting the pumping. But the tech, staff  and cardio assured me that I'll get use to this and it will be just like after I got use to it at first. I really don't feel any different but sure am glad I have this special friend.  My advice, do it.

I understood your last sentence!

by jp - 2017-09-14 01:11:50

Thanks for your thoughts Emily. Actually, much of what you said is going right over my head. I don't understand the expressions like "100% paced level" vs 30-35% level. But I understood "do it". Did you have a low heart rate? Is that why you had to get the pm?

I agree

by Good Dog - 2017-09-14 08:33:59

I agree with all the previous comments. Don't put it off any longer. If you do, you may be asking for something bad to happen. I had my PM implanted 30 years ago and my life has been completely normal. To this day, no restrictions. My PM has not stopped me from doing anything. I mean that literally. 99.999% of the time, I forget that I have a PM. The only impact my PM has had on my life is positive!

We all often think that we are unique. You are not. Save yourself and your family some grief.

 

Sincerely,

David

simple

by The real Patch - 2017-09-14 12:30:48

when your heart rate is too low, and yours is too low, the organs do not get an adequate supply of nutrient enriched blood to sustain healthy function, you slowly are dying...but hey hold off long enough and you won't need one.

Having a pacemaker is not a big deal, dying most likely is

Its Time

by ljharper62 - 2017-09-14 12:34:25

I was told that a low heart rate becomes dangerous when it is in the 40s. I have a near faining episode (the ground was literally spinning up to meet my face, or that's how I remember it). I am 55 and pretty active. At night I had a sensation that I forgot how to breathe. I'd have to shake myself awake to take a breath. I was seriously wondering what the heck was going on with me.

My primary first took me off of blood pressure meds and checked my tsh levels - both can cause a lower heart rate. But my rate stayed low and my tsh was normal. He sent me to a cardiologist that day and I had an appointment with an EP the next day. I had no other tests outside of the ecg that confirmed the low heart rate. Both my regular cardiologist and my EP said that there aren't any medicines that will "fix" bradycardia and with a failing SA node the fix is a pacemaker. 

I had no hesitation. I've had mine for the last 4 weeks and while I am still sore on occaision, I feel so much better. All of the issues with dizziness and near fainting spells are gone. I typically walk 3-4 days a week and my doctor okayed me to start adding back other exercises slowly. 

 

Best of luck to you

JP - as we spoke earlier today ..............

by MartyP - 2017-09-14 15:37:03

To a person, the answer is "just do it" no more pondering, no more second guessing. Certainly ask all your questions of your doctor, find a slow spot in your calendar (not far in the future) where you can take a week off (that should be enough unless you need to do a lot of physical labor), get it done and get back to all of us and all your family and friends who care about you when your "Tesla" is charged up and keeping you motor running.

"When In Doubt There Is No Doubt"

Age appropriate tiredness?

by Gotrhythm - 2017-09-14 15:39:01

Shortly before the need for a pacemaker was diagnosed, I remember remember remarking to a friend that for the first time in my life, I felt old. I was 68. I was tired, apathetic, and lived in a mild fog in which I sort of, kind of grasped what was going on around me, but I look back at some of the things I did--like driving when I was close to passing out--with no awareness of the consequences and shudder.

I credit some of my denial of needing a pacemaker to that mental fog. The thing is, it didn't occcur to me that with a pacemaker, I wouldn't have to feel or act old. I could be alert, vibrant, witty, engaged. I could feel like myself.

You've been knowing your sinus node was going for several years. You know you feel pretty rotten sometimes. Would you like to feel better? You know what the answer is. 

 

We spoke a few days ago ......

by MartyP - 2017-09-16 21:34:15

And I was thinking about you today and was wondering if you were still trying to make a decision or, with all the thoughts provided had the answer come to you?

You are one of the lucky ones who get the chance to make a decision,  many of us had no time to think about it.

Please let us know.

Thanks all!

by jp - 2017-09-16 23:51:10

Thanks everyone for your great, caring, counsel. And Marty, thanks so much for that long conversation and your terrific collegial outreach. That talk, and really, the counsel from you all, has helped me over the edge. I needed to hear, this isn't the flu, it's not going to get better. You'll be pleased to know I've altered my strategy - denial is behind me. I've made the appointment. October 12, if all goes well, will be my day. Funny, my doctor's personal assistant offered me two dates, Thursday the 12, or Friday the 13th!  Can you guess which I picked and why?? ;)

Sincerely, thank you all. You've made me feel so welcome and supported. I'm grateful. Hugs to all. Party at my place on the 13th!!

You know you're wired when...

You need to be re-booted each morning.

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