Manual check o heart rate different than readout on wrist monitor

Good Morning All!  The past month or so I have been having episodes where my heart thumps for a time.  I have manually taken my pulse rate during this and it seems my heart thumps twice, hesitates and then thumps twice again.  My pulse is around 46 during this time.  My pacemaker is set a minimum 60.  Could their be a problem with my pacemaker?



by Marybird - 2021-02-16 09:50:25

Not an expert here, but your description of those thumps sound to me as though they could be PVCs, which when I have had them, have sounded and felt to me like a thump, followed by a pause, then normal heart beats commence till the next PVC. If you have two PVCs, with a normal heartbeat in the middle of them ( bigeminy), that might sound and feel like two thumps with a pause. If you're measuring your heart rate with a pulse oximeter or blood pressure monitor, probably even manually, it won't count the PVCs as a beat, as I understand it. So the reading will come out by about half of what your heart rate is. Individual cases vary, but in general PVCs, even in multiples such as bigeminy, trigeminy ( that's one PVC followed by two normal heartbeats), aren't considered significant unless they reach somewhere around 20% of the heartbeat "burden". 

If its PVCs, it's not your pacemaker. 


by Tracey_E - 2021-02-16 10:59:37

Counting manually is usually more accurate than the monitors. However, there can be small between the stronger beats that we don't feel so the count still may not be accurate. 

PVC's are little half beats between the full beats. They don't feel good but are generally harmless. 

When in doubt, check with your doctor, but odds are it's not the pacer or anything to worry about. 


by AgentX86 - 2021-02-16 13:25:19

That's exactly how bigeminy acts.  Sometimes is strong-weak-strong-weak... but the two-pause-two is another common pattern.  How did you "measure" your heart rate?  Did you count the two lumps as one?  If so, your "heart rate" would be double that.  To the pacemaker, a PVC counts as a heartbeat so it'll start its timer from zero at that point so the effective rate may be lower (counting two as one) or higher (double counting). In any case always bring any such thing to your EP's attention.

I thought the bigeminy was about the worst arrhthmia I've had.  It was awful but fortunately the fix was easy (up the heart rate a little). They found out what it was when I sent them a remote transmission.  The bigeminy PVCs were obvious and I was told not to worry and the fix implemented.  No big deal

You know you're wired when...

Your pacemaker receives radio frequencies.

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I wouldn't be alive if it wasn't for pacemakers. I've had mine for 35+ years. I was fainting all of the time and had flat-lined also. I feel very blessed to live in this time of technology.