Replacement pacemaker set 10 beats per minute less than the old one

Hi, hope everyone is doing ok.  I had my pacemaker replaced this morning, it all went well, the leads were fine.  I'm now home and having my lunch but feel a bit dizzy.  This could be as a result of having had it replaced only 4 hours ago.  However, I noticed before I left hospital that I was pacing at 60, I was set at 70 for the past 12 years.  I queried it with the nurse and he said that the Dr makes decisions based on lots of reasons.  Is 10 beats a minute a big drop from what I've been used to, does anyone know why it would be dropped to 60bpm?  I had a St Judes previously and have been inplanted with a Medtronic this morning.  I'm 67, fit and healthy, do you think 60 is too low?  Thanks.


9 Comments

Mine is 60

by Swangirl - 2020-07-29 12:38:47

What percentage are you being paced?  My doctor thinks a lower setting will allow my heart to beat on it's own more often.  My previous pacemaker was set at 50 and I was paced quite rarely.  Now with an AV block I am paced at a higher percentage.  

My device has rate response or other bells and whistles so when I'm hiking or playing pickleball or in a circuit class my heart will keep pace quite well and I am rarely breathless

factory settings

by Tracey_E - 2020-07-29 16:50:51

Sometimes they don't put all your settings back to how they were on the old one. At this point the drugs in your system could be causing the dizziness. If it continue more than a few days, I'd ask to have this one set like the old one because that was working for you. 

Get it changed back to what you're used to

by crustyg - 2020-07-29 19:28:10

Don't be British about this, get it changed back to what you need.

'Dr makes decisions based on lots of reasons' is cover-my-ass for 'I don't know why it was changed, and I'm not senior enough to have the authority to a) challenge this nonsense, b) just change it on my own authority'.

Since Siddaway, consent in the UK requires full understanding of what's being done and what's been planned.  If your EP doc has changed your lower rate limit without your consent that's invalid, and actionable in the law of Tort.

Your choices:

1 Maximum charm - get it changed back to your usual lower rate - ASAP

2 Threaten to sue your EP doc or move to one who actually knows what they are doing

3 Make a formal complaint to the GMC *AND* the body that regulates EP techs about an unconsented change

or a combination of all 3.

Politely remind them that a) this isn't the 1950s and Sir Lancelot Spratt died years ago, b) that *ALL* patient management is by CONSENT, c) this is *your* heart, *your* PM and *you* life, not theirs.  But having recently watched a 'professionals only' webinar about restarting Cardiology services in the UK post Covid-19 which included a big segment from Central England, I'm not entirely surprised.  Middle Ages barely covers it.

Best wishes.

ditto

by dwelch - 2020-07-30 01:50:42

I think you need to call them up and get an appointment with your EP not a tech.  And get the settings changed back to what you were used to, or at least your lower limit.  Get used to the new device or other settings and meds or whatever then talk about lowering it.  The issue may not be the lower rate, but they need to have a good answer as to why did you muck with my pacer and as a result muck with me and my heart.

I basically fired a doc for this, wouldnt explain the rate change and refused to put it back, so i went and found a different doc, and was much happier for it, much better doc the next time.  The prior one simply treated me like a lab rat, lay down, and click away on the interrogation machine, didnt talk didnt explain, any communication was one direction, I changed your rate to this.  I have had this other rate for 20 years, bumping it up is goign to keep me awake at night.  Well just try it out.  It kept me awake as expected...

Pacemaker Default Settings?

by Marybird - 2020-07-30 16:20:14

Just wondering if your new pacemaker is set pretty much at default settings (such as a lower heart rate of 60), and settings will be set specifically for your needs and with your input at a followup visit and pacer check. 

Settings?

by JerseyGM - 2020-07-30 18:42:15

I had my pacemaker put in June. I have never been informed of my settings. Do I have to get this from the cardio doctor or is there another way? Thanks in advance for any response 🙂

JerseyGM

by Gemita - 2020-07-31 11:37:43

Over here in the UK when I want information following my pacemaker checks, I usually formally ask for access to my health care records by signing and completing a form provided by the hospital where my pacemaker records are kept.  It takes a little while to get them (maybe up to 6 weeks), but they provide me with my complete pacemaker records, or as much or as little data as I request.  There is no fee to pay if I request to have my data placed on a disc for viewing on a computer.  There may be a charge for paper copies.

I see you are in the United States.  Maybe you could ask your pacemaker clinic direct this question, or your EP, but they are your records so they cannot keep them from you. Some folks have even asked for their downloaded data to be placed on a USB flash drive device which they can then view at home.

Thankyou

by Hot Heart - 2020-08-01 08:38:29

I'll speak to the medical team next week and ask the reason why.  They have always been really accommodating so I'm sure they will discuss it with me.  The only reason I couldn't talk to them after my surgery was that I was in a discharge ward when I realised I was pacing at 60 and the medical team had gone back to theatre.  I was really impressed with the system from walking through the door to walking out again, felt safe from Covid.  I've been for about an hours walk yesterday and today and feel fine, just a bit sore, and slept like a baby.  Thanks everyone for your comments.

Lower pacemaker setting

by Aberdeen - 2020-08-02 17:36:30

My CRT pacemaker is set at 50. My previous pacemaker (dual lead was set at 70). I collapsed at home, then was diagnosed with LVSD and RWMA. I now have to take a beta blocker, ace inhibitor and aspirin.

I feel reasonably well and my pulse is between 60-70. Both my pacemaker surgeries were emergency operations . (January and then May this year)Also because of COVID my last appointment was a telephone one. I also have a Medtronic monitor at home. I am awaiting another echocardiogram. I would like to ask more questions why the first was set at 70. Also has anyone else had my experience? My dual lead pacemaker caused damage to the previous healthy left side of my heart. I would like to hear from someone else who this has happened to as it has been a shock for me.

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