New PM- what to expect

what to ask

by Tracey_E - 2018-07-13 18:43:04

First thing to ask is, what is your diagnosis? It sounds like second degree heart block or possibly tachy/brady. Or both, when the electrical systems get screwy we can have a little of this and a little of that going on. 

Heart block is when the atria is beating normally but the signal doesn't make it to the ventricles. Second degree means either some of the signal is getting through all of the time, or sometimes none of the signal is getting through. Third degree would be none of the signal getting through all of the time. 

Bradycardia is the heart going too slow, whatever the cause. Tachycardia is when it goes too fast. It's possible to have both, that's tachy/brady.  If you weren't doing anything and your rate jumped, it was probably all you. If it gets to be a problem, there are medications that can slow it down. The pacer is only a gas pedal, not a brake. It can't do anything but watch when the heart speeds up on its own. 110 isn't that horribly fast. You wouldn't want a resting rate that high, but a few minutes at a time is probably more annoying than dangerous. 

Try not to get in the habit of checking your heart rate all the time, it'll make you crazy! If you feel odd then count, but otherwise trust the pacer to do its job and try to forget about it. 

Expectations depend on diagnosis.

by phil54 - 2018-07-14 05:36:08

My problem is Sick Sinus Syndrome so I can only respond from that perspective. I got my PM about two years ago but my heart still races from time to time.  As TraceyE said, “the pacer is only a gas pedal, not a brake”.  Sometimes when I’m doing a brisk walk on the treadmill at the gym (and holding on to the handles that measure heart rate) I see my HR suddenly jump from the high 80s / low 90s to around 140 or more.  The first time it happened I got straight off but after discussing it with my doctor I just slow down to say 4 kms/hr and it passes.  Six-monthly check-ups show that my heart fibrillates most days, sometimes for a minute or so, sometimes for hours.  I guess it’s just something we have to live with.

What to expect

by Theknotguy - 2018-07-14 10:53:28

What to expect is very hard to answer.  It depends upon a lot of things including your attitude.  As TraceyE indicated the pacemaker is a "gas pedal" and keeps the heart going when it otherwise wouldn't.  As she indicated the first thing is to find out what you have.  That determines treatment.  Second thing is to figure out how you're going to live with it.  Third thing is to just continue living.  Sounds simple but that's about it.  

If you're tacky/brady as TraceyE indicated there are medications for that.  Since doctors can't just look at you and tell you what you've got, it may take a while to get the right medication.  Finding the right medication could take up to a year.  Since it takes about a month for a medication to settle in, that means it takes about two months for doctors (and you) to determine if a medication works.  Even then they may have you on a medication for a couple of years and then switch.  It takes patience on your part.  Frustrating at times but that's the way it works.  

Next is to figure out how you are going to live with the situation. Some people chose to complain. Others to make the best of the situation and move on.  Main point being the pacemaker can be a tremendous help and you can lead a fairly "normal" life with it.  Surprisingly your attitude towards your heart problems and your pacemaker can have a big determination on how things go.  I volunteer at the hospital where I got my pacemaker.  Sometimes I get into conversations when I'm wheeling people out.  You can see the thoughts going through their minds, "If he's got a pacemaker and is wheeling people out, maybe there's hope for me."  The future doesn't have to be all doom and gloom.  

Third thing is to continue living.  Yeah, I'm in afib 16% of the time but I'm retired, volunteer at two charities three days a week, and volunteer with two service organizations.  I lead a fairly normal life and have a good time most of the time.  It just depends upon the attitude.  Like I tell a lot of people, "If you get afib, you go to the hospital.  If I get afib, I just take a pill and keep on going."  If you see other posts from TracyE you'll see she's very active in spite of having a pacemaker.  It isn't a limitation, it's a help.  

Finally, medical science is on your side.  There have been amazing breakthroughs in the past years and more are to come.   Some things that were untreatable in the past are quickly taken care of now.  That doesn't hold true for everything but the future is brighter than it has been.  Within the past four years we've gone from bulky pacemakers to ones that fit inside the heart.  Just this last year a procedure was developed by Medtronic that can repair heart valves without having to cut open the chest.  This or early next year a mitral valve fix will be out on the market too   A lot of things coming.  

In the meantime I hope things go well for you with the new pacemaker.