Base rate

Hi there,

Yesterday I had my CRT-P pacemaker turned on for the first time since I had it put in on 9th May. I'd been having a lot of discomfort after the procedure as they has trouble getting the 3rd lead into place so it was decided to turn it off until everything had settled down. My AV node ablation is in 3weeks.

So I heard them say that my base rate is 60. 

My question is : do base rates vary? Because I've noticed when I sit down or when I lay down in bed last night and obviously my heart rate goes down and I can feel the Pacemaker sort of "kick in" just for a few beats. It's not painful... almost like a tickle in my heart. Is this normal? Will I always get this? Don't know whether to phone and ask someone because it's not awful. I'm trying to manage my expectations really. 

TIA for any advice 😊


4 Comments

Base Rate

by Gemita - 2022-07-01 07:18:09

Toni, yes, our pacemaker base rates can vary (can be set to a level to suit us).  For example, 60 bpm seems to be the unadjusted device setting.  Some members have their base rates set lower, at 50 bpm, most are on 60 bpm and some are higher at 70/80 bpm and so on depending on our heart condition, patient and doctor preference.  If a patient feels well on 60 bpm, they may leave it set at that rate.  Mine is set at 70 bpm because it works best for me.  Of course our own natural heart rate will vary too depending on whether we are at rest or active and also on any health condition present.

Our base rate, once set, should never fall much below the set rate (my 70 bpm base rate sometimes goes to around 68 bpm but that is normal).  Of course we may see this rate increase with exercise or arrhythmias and that would be normal too.  Hopefully that answers your question.

When I first got my pacemaker, I felt lots of additional beats and my arrhythmias increased until my heart settled and I got used to being paced.  Perhaps this will be the same for you too.  My natural heart rate is way below 70 bpm but I don’t feel my pacemaker kicking in at all any more.

I don’t know what you are feeling Toni, how symptomatic you are?  As it is coming up to the weekend, a quick call to your pacemaker clinic would do no harm and might help to reassure you.  Please remember you still have AF and arrhythmias getting through your AV Node to affect your ventricles, so perhaps it is the arrhythmia that is causing this sensation, not your pacemaker and once you have had the AV Node ablation, this feeling might disappear?  

Good luck with the AV Node ablation

Base rate

by toniorr11 - 2022-07-01 08:37:19

Gemita

Thanks so much for your reply. 

That's very useful information. I can definitely feel it kick in when I'm at rest or in bed. I'm suspicious that it needs to be set a teeny bit lower but it's not awful and I can't feel it at all most of the time. I'll maybe see if it settles. You're right about the ectopics too. But they're definitely reducing. Gosh this is all so new! 

Base rate

by AgentX86 - 2022-07-01 13:33:34

I'm not sure why you have a three lead PM if you're going to have an AV ablation but your doctor knows better than I. Perhaps you're paroxsmal and they want to detect AF onset and switch from DDD to VVI?  It's worth an ask, IMO.

I've had an AV ablation, as well, and have a CRT-P but no atrial lead (two ventrical leads only).  The atria are in permanent flutter so don't do anything useful anyway.  But the atrial lead would be useless in any case because if were used the arrhythmia in the atria would then pass through the pacemaker instead of the AV node.  There's no gain there.

I'm not sure what you're asking.  Your base rate won't vary over time, unless changed by your EP/PM tech. Others may have different base rates set.

If you're asking why your heart rate changes, even though your base rate is set to 60, as the name suggests, that's the base, or bottom rate.  If your natural pacemaker is above 60bpm, the pacemaker won't do anything other than watch.  If it drops below 60bpm (one second between beats, really) it's insert a beat or beats to make it at least 60.  You pacemaker can't slow down your heart, only make it beat faster. If you move much, your heart may want to speed up  normally.  Your pacemaker isn't going to do anything about it.

You can measure a number slightly different that the base rate bcause of the margin of error of the measurement. You can't measure partial beats so your may count 14 or 15 in a fifteen second count, which would be a heart rate of 56bpm or 60bpm.  Likewise, you may get  a heart rate of 58, 59, or 60 if you count for 30 or 60 seconds.

 

Base rate

by toniorr11 - 2022-07-02 12:07:45

Thanks for your reply AgentX86.

I don't understand your first paragraph because I actually had no idea until recently that there was any difference between pacemakers and I just got what I was given! However I will ask when next at clinic.

Re: base rate. I'm wondering if perhaps mine could be set a little high at 60 only because when I go to bed and my own heart rate decreases it seems to kick in and although it's not painful at all, it takes me by surprise and I wake up. I will ask on Monday anyway. 😊

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