Pacemaker dependent?

Pacemaker dependent

by AgentX86 - 2019-12-08 13:04:46

There are different definitions of "pacemaker dependent" but the most useful one is that your heart, without your pacemaker won't beat on its own at all, or won't at least fast enough to sustain consciousness. Being 100÷ paced is not the same as being dependent. In your case, with a resting rate of 27bpm, you could be either. When they test for dependency they run the pacemaker down to 30bpm (the lowest they're allowed) and see if the heart takes over at that rate (it's a really unpleasant feeling if you get down that far).

On the other hand,  being paced 100% means that your pacemaker is programmed to pace faster than your SI node such that the artificial pacemaker takes over completely from the natural pacemaker.

If you're dependent, it doesn't mean that if your pacemaker dies, you do too. There there a several places in the heart that will pace other than the sinus node. The fastest of these usually takes over. While they may be too slow to remain conscious, they give one time.

Thanks Agentx86

by Heartfelt - 2019-12-08 13:19:48

I did not know there was another source besides the sinus node that could take over. It’s been depressing to watch my decline. When I first got the pm I was only 60% dependent; now I am 85% on settings of  70bpm during the day and 60bpm at night. 

Pacemaker dependent

by AgentX86 - 2019-12-08 13:49:52

You're not 60÷dependent, you're just paced 60% of the time. Even if you're paced 100÷ of the time,  all it means is that your pacemaker is set to a higher rate than your heart would sustain naturally. If your pacemaker went away, you'd pace at the somewhat slower rate. If you were dependent, the rate wouldn't be fast enough to support conciousness.

There are several other sources of pacing, other than the SI node. Generally the next slower pacer is the AV node. In theory, any of the nervous fiber in the heart could be a pacemaker. Indeed that pretty much what PACs and PVCs are - ectopic beats from other than the SI node.

Life doesn't change when you;re "pacemaker dependent."

by Gotrhythm - 2019-12-08 14:21:36

You're taking the notion of being "pacemaker dependent" too much to heart--if you'll pardon a pun.

And I think you're a little mixed up about how the pacemaker works. You said you will talk to your doctor when your heart "can't get to 60 or 70 on its own."

Your heart isn't doing that now. That's why you have a pacemaker. What "beating on its own 15%" means is that approximately 9 times in 60 seconds, your heart beats on its own. All the other beats are generated by the pacemaker. 

Hrer's how this works. The pacemaker lets your heart do every bit it can on its own. It times every single beat. When a beat is due, if your heart generates a beat then the pacemaker does nothing. It just starts the clock again.  If your heart doesn't beat when the time is up, the pacemaker will generate a beat. Then once again it will wait to see if your heart will beat on its own. And so on. Day in, day out. Year in, year out.

In terms of your experience, there's no difference between being paced 99% and being paced 67%. Since a beat is always there when you need it, you feel the same. If or when you become pacemaker dependent, it won't be neccessary to "do" anything. You are already doing it. You will definitely need a pacemaker but hey--Good News!--you're set. You already have a pacemaker and it will do exactly the same thing it's doing now.

Even if you're "pacemaker dependent," your pacemaker will be doing exactly the same job it's doing now.

Gotrhythm- thank you!

by Heartfelt - 2019-12-08 14:26:14

I understand now. Thank you. 

Glad I could help

by Gotrhythm - 2019-12-08 15:39:15

That's what I love about TPC, and the reason I keep coming back even though I rarely post for myself.

There is so much one needs to already understand just to able to ask the right questions.  

Fortunately, we can come to TPC where there are many people who know a lot--like AgentX and many others, and people like me--who are sometimes able to get to the heart of the matter.

Oops, another pun. ;-)

Pacemaker dependent

by AgentX86 - 2019-12-08 16:11:54

BTW, I've been pacemaker dependent since I got mine.  I had an AV/His ablation so neither my SI nor AV node do anything. I have no detectable escape rhythm either, yet I live perfectly normal life. I walk a *lot* (can't run because my knees and feet would rebel). I can do anything I did before, plus some. There in really nothing to worry about but you're not even close to that and unlikely to ever get there.