The setting parameters when there’s no underlying rhythm.

Hi,

My 6 year old went into complete heart block last February following an open heart surgery, and she had a pm placed on Valentine’s Day. I know the bottom parameter is 80 and the top is 180. She’s sleeping (fairly deep sleep) and her heart rate is 90-93 instead of 80 like it was in the hospital. She had her first pm appt with the ep on March 25, all looked good. Can anyone explain why it would be 10-13 bpm higher than the low setting at sleep? She doesn’t have a fever or anything.

3 Comments

Perfectly normal

by AgentX86 - 2019-04-16 22:58:19

The lower heart rate setting is just the floor, where the pacemaker will kick in so it doesn't go lower.  As long as her heart is supporting a higher rate, the pacemaker just sits and watches.  The normal heart rate for children five to fifteen is 80-120bpm, so she's right in there.  You may be getting a little OCD about this.  Relax.

Up and down

by alicia6650 - 2019-04-16 23:12:55

I think that its reasonable for a heart rate to vary from the lowest setting. The low parameter of 80 means that her device won't allow her to drop below 80 beat per min, but if her heart is beating a little higher on its own and in a normal sinus rhythm, I don't think the pacemaker will kick in. I think there is a normal fluctuation of heart rate during sleep. If there was something concerning going on they probably would have seen it when they interigated her device. Even if her heart rate goes up a little, as long as it never gets to a dangerous or worrisome rate I wouldn't worry too much about it. 

But if its bothering you, call your doctor. There is no reason you shouldn't ask the EP doc every single question you have...when caring for yourself OR your child, YOU are the best advocate. And the only way to be the best possible patient and/or parent of a patient is to stay educated and ask questions!! I am sure it is so stressful to deal with this as a parent- so do everything within your control to make it easier on yourself. If that means calling the doctor three times a week while you get used to all this, so be it! 

 

Good luck to you and your daughter!!

av block

by Tracey_E - 2019-04-17 11:57:36

With av block, the main job of the pacer is to make sure the ventricles beat when the atria does, so that just means her atria is going faster than 80. As the others said, when in doubt don't hesitate to ask her doctor but most of us with av block don't need the pacer to make the atria go faster, we just need it to make the ventricles stay in sync. Also, it's possible that her heart is healing from the surgery. 

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As for my pacemaker (almost 7 years old) I like to think of it in the terms of the old Timex commercial - takes a licking and keeps on ticking.