Heart Rate over 60?

Your resting HR is now controlled by *you*

by crustyg - 2021-02-21 03:35:15

Hayden: now that you have a dual-chamber PM, your normal, healthy SA-node is controlling your HR.  The atrial lead detects the electrical activation and the PM passes that activation down to your RV, bypassing your CHB.

Given your history of anxiety, and the fact that younger folk generally have a higher HR than seniors, and, at a guess, your lack of physical activity due to various factors, your SA-node is driving your heart faster than you are used to.

Hopefully we'll be out there soon, enjoying the longer days, better weather and your HR will come down naturally.

My thoughts

by Gemita - 2021-02-21 04:18:15

Hayden on what I believe might be one of the reasons behind the higher heart rate although much can affect our heart rate including anxiety, fear, excitement, trauma, exercise, vagal tone, health conditions.  If you are symptomatic with your higher heart rate I would check with your doctors but 75 bpm is still very much within the normal SA node range of 60-100 bpm.

Normal intrinsic (natural) heart rates (adult ranges) slow from top to bottom along our electrical conduction system.  They are as follows and I attach the link which might be helpful:-

https://ekg.md/content/electrical-conduction-system/

    ▪SA node (60-100 BPM) =>

    ▪Atrial cells (55-60 BPM) =>

    ▪AV node (40-60 BPM) =>

    ▪His bundle (40-45 BPM) =>

    ▪Bundle branches (40-45 BPM) =>

    ▪Purkinje cells (20-40 BPM) =>

    ▪Ventricular myocytes

You now have a dual chamber pacemaker Hayden.  Your atrial lead in your right atrium is following your Sino atrial node which has an intrinsic heart rate higher than the fixed rate of 60 bpm which was previously set by your technicians for your earlier pacemakers.  The only problem was your heart block prevented your natural atrial rate from passing through your AV node to pace your ventricles at the higher rate.  

Your first three single lead pacemakers treated your AV block I believe by pacing the ventricles at a fixed set rate of 60 bpm.  The new dual lead pacemaker will work differently in that the atrial lead will sense your natural intrinsic heart rate in the right atrium (say at present 75 bpm) and pace your ventricles at this rate.  If the pacemaker is set up correctly it will give you a much more natural heart rate, although it may take you time to adjust to this.  Are you getting any troublesome symptoms from the higher heart rate?  I believe you are on a beta blocker for your non sustained VT and this should hold down your heart rates in any event.  It all sounds normal to me Hayden at this stage and I wouldn't be worried.

Otherwise, how are you doing ?  Are you healing nicely ?

it's a good thing!

by Tracey_E - 2021-02-21 11:08:28

To expand on what crusty said, adding the second lead means your sinus rate is setting the pace now. The higher rate might take some getting used to but in the end I would think you'll feel better with the heart being in sync. 

Thank you,

by PacerPrice - 2021-02-21 13:24:16

Thank you for your help,

I wasn't quite sure what was going on but using all of your information and Gemitas link (thank you) I have realised that my own heart rate must be a bit higher than 60, which is healthier now I am being paced like a "normal" heart. It is quite strange going from the last 17 years where I have been paced with a single chamber pacemaker with an almost fixed rate of 60, to now a natural heart rate, but I am sure like you have said, I will get used to it with time. 

Everyone on this group is always so helpful and kind and I thank you all for that, you really know how to give some piece of mind and alleviate some anxiety of mine. 
 

Thank you Gemita, I am feeling much better. The scars are healing really well, I have been given some tape to stretch over Them for the next 6 weeks ( this is a new thing they are doing at great ormand street to help reduce the size and appearance of the scars). I am feeling good, no pain anymore but I still do feel tired quite a lot of the time, but I think that could be more to do with the fact we are in lockdown and I am practically not going anywhere all day.

I have a pacemaker appointment on the 3rd of March where I will have a exercise test, too make sure the new dual chamber+ beta blocker has got rid of the exercise induced non sustained VT.

How are you doing?

Thank you all 

I think you are doing very well

by Gemita - 2021-02-21 14:05:41

Hayden, I am so pleased to know you are being well looked after by Great Ormond Street Hospital, but we wouldn’t expect anything less, would we?  Good luck for the 3rd March and I hope you get good results.

How am I?  Well putting on some lockdown weight Hayden and am getting very angry with myself and taking firm action.  I am on a diet now.  I don’t eat the wrong foods, I just eat too much of the right foods so for the moment I am restricting myself and getting more exercise.  I will soon be back to a happier body weight (I hope).  Got out into the garden yesterday.  Was spring like down here.

Yes this lockdown is making me feel lethargic also, probably why I am putting on weight too.  I think when we are free to move around without restriction, when we can make plans again, we will feel brighter and use up more calories.  Don’t forget too that your beta blocker can make you feel very tired Hayden, especially when we first start treatment.  Hopefully you are on the lowest dose to stop those non sustained VT episodes.

Glad you are well,

by PacerPrice - 2021-02-23 16:39:47

I am glad you are well Gemita, 

I too seem to of put on some weight over lockdown (haven't we all!:)) however I have always been slightly underweight so getting the extra weight in is quite nice for once. I am happy with the announcement Boris Johnson made last night so hopefully we are even closer to getting back to our normal selves!
 

And yes I do think the new beta blocker has been contributing to my tiredness, but I need to take it to help the non sustained VT. the new dual chamber pacemaker should have stopped that however, my report says it could have been induced due to local stimuli, which the doctor says could have been the short lead pulling on my ventricle(how strange). 
 

Im glad you are well, always nice to talk with you,

Hayden