Heart rate

Hi everyone,

question---at the start of my problem( asymtomatic bradycardia) . pvc count 22,000-- EP did an ablation and pacemaker done on same day. Put on flecainide 50mg twice daily. In three months pvc count dropped to 4,500.

pacemaker was set at 80bpm at the start. I asked my cardiologist if 80bpm could be reduced to 70bpm. He said no with no explanation.

anyone have such a similar experience? I tried to condense this as best as I could.    Thanks for your help.   Old Jock


6 Comments

Over pacing ?

by Gemita - 2020-01-02 19:40:37

I have been on both Flecainide and higher heart rate pacing to try to stop my arrhythmias. I haven't had an ablation which may be necessary in the future although everything is mostly calm at the moment.

I guess your doctors don't want to risk triggering your PVCs again by lowering your heart rate from 80 down to 70.  I was told that my arrhythmias (including benign ectopics like PVCs) were predominantly bradycardia induced and that by keeping a strong heart rate I might keep arrhythmias at bay. It doesn't work for everyone but it certainly works for me. 
 

Flecainide didn't work well for me. Between your pacemaker, your ablation and Flecainide, your PVCs are being well controlled so do you really want to change anything right now ??

PVC’s

by Old jock - 2020-01-02 20:27:01

You have a good point there. Right now I am swimming (laps) 3 days a week and walking 2miles on alternate days. I read that high settings on pacemaker significantly lowers ejection fractions (25%). Study also said based on data available that pacemakers should not be set at more than 75bpm. I guess I'll mark time on this. Thanks for the feed back. 
                OLD JOCK

PVC’s

by Old jock - 2020-01-02 20:27:05

You have a good point there. Right now I am swimming (laps) 3 days a week and walking 2miles on alternate days. I read that high settings on pacemaker significantly lowers ejection fractions (25%). Study also said based on data available that pacemakers should not be set at more than 75bpm. I guess I'll mark time on this. Thanks for the feed back. 
                OLD JOCK

Are you predominantly right ventricle paced ?

by Gemita - 2020-01-02 20:49:53

Hello you are doing very well I see !!

My understanding is that with high % right ventricular pacing (alone) this may ultimately lead to heart failure in some patients.  I have dual lead PM with very low percentage right ventricular pacing - almost 98% paced in right atrium so I do not feel overly concerned. If ventricular pacing increased I would be more concerned. Do you know what your % right ventricular pacing is ? 

Pacing

by Old jock - 2020-01-02 23:17:29

Hi,

I don't have that info on right ventricle---I have a dual pacemaker, Assurity

model 2272 and is attached to right atrium and right ventricle. I'm looking to get some info from Merlin monitor at the moment. Thanks again for info.

    OLD JOCK

Yep, BTDT

by AgentX86 - 2020-01-03 00:13:19

I also had an AV/His ablation and PM.  They started me out at 80bpm because there is a high rate of SCA with new AV ablation patients.  After a month they lowered it to 70bpm and the plan was to reduce it to 60bpm after the second month.  Plans changed when I started throwing bigiminal PVCs (felt awful) at night.  The answer was to raise my rate back to 80bpm.  The idea is to "over pace" (pace faster than) the PVCs.  Whatever is causing the PVCs doesn't have a chance to do its thing because the heart gets depolarized by the PM before it has a chance to. Worked for me and though I don't like being paced at 80bpm, PVCs were worse.  They did set my heart rate down to 50bpm at night so I could sleep.  Once in a while the PVCs will start up but it's a decent tradeoff.

You know you're wired when...

You participate in the Pacer Olympics.

Member Quotes

I feel so blessed to have this little gem implanted in me. When I think of the alternative it is quite overwhelming sometimes.