Newbe

I'm new to a PM, still can't believe I've really got one!  I had afib and decided to not have an ablation, as I didn't feel anything.  I thought"no problem".  Then I needed a hernia repair and the surgeon wanted a cardio release.  Cardio did a test and didn't like it so recommended a PM.  Got it done and now most everything is way better.  My sleep is the best in a long time.  I don't see the dr for 6 months, so how do I know when it's OK to move my arm, drive, etc.  I'm now 2 weeks after implant, hate sleeping with arm band.  PM is set for 70 BPM, but my normal is 58.  I know doctor makes some decisions, but is 60 a better number?  Thanks

1 Comments

It's a learning curve

by crustyg - 2019-10-20 17:42:47

Glad that you're sleeping better - very important for recovery: probably should ditch that armband - all you really need to do is avoid lifting your elbow above your shoulder on the implant side, and even that restriction is debated with modern, actively fixed leads.

Chances are that you've been set up with default PM settings.  For technical reasons 130 is the common max, and many EP docs are nervous providing a lower value than 60 or so - but a lot depends on your age, heart health (don't laugh, I mean health of arteries, muscle, usage etc.).  50/160 is common for us younger athletes, but you are a proper senior, so limits will commonly be tighter (narrower).

Now starts the negotiating process: if you provide good reasons for wanting a lower minimum rate your EP doc will probably get it adjusted.  But be careful what you ask for - I was at 50/160, asked for 45, got it, did Pilates next morning and went straight from there to the EP clinic to plead for it to go back to 50 - just couldn't use the muscles at any rate with such a low HR and no feed into the rate response algorithm whilst scissoring legs on my back.  But I live 5miles from a teaching hospital and there are always EP techs around.  Might not be so easy for others.

Some PMs offer a different minimum rate for sleeping for exactly the reasons you've discovered.  Ask about it.

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