Sustained increased pacing when falling asleep

Periodically, just as I am falling asleep, my pacemaker kicks in and raises my heart rate to 120 and sustains that pace.  Sometimes it is for 5-10 minutes, other times it is 1-4 hours.  I know my inherant heart rate is lower than the low setting on the PM, and I wonder if this is happening when my HR drops below 60 bpm.  Also - I am not moving when the HR goes from 60 to 120 during these incidents.

As you might imagine, this isn't much fun, and really ruins my night's rest.  I thought for a while that it might be related to days when I drink a few beers (never more than 3).  I am currently on a dry January, and not drinking doesn't seem to impact the frequency of these events.  Also, I seemed to notice this on evenings of days where I exercise - I am a jogger.

Has anyone else experienced this?  If so, what did you do?  My doc and the device folks at my hospital aren't concerned, yet cannot give an explanation for why this is happening.

I have a history of A-Fib./Flutter, and this doesn't feel much different to be honest.

3 Comments

What's really going on?

by Gotrhythm - 2018-01-22 15:01:32

It's really, really unlikely that your pacemaker is suddenly driving your heart rate up and keeping it up when you are at rest. That's just not how pacemakers work. Your pacemaker is timing the interval between every single beat. When it's time for the next beat, f your heart beats on it's own, the pacemaker does nothing. But if the interval gets too long, the pacemaker will supply a beat. Then once again, it will wait to see if your heart will beat on its own. And so on. 

But, the pacemaker will not prevent your heart from speeding up on its own.

It seems to me that a first step is to acertain whether you in fact are having A-Fib episodes. You say it doesn't feel much different. My pacemaker automatically records A-Fib; it's possible yours does too. If that's the case, a simple interrogation of your device can provide the answer.

In my experience, doctors repond best to succinct, direectly expressed questions., i.e. "When I'm falling asleep, it feels like my heart is going into A-Fib. Would interrogating my pacemaker show if that's what's happening?"

If the problem is in fact A-Fib, then listen to Robin. She knows a lot.

 

Simple

by ROBO Pop - 2018-01-22 18:36:08

Your pacemaker will record these events and when they do an interrogation they will be able to get a read out and determine the cause. 

God it pains me to say this, but Gotrhythm is right, it's not your pacer doing that. 

Ask the Dr what is going on. Likely PVCs or SVTs

Likely to be AFib

by Paced2017 - 2018-01-22 19:16:23

Given that you have a history of AFib/flutter then I think this is the most likely reason for these high heart rate episodes. You can confirm this by noting down the date and time when these occur and then confirming whether this matches up with data downloaded from your pacemaker. But as mentioned it may also be PVCs or SVT.

Many people get AFib without symptoms. If interrogation of your pacemaker shows that you are spending alot of time with AFib, then medication can help to bring your heart rate down. This will help to reduce the risk of getting heart failure in the future.  But more generally weight loss is really important for people who are overweight/obese and can dramatically reduce the time spent in AFib. And limiting alcohol is also recommended based on research studies, although this may not have helped you.  

 

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So, my advice is to go about your daily routine and forget that you have a pacemaker implanted in your body.