Heart rate dropped

New member here, I  Got my pacemaker put in in August. Tonight earlier I had some sharp pains and according to my fit bit my heart rate got down to as low as 46. It's normal now but should I be worried? Because it's not supposed to get below 60.Thank you in advance


A very common complaint on this forum . . .

by Gemita - 2020-11-21 04:14:02

but nonetheless a very difficult one for some of us to tolerate.  

I believe you are suffering from ectopic beats which are benign rhythm disturbances (arrhythmias). In my experience, I have found that when I develop them, my home monitors cannot always accurately assess my heart rate or rhythm since these slow, irregular, pausing, inefficient beats often confuse my monitor into thinking the heart rate is slower than it is.  The pacemaker however, accurately records the heart beats.  I have had this conversation many times with my doctors, who reassure me that my heart rate cannot drop.  It sure feels like it sometimes.

I usually feel/check my neck pulse to count my heart rate more accurately and to feel the rhythm disturbance better, but this isn't easy when dealing with these irregular beats.  But no, your pacemaker will not allow your heart rate to fall below the minimum set rate.  Our home monitors do not work well with an irregular rhythm and frequently give an inaccurate reading. 

I would though recommend that you speak to your doctors about the sharp chest pain if this continues.  New chest pain symptoms should never be ignored, especially if you are symptomatic.  From your symptoms, there may be inflammation present and this definitely would not be helping.  You could also ask your doctors for external longer term arrhythmia monitoring if you get further symptoms like chest pain, breathlessness, dizzy spells.  I hope for the very best and welcome to the Club


by AgentX86 - 2020-11-21 13:25:48

The problem with ectopics is that they confuse the pacemaker.  The pacemaker is set to beat once a second (assuming 60bpm).  If a beat is sensed within a second of the last beat it "inhibits" itself for the next second.  The ectopic beats (usually premature ventricular contractions or PVCs) come too soon after the last beat for the heart to completely fill with blood so results in a weak beat.  This is why most heart rate monitors will see it as a dropped beat.  It's there but it's less useful.

Since these ectopic beats are weak, the heart doesn't pump as much blood as it otherwise would so your hear gets starved of oxygen but your pacemaker thinks everything is fine - the beat goes on. 

As long as there aren't too many of these ectopic beats it's not a great concern.  If something like 10-30% (I've read both numbers) of the beats are these PVCs, it becomes a problem worth doing something about. 

I''ve had them and know they're not fun.  I had them every other beat at times but my EP only said something because I was concerned.

The bottom line is that you should tell your EP about this but don't be too concerned unless he is.  I'd be more worried about the chest pain.  With the ectopics, there will be less blood flow. Chest pains are one sign that the heart isn't getting enough oxygen.  There should be plenty of reserve capacity in the system to keep up with the heart's needs but the chest pain suggests otherwise.  This should at be discussed.


by PacedNRunning - 2020-11-23 07:07:25

I've learned when our we hit our lower rate limit our heart rate slows between beats. The Fitbit and other watches do not pick up these beats correctly.  You have to drop below your LRL 60 in order for the PM to pace.  I have apple and Fitbit. My LRL Is 45 and I see many under 45bpm per the watch. The PM is more accurate.  I also don't use one reading from these devices.  I get an average. So if my average rate is 48bpm for resting and my PM I set at 45, I'm good. Now if my LRL was 45 and my average resting rate from my watch said 40, then that would signify an issue that needs further looking into.  What is your daily resting rate? Is it at or near your LRL of 60?  That's what really matters. So basically it's ok to see lower readings here and there but you should not average below your LRL of 60

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