Altered sleep

why do you have it?

by Tracey_E - 2019-01-24 22:35:54

If you have av block, then your resting rate is not determined by the pacer, but by your own natual sinus rate. The pacer just makes sure your ventricles beat when the atria does. If you have sinus disfunction, then you may or may not be pacing at your lower limit. So, that's a question to ask at your check up.

60 is a standard lower limit, under that is bradycardia which is why we get paced in the first place. It's possible to feel good with it lower but many of us either wouldn't have a lower rate even if it was set lower, or wouldn't feel good with it lower than 60. Only way to know is to try it. However, I'd wait a few weeks, maybe even a few months, to make any changes. How low was your rate before? Mine was in the 40's, then dropped to the 30's, so when I had a perfectly normal rate in the 60's it suddenly seemed like it was racing. It didn't take long for it to feel normal. 

Are you waking at the same time every night? They may have it set to do a self check, and they deliberately program it for when we are asleep. They can change the time or possibly turn it off if it's waking you. 

Altered Sleep

by Tem - 2019-01-24 23:56:30

At the first pm check in hospital the technician asked me where I want the lower limit set. He was happy to set it at 50, but I preferred 60 for the reasons you gave. My resting bpm was between 40 + 55. I have been very athletic all my life + always assumed that lower heart rates were a sign of fitness. Unfortunately it works against you as you age. Ageing athletes  are very prone to heart rthymn disorders, as I discovered. I wasn’t informed as to whether the self test was operational. The forum has provided me with plenty to enquire about on my next visit. I just feel wide awake at 60bpm. It does not go below 60 when set at that level.

Sleep quality

by Selwyn - 2019-01-25 07:54:45

Anxiety itself can disturb sleep. 

Who is not anxious 3 weeks after having a pacemaker insertion?

Why blame the poor sleep on your sleeping pulse rate?

Side effects of lowering the resting pulse: 

1.Prolonged PM  battery life.

2. Increased risk of thrombosis /embolism, therefore stroke, sudden death. ( Reason is that vascular flow rate depends on your cardiac output, and the cardiac output is diminished in proportion to your heart rate. A low flow rate predisposes you to blood clotting).

3. A lowering of your blood pressure ( same reasoning as 2.) Of course, a very low BP may cause problems such as impaired kidney function. Ever tried to get up at night  with a low BP/heart rate-?  dizziness, fainting can occur.  Generally speaking bathrooms are unyielding when you hit them!

Sleep Quality

by Selwyn - 2019-01-26 10:08:22

I am not suggesting that a stroke will follow with a low heart rate- what is being talked about is an increased risk, my so called, "predisposition"

(My on line  Dictionary explains this word meaning by : 1 lack of exercise may predispose one to high blood pressure: make susceptible, make liable, make prone, make vulnerable, put at risk of.)

If you care to educate yourself from an external source:

"Low heart rate. People who exercise extensively can have a lower-than-average heart rate and blood pressure. Both could be risk factors for blood pooling and clotting. A resting heart rate of less than 60 beats a minute, though not dangerous in and of itself, may increase the risk for formation of a clot.12 May 2014
The Downside of Low Heart Rate: Athletes Who Get Blood Clots ...
https://www.everydayhealth.com/.../downside-of-low-heartrate-athletes-who-get-blood-clots   ( Google the Title,By Beth W. Orenstein.Medically Reviewed by Farrokh Sohrabi, MD)

Clearly the more vascular disease you have the more you are at risk. The more dehydrated you get ( does this mean atheletes?) the more at risk you are. 

Endurance atheletes have their own morbidity and mortality. Look up the statistics for marathon deaths and educate yourself further:

'Eleven runners have died while running the London Marathon since it began in 1981, and every year a handful of runners die while competing in such events (one study put the rate of sudden cardiac deaths during a marathon at 0.8 per 100,000 participants '.

'Many amateur athletes wear their reduced heart rates as a competitive badge of honor, proof that they are really fit. Unfortunately, sinus bradycardia is not always an effect worth boasting about. Lifelong athletes with low heart rates need pacemakers later in life much more often than the general population.'

And, " 'of course' an EP would NEVER allow HR to be lowered below a threshold that might lead to problems"! Where have you been for the last few years of reading this Club site?! ( Why not see  HOGG  2018-07-14 09:54:49 post on this site)

I have spent 40 years, as you put it,' playing doctor,' studying physiology when you were still at school!  . We know, there are known knowns; there are things we know we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns – the ones we don’t know we don’t know. I continue to learn medicine and do postgraduate study modules and try to keep up to date.

Try to demonstrate some objectivity.

Selwyn

ar_vin

by IAN MC - 2019-01-29 13:17:00

I don't know which is the worst ....   your ignorance, your arrogance or your rudeness.

Selwyn has a lifetime's experience as a doctor. I have learned much from his contributions. I wish that more doctors contributed to this site !

Ian

Thrombosis Risk in Endurance Athletes.

by Selwyn - 2019-02-01 08:21:07

Deep vein thrombosis in athletes: risks of racing and resting

Beth Parker, Paul D. Thompson, Peter Kriz and Pierre d'Hemecourt

AMAA Journal. 23.1 (Winter 2010): p7+.

Fully referenced and cited by many authors.

Although not a journal article https://www.msdmanuals.com/en-jp/home/heart-and-blood-vessel-disorders/venous-disorders/deep-vein-thrombosis-dvt

offers a view concerning flow rate, where as every physiology student knows: Cardiac Output= Heart rate x Stroke Volume .  Flow rate then depends on cardiac output( and therefore heart rate), the diameter of the vessel, and the viscosity of the fluid within. 

Really!

Selwyn 

takes a while

by dwelch - 2019-02-12 06:08:53

A combination of the pacer changes your hearts rythm for the better, how much better and how depends on your condition and how they are treating it.  And anxiety.  Pain alone after a new pacer (am on number five) I dont sleep well for the first few weeks, but then settle in before I realize it...First pacer took longer, my lower limit was much faster than my normal resting or sleeping rates, plus no doubt the anxiety factor.  It will pass you will settle in to this new life.

Let's not fight

by ChristopherTodd - 2019-02-26 17:58:53

I just had pacemaker put in 2 ago this past Friday. My heart swelled then had to be cut again to move lead. Now I was paced at 50 but heartrate was 43. Today they raised it to 60 and not so tired since leaving dr office. I am anxious beyond belief and really need some feedback and support, that's why I am here. I appreciate anything you have to offer. 

Thanks

Todd