What to expect after a CRT-D installation

Good morning I'm a newly joined 58 yr old male and I unexpectedly had to have a CRT-D installed 4 weeks ago. I'm on Sotalol as well.  I was expecting the side effects of the medications such as light headedness etc, all that is fine.  I do however also have occasional bouts of higher then normal heart beats at rest, and increased blood pressure that last anywhere from 5 minutes to 50 minutes, which isn't listed as a side effect.  Is this something I should expect and get used to? or is this something the cardiologist should be made aware of?  Thanks everyone,


Welcome to the Club!

by MinimeJer05 - 2022-01-06 12:18:46

Hello and welcome to the club! 

One thing most people on here can agree on is that no implant seems to be the same in terms of short-term or even long-term side effects. Plenty of people aren't use to having a "higher" heart beat at rest -- if you don't mind me asking, what numbers are you seeing? I think general rule of thumb is that your heart can run a little fast/high after a surgery and might take some time to go down.

I don't notice this as often while resting, but more so while doing very light tasks like walking around the house -- it's definitely 10-20bpm higher than normal, but I've also had a slower recovery period and haven't been as active as I regularly was.

How high is your blood pressure raising to? I found my at-home monitoring can be very touchy, I can take a reading right now and show you the results of 140/100 and then take it 3 mins later (after sitting here and not moving) and show you 120/80. 9 times out of 10, it's in a good range. I find the best way to test it is to put the cuff on, sit still and not talk for about 5 mins, with feet on ground, legs not crossed, back against chair and arms straightened out. 

If you are able to replicate these higher occurances frequently and can note that you aren't actively doing anything to change them, then absolutely bring it up to your doctors. Without knowing how high is "too high" for you, I can't comment on if it's something to be extremely worried about or more than lilkely just part of the adjustment period.

Everyone has different levels of normal too. For me, sitting on the couch means 70-90bpm, sleeping is 60-70. Walking around is 95-115bpm and actively working out is 120-160bpm.

Your normal might be much higher or much lower than me and that is OKAY. 

Don't be alarmed, but do continue to monitor and report your findings.

Again, welcome to the club!


thanks for the reply

by wikesaka@telus.net - 2022-01-06 13:21:01

I'm grateful for any information I can get with this new event. my resting Heart rate is in the low 60's, with Blood pressure usually 116 over 83 or so.  but once or twice a week I will be just sitting on the couch and my pulse will jump to 85 beats, and blood pressure will be 125 over 91?  I'm not used to my heart going up and down like a yoyo?  Is this normal?

How you are feeling may be more important than those numbers

by Gemita - 2022-01-06 14:00:44

I always go by how I feel and from your post you say you are on Sotalol and feel fine.  I would expect shortly after a CRT-D implant that your heart rate and blood pressure would be somewhat volatile until you and your heart settle down to being paced or until your settings have been personally adjusted to suit your lifestyle.

Looking at your heart rate jumping up to 85 bpm, this is not unusual.  A heart rate of between 60-100 bpm would be normal, anything over 100 bpm would be considered tachycardia.  A blood pressure (systolic of 125 is very good).  Diastolic is slightly above normal at 91, but only just up from your usual 83.  Do you know what your Base Rate setting is (lower pacemaker minimum rate)?  Sometimes when we first get our pacemakers to correct a slow heart rate, a higher Base Rate setting can affect (increase) our blood pressure.  Alas it doesn’t affect mine because I have low blood pressure most of the time, but a higher heart rate can cause an increase in blood pressure for some.  However, personally I would not be worried about your readings and in any event with a CRT-defibrillator, I am sure your doctors will be monitoring you for any serious rhythm disturbances or high heart rates? 

I hope your myocarditis is under control and that your CRT will work well for you and ease any symptoms from heart failure.  Try not to worry about the Defibrillator.  It is there to protect you and to keep you safe.   Of course if you are concerned, please contact your clinic for advice, especially if you get symptoms which concern you (like chest pain, breathlessness, fluid retention). You could take three blood pressure readings a day (a.m., mid day and p.m. for about a week) and give these to your doctors for assessment to see if your blood pressure needs treating?  I wish you well and welcome to the Club.

Life with a pacemaker

by Gotrhythm - 2022-01-07 12:05:30

When I first got my pacemaker I had the erroneous belief that from now on, the pacemaker was in charge of my heartbeat. That made it hard to understand why certain things were happening.

The truth is that your heart is still capable of beating on it's own. The pacemaker just makes sure it doesn't go too slow. A heartrate between 60 and 100bpm is considered normal. And it's normal for the heartrate to fluctuate even when you're sitting down. Maybe a litle worry crossed you mind, you saw a polititian you hate on TV, heard the phone ring... the list is endless and completely individual.

Ditto blood pressure. The so-called "lie detector" test, or polygraph depends on the fact that HR and bp do vary, even when sittling still, because of things outside our consious awareness or control.

Because of the natural variation one reading or even two won't mean much. As Gemita says, take it at the same time, maybe serveral times a day for a week. That will give you a better idea of what's really happening.

I know you're still trying to tease apart the effects of the pacemaker and the sotalol.

Rest assured that the pacemaker doesn't control blood pressure or directly affect it at all. Even with a pacemaker your bp can still go too high or too low for other reasons.

As mentioned above, a pacemaker will not keep your heart from going fast. What a pacemaker will do is keep your heartrate from going too low, so it offers some protection from a too slow HR which can be a sotalol side effect.

Hope this helps.


My appreciation

by wikesaka@telus.net - 2022-01-08 19:41:39

I had a pacemaker review yesterday, she said there have been no indicators of Afib or vtach, and that is working at 99.9% for cardiac synchronation, and had to sync approximatly 6% of the time, she said this is good?  I'm continuing to monitor this, as today for instance, I was sitting on the couch, and I felt odd, my BP got up to 136/96, while my pulse was 54?, this went up and down for almost 50 minutes. its just WEIRD!

I appreciate everyone's comments its VERY helpful to hear what others have experienced!  thanks!

What to expect...

by AgentX86 - 2022-01-08 23:54:47

Your blood pressure, while not perfect, it's not bad.  I wish I could get it that low reliably.  What you're feeling is not your blood pressure.  You'd have to have a sky-high blood pressure to feel it. It's not something to get used to, per se.  It's something that you shouldn't obsess over.  OCD isn't a good thing.  If you're feeling OK, don't worry about it.  It's not a problem checking it once a day at the same time, preferably. Before bed is good. Obsessing over it is not good. You have a life to live.  Let your ICD do its thing.

You know you're wired when...

Friends call you the bionic man.

Member Quotes

I've seen many posts about people being concerned about exercise after having a device so thought I would let you know that yesterday I raced my first marathon since having my pacemaker fitted in fall 2004.