Heart rate drop with extra beats

PVCs?

by AgentX86 - 2019-09-21 21:08:19

It sounds to me like you're getting PVCs (yes, PACs can do the same thing but I'm intimaely familliar with PVCs).  These will fool your pacemaker into thinking that a heartbeat has occured so it won't fire.  However, it's sorta a halfa beat because the heart hasn't completely filled with blood, so it can't pump a "full load".  This can feel like a skipped beat (it's not) and often confuses simple rate monitoring devices, like watches and BP meters. Your EP is right.  Your rate isn't going into the 30s but it sure can feel like it and your toy may tell you that it has.  You really need to count the beats by hand to get an accurate rate.  You may need to use the carotid artery, rather than the wrist to feel all of the beats.  You may not even feel it there.

The best course of action is to initiate a remote interrogation when it's happeneing.  Your PM tech can then see exactly what's going on.  Pacemakers don't record these sorts of things so you're going to have to catch your heart in the act.

What matters is how you feel.

by Gotrhythm - 2019-09-22 16:58:44

I remember having the same question and confusion. And I also had pacemaker techs tell me it was "impossible" for my pulse to seem to drop like that. 

What AgentX86 says is right. The pacemaker only supplies a beat any time your heart doesn't beat on its own. A PAC or PVC is a "real" heartbeat, that your heart initiates and so your pacemaker counts it as one of the 70 per minute. But those kinds of heartbeats are called "premature" because they happen before they are supposed to. 

PACs and PVCS are very inefficient heartbeats that might not be detectable to a pulse ox. If you have a lot of PACs, PVCs, you don't feel so good. Although your heartrate "is" 70, if half or more beats are premature, you might feel the same as if your heartrate was 30-40.

Here's what you need to understand about the pulse speeding up to 110-120. If you are at rest, your heart, not the pacemaker, is doing that. The pacemaker can't prevent your heart from beating faster. It can only time your heartbeats and supply any that are missing to make sure you get at least 70. 

I'm not sure what you are arguing with your physician about. Okay, the physician is right. The problem most likely isn't the pacemaker, but so what? What matters is how you feel. That's what you really need to communicate to him and what he needs to address with you.

Heart ♥️ rate dropping

by Pink - 2019-09-22 20:18:07

Thank you! Yes I’ve discussed my symptoms with my EP. He also thought it may be an atrial lead sensing issue. I have a lot of Ectopy. Some days it the PACs last 5 minutes some days 8 hours. It’s exhausting. I appreciate the feedback. 👍🏼

Apple watch

by CMH22567 - 2019-09-23 08:15:39

At the risk of people disagreeing with me, but try not wearing your Apple Watch and see if it makes a difference. I know my fitbit caused interference and I am paced at 100 percent  so the interference was the cause for  my heart rate to drop.

Dear Pink

by CMH22567 - 2019-09-23 08:26:39

I understand how you feel. The same thing was happening to me for 5 months until I had a great technician and awesome electro-cardiologist who listened to my symptoms and they made the correct adjustments to my pacemaker. They increased my min rate from 60 to 70, dropped the power from 5 to 3, this pushed my blood pressure up from 70/40 to 90/60 and I was able to function without the endless ectopic symptoms of fatigue, sweating, dizzy. Until then I was constantly told the pacemaker was fine and all I needed was reassurance. All I needed was the pacemaker to be adjusted to suit me.