Pacemaker Pulsing Rate

Your PM is just like ...

by donr - 2018-09-10 15:46:39

...Rocky Balboa "Ya godda do what ya godda do!"  In your case the PM has to keep a lot of beats going to keep you above the magic number of 60 BPM.The PM  is like a fire dept - always on the alert, 24/7/365!. 

Your PM monitors EVERY beat your heart takes.  If the beat isn't on time, it sernds a message to the heart to beat!.  Sounds like your heart rarely beat on time.  The PM is just a fancy, high tech timer.  It starts counting ass soon as a beat takes place & if another beat doesn't start within a second of the previous beat, it sends its pusde that starts the next one.  That one second wait time is based on a HR of 60 BPM. )   So it's not working on a time basis, but rather on a number of beats.  84% is no big deal - mine works over 99% of the time & has for nearly 14 years.  It is NOT Unusual for high per cent use rates for a PM.  You are in good hands.

Donr.  

New pacemaker

by AgentX86 - 2018-09-10 15:47:40

At a normal resting rate of 40ish, your new pacemaker is pacing 100% of the time you're resting and sometimes when you aren't. All seems to be normal for Bradycardia treated with a pacemaker.

It's really good that it's going so well for you. Makes one enjoy life again.

Of course you think of questions after you see your EP. That the way we're built. ;-) Ask here (and again when you see your EP next).

% Pacing

by Going Forward - 2018-09-10 16:55:22

I am 3 weeks out from implantation with a very similiar history. I went in for a check 3 days later and they said it was pacing 99% of the time. Mine is also set for 60 as a baseline--is this the standard, default setting? I am going to ask my EP if moving it up to 65 might help with endurance and orthostatic intolerance. They are much better with the 60 baseline but maybe 65 would help even more? Anyone's experience?

pacing

by Tracey_E - 2018-09-10 16:59:24

I've paced nearly every beat since 1994. Don't over think it. Under 60 works for some people but most of us do much better with a pulse over 60. If we feel good, we are pacing the right amount. The heart is still doing the beating. All the pacer does is send the signal, the heart responds by contracting. 

Going Forward,  yes some people feel better with it set higher than 60. 

Change to Lower

by PacedNRunning - 2018-09-10 17:03:36

I had the similar issues. I’m 17 days post. I was originally set to 45 bpm Low end. The morning after surgery I was pacing a lot. My heart normal Resting is 40-45. So he adjusted it to 40 bpm that morning. I was fine until I went to sleep and woke up to my heart pounding weirdly for 4 mins. He then set it to 60 bpm bc I was going into junctional escape rhythm. I was pacing 70% At that time. Before it was less than 20%. I didn’t like being paced that much. I never had issue with bradycardia before just occasional dizziness and shortness of breath. Anyways , I had it turned backed to 45 bpm and I pace a lot less back to 20%. So much better! Maybe have them find that sweet spot and if your not having symptoms turn it down some. 

Pacing rate

by AgentX86 - 2018-09-10 21:55:50

When I had my pacemaker implanted in February, they set the minimum rate to 80bpm.  My EP said that I probably wouldnt like it (I didn't) because I was used to 40-50, when it wasn't 110 (AFlutter).  He said that there was a risk of sudden cardiac arrest if it was set too low for the first few weeks.  This had something to do with the AV ablation but I don't know much more than that.  At the 30-day check, they lowered it to 70, where it's been since.  I really don't mind 70 much but I'd prefer it lower, at least at night.  I'm going to ask (6-month check Friday) if they can put it on a timer (I know the pacemaker knows the "time" - sorta) so it can be 60, or even 55 at night and maybe 70 during the day.  I have some other adjustments I want to have made, too.

The comment was made above about a higher base rate allowing easier exercise.  This isn't the case.  During exercise, either the SI node or the rate response feature of the pacemaker will increase the heart rate to accomodate exercise.  If the SI node is in control, there is nothing that needs to be done.  If the rate response is turned on, then some adjustments may be needed to match demand better but the base rate doesn't have to change.  It should be set just high enough to make sure the body has enough blood to function at rest.

To all the Newbies outr there...

by donr - 2018-09-11 00:59:46

...(That's all of us w/ less than abot a year of pacing)  unless you are unusual, you do not feel yourself being paced.  Ask Tracey - paced 100% - I'll bet shew feels nothing.  I'll bet she does not even sense her PM being there.  I'vbe been paced since Feb, 2003 & till  this day can never tell you I'm beig paced - & I run a bit under Tracey's 100&.  I'm 99+% paced.  MOF, I am so oblivious to the existence of my PM that I have to syop to think that I even have it. 

Now - that beig said,  I did know when I was being OVERPACED during the first 3 weeks of my hosting duties.  I never felt a single pacing event, but knew that I was being paced TOO Fast ast my base rate.  They had me paced at 80 BPM. Before going into the OR, I tild my EP that I was a natural 72 BPM, so knowing beter than I bout HR, he stuck me at 80.  I was miserable.  How did I know?  Because I was constantly agitated & anxious.  Hyper -alertstressed out.  I went to my cardio & told him, he set me back to 70 & told me to go out & walk around the hall for 5 min & come back to tell him how I felt.  Worked like a charm.  My HR just did not match my mood.  

"They"just do not like to make too frequent changes at first while you get used to the idea of luggig your Titanium Buddy around with you for a while.  

I'd hazard a guess that none of us had any idea abot what our pacing rate would be pre-implant.  Why?  Because nothing runs long enough to get a hint - except a Holter or a Zio monitor.  Nothing counts individual beats - other than a PM - long enough to calculate any such number.  besikdes, if they did calculate the predicted pacing %, you would never believe it!

Before you started down this road, how many of you realizd that a normal heart at 60 BPM beats nearly 3.6 MILLION times in a 30 day month?

It's a whole new world we are living in - one we never knew existed.  You have to adjust to a new reality to survive comfortably in it.  Just think of the things you now know about the human boy that you did not know before.  The heart & it swcirculatory system are wonderous devices - more complex than man ever believed before the invention of the PM.  Enjoy it!

DonR

correct

by Tracey_E - 2018-09-11 09:27:46

I feel nothing. The signal the pacer makes is itty bitty. I can feel the faster rate but not the pacing. 

Leave Well Enough Alone

by epic44 - 2018-09-12 17:48:59

Thank-you for the replies on the pulsing rate.  I am a newbie as someone mentioned with not a lot of experience with my pacemaker.  I feel really good.  A lot better than I did before the implant.  It's doing its job, quietly and efficiencently.  Unless there is a problem I am going to "leave well enough alone". It is strange but since the implant I think I have a "better sense of well being overall".  Not going to rock the boat.

well being

by Tracey_E - 2018-09-12 21:28:04

Many times having a low rate, and the lack of oxygen that goes with it, happens so gradually that we have no idea how bad off we were until we have a normal rate again. We compensate, we tell ourselves it's not enough sleep/too much stress/ etc etc etc. The most obvious symptoms are fatigue and dizziness but all of our organs need oxygen so it's not your imagination that you feel better overall! My eyesight got better, my brain wasn't as foggy, some irregularities in my blood work went away. Oxygen is a good thing :o)