New Pacemaker patient

I had a two lead Medtronic PM implanted on Nov. 7th. I feel great one day and exhausted the next. The days I feel bad my BP is erratic.

One night I could not sleep and I checked my pulse and it was 91 BPM!  I read that it takes some time for  your body to adjust.

Thank you for your insight. (I realize everone is different....to a degree)


7 Comments

It's an accelerator, not a brake

by AgentX86 - 2019-11-18 23:21:41

Your pacemaker can only make your heart beat faster it cannot make it beat slower.  If you have some sort of arrhythmia (SVT, AF, or AFL) it can't do anything but watch it.

pacemaker

by nana judy - 2019-11-19 08:32:19

I am totally lost! I have A-fib and A-flutter. My understanding was the pacemaker with AV ablation would correct the problem. What good is a pacemaker if all it does is watch? I will be glad when I go in to have my pacemaker check-up I have questions that need to be answered and should have been answered before I left the hospital. I understand that if my heart rate falls below a certain rate the pacemaker ups the heart rate. If that is the only thing it does then why do the procedure when A-fib or A-flutter is the problem?  

AV node ablation

by AgentX86 - 2019-11-19 08:46:43

That's a whole different kettle of fish. The AV node ablation stops any signals from the atria to the ventricles, so Afib/Aflutter don't propagate to the ventricles. If you didn't have the pacemaker there is _probaby_ an "ectopic" beat that would keep you alive but perhaps not even conscious. The pacemaker is added to increase the rate to a normal level. The PM still can only increase the rate. It cannot decrease it. If you then have an arrhythmia started in the ventricles (PVCs, VTach, or Vfib), all it can do is watch. An ICD can stop the heart in Hope's that it'll restart in a normal rhythm but a pacemaker can do nothing but watch. Of course even an ICD won't do anything for PVCs (the cure would be worse than the disease).

Pacemakers with Arrhythmias

by Marybird - 2019-11-19 12:01:52

I was told by the EP that put in my pacemaker that the pacer keeps the heart rate from falling too low. If you have a tachyarrhythmia ( such as afib, a-flutter, SVT- atrial tachycardia in my case), medications are given to keep the heart rate, or heart rhythm under control. In some people, those medications make the heart rate go too low, but they are needed to control the arrythmias. It's also generally believed that these medications may not actually cause the bradycardia but unmask an underlying problem the person already has. That seemed to be the issue in my case, or so my docs said.

But essentially, in a person with a tachyarrhythmia with a side of bradycardia, the pacemaker keeps the heart rate from going too low, allowing for high enough doses of the medication to control the tachyarrhythmia. And I'm happy to report that works for me.

Ambien anyone?

by mspriss - 2019-11-19 23:02:06

Thank you all for responding to my concerns.  My PM is set at the low end of 60.  I could not relax and read and I checked my PR with a phone app. It was 87 BPM  

I've taken OTC sleep aids for years but now it doesn't relax me at all. While in the hospital for four nights I was given Ambien  It helped me relax,  I've never taken script sleep tabs but......I'm more than ready to ask for one now! Do any of y'all take a script sleep aid?

MELATONIN

by Gemita - 2019-11-20 16:40:28

Hello MSPriss,

I too have a dual lead Medtronic PM and initially I got tachycardia at night and sleep just wouldn't come and I felt dreadful and thought I had made a terrible mistake in having the implant. All of a sudden my heart seemed to be jumping around far more and at first I thought my PM was faulty. Now 18 months on and looking back, I realize I had gone through so much and my poor heart was just trying to adjust to being paced and to get over the trauma of all the tests I had to endure. 

As far as a sleep aid is concerned, I was told that beta blockers which many of us take to control heart rates during arrhythmias, can lower melatonin levels and that is why so many folks may find it hard to sleep or to stay asleep.  My sleep consultant suggested I take a low dose of melatonin a few hours before bedtime.   He did not recommend anything else because of the potential to develop dependency and the need to increase the dosage over time. 

AV node ablation

by Sandraphm - 2019-11-22 16:29:18

I've had four ablations and after 3 years I'm starting to have tachycardia again (occasionally getting up to 187 while I'm sitting).  I just had a pacemaker put in Nov. 6.  It's my understanding, as with Marybird, that the pacemaker is to make it safe to give me the meds needed to control the afib, aflutter, or whatever, without my heart rate falling too low.  They decided to put it in after my resting pulse rate was 41 and a stress test only got it up to 81.  I have noticed a lot of fluctuation with my pulse rate, but I've been assured by my doctor that's normal for only 2 weeks in.  He did say there was a slight chance that the pacemaker may eventually prevent my heart going into afib, aflutter, whatever, but that's not it's primary function.  That would be icing on the cake.

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