Pacemaker sleeping Lower rate

Hi  everyone,

I've just had a 3rd PM interrogation & it is working as it should do I am assured. I was a tad surprised when told I was being paced at 98% upper & 2% lower is that good or bad?

Has anyone had their lower Pacemaker BPM rate lowered at night to improve sleep if so has it worked, my own PM lower rate is set at 65bpm day & night. So we talked & have adjusted it too 55bpm at night in the hopes my sleep pattern improves ( I constantly wake & am restless throughout the night), sure am hoping for an improvement!!

Best wishes & Stay safe everyone



by Tracey_E - 2020-07-13 10:37:21

If you are feeling good, you are pacing the right amount. There is no number that's good or bad. Some pace less than 1%, some pace every beat. 

Good or bad

by AgentX86 - 2020-07-13 11:07:46

It's very good. Excellent,  in fact.  You're still 0n the green side of the grass. It gets no better than that.

Nightime settings: Yes. I'm paced at 80bpm during the day to scare off the PVC demon. From midnight to 6:00AM, it changes to 50bpm. It does make some interesting times if I'm out late or up early but it generally works for me. There is something to think about,  however.  It's called Daylight Savings Time. I have to have my pacemaker's time changed just like some of the antiquated clocks in the house. I set my in-person appointments up near the time changes. The three month interrogations, between, are done using the remote box.

BTW, where did you get my picture for your intro line?

Pacemaker sleeping Lower rate

by WazzA - 2020-07-13 11:25:48

Didn't even think about summer time & winter time, I'll bear that in mind . I'm sure it's weird at times if you stay up late & your ticker suddenly suddenly slows to night time resting  :-) 

Best wishes

Spared no expense!

by crustyg - 2020-07-13 12:22:11

I'm afraid I've decided not to endorse your Dinosaur Park, Mr Hammond.

It's a great pic, and at the size I see it, made me think of the fab film.

Not all PM's have a sleep-mode lower limit, but it seems that it can be a really useful feature for some.  I sleep really badly, but for a bunch of different reasons, none of which can be blamed on my PM.  I have a real problem with upper airway closure as I drop off, but a trial of CPAP didn't help with the sleep disturbance, even though it stopped me snoring as I fell asleep (even when sitting up - and I have a 15inch neck).  I'm told by those more expert in these things that there are a *lot* of factors to consider.

sleep problems

by Gemita - 2020-07-13 12:38:08

Hello WazzA,

I would say those numbers 98% (right atrium?) and 2% (right ventricle) were good figures to have.  Mine were, within the last few weeks, almost 100% right atrium and less than 1 % right ventricle (RV).  I find ventricular pacing uncomfortable and of course there is always the fear that with high RV pacing this could lead to problems in the future in some unlucky individuals who might develop heart failure symptoms, but of course many of us are paced 100% in the RV without any problems at all.

I prefer a higher heart rate at night to keep my ectopics away but I hope your reduced HR settings help you.  It is miserable to have sleep problems.  You could look elsewhere too.  Beta blockers are known to cause sleep disorders.  Both hubby and I can struggle at times and lie awake for hours without relief.  My sleep consultant said that beta blockers can use up melatonin which induces sleep, so replacing melatonin might help or ask your doctors about taking certain medication at a different time.  It may not be your pacemaker settings since so many conditions can affect sleep.  If it is a real problem you could ask for a sleep study to check whether there is any sleep apnea occurring or restless leg syndrome or other sleep disorders, but only a thought if things get really difficult to manage.

Yes you look most distinguished with your beard WazzA and I am sure AgentX86 does too.

Sleep well

Pacemaker sleeping Lower rate

by WazzA - 2020-07-13 12:48:21

Thanks Gemita, I do have some nasty nightmares with Bisoprolol so will bear that in mind. 

Lower Pacemaker Settings

by Marybird - 2020-07-13 13:40:34

I have a St. Jude Assurity dual chamber pacemaker and I'm not aware of a day/night minimum rate setting feature in this one, if there is a function like that I'm not using it.

That said, last summer during my 6 week followup after the pacer implant the EP set the minimum heart rate at 55 BPM, he said so I wouldn't pace up to 60 at night as this wasn't necessary during sleeping. He also turned on the rate response (which for some reason wasn't turned on when I got the pacemaker), and told me this would make a big improvement in the way I felt. He also said with that I would only see the 55 heart rate when I was perfectly still, it would be higher than that with any activity at all. At that time, before the minimum heart rate was reset to 55 from 60, and prior to the rate response turned on, my pacing rate was atrial 84% and  ventricular less than 1%. When it was checked during the next office visit in January 2020, the atrial pacing rate was 91%, ventricle still less than 1% (they tell me they don't want the ventricles paced ideally). We all agreed the pacer settings were fine where they were and no chnages were made. 

Turns out the EP was right on all accounts, though sometimes I see the heart rate at 55 when I'm playing couch potato but no surprise there. I kind of got used to a low heart rate before the pacer, so I find the 55 when I'm sleeping kind of cozy, and with the rate response it goes up where it needs to with activity. I generally sleep well, which would be more of an issue with a higher heart rate- on occasion I still get some tachycardia at night, but not that often and I can ride it out. I think part of the reason I sleep well is also the medication I take for high blood pressure and tachycardia ( diltiazem, metoprolol amd losartan) and I throw in a 5 mg melatonin tablet for good measure. 




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