Have a Biotronik pacemaker which I had fitted nearly six weeks ago. It was set at 55-120 I seem to remember but am having episodes of 52-140. Will it not work properly until after the ablation?



High heart rates

by Gemita - 2022-10-30 08:16:22

Di, good morning.   I believe you are having an AV Node ablation soon.  Yes unfortunately you may have to wait to get some relief from your arrhythmia/tachycardia until then.  The AV Node ablation should effectively stop the high atrial rates from getting through the AV Node to push your ventricles (lower chambers) too fast.  If you have AF, this will also stop the irregularity of rhythm from passing through, so you should feel so much better.  Please don't worry about the slight fall in the lower rate to 52 bpm.  If your lower rate has been set to 55 bpm, it can be normal to go slightly below this, even when not in the presence of an arrhythmia.  But there is nothing wrong with your pacemaker.

Are you taking any beta blockers in the meantime?  If not and your 140 bpm heart rate is causing problems, ring 111 for advice or attend A&E, or speak to your Cardiologist/EP or pacemaker clinic first thing tomorrow.  A rate control medication should be able to bring this down.

Good luck and please let us know how everything goes.



by Gemita - 2022-10-30 08:56:30

Di, I don't know how much your doctor has told you about a pacemaker and an AV Node ablation.  Very briefly, a pacemaker cannot stop an arrhythmia or a fast heart rate, only an ablation can attempt to do this, or medication, or a cardioversion.  A pacemaker can however effectively treat bradycardia and prevent a drop in heart rate below the set lower rate limit.  It can also effectively treat long pauses and heart block which is what you will have after an AV Node ablation.

An AV Node ablation will stop a fast atrial arrhythmia by blocking the signals coming from the upper chambers (atria), preventing these from getting through the AV Node to affect the ventricles, the main pumping chambers of our heart.  

Unfortunately though, with an AV Node ablation, you will still have the arrhythmia present in the upper chamber, but you should no longer be troubled by it, especially with your pacemaker pacing you at a steady heart rate.  An AV Node ablation is really only done when all other attempts at control of an arrhythmia have failed.  

Rate control

by DiD - 2022-10-30 10:10:52


i take 1.25 Nebivolol and still have my Flecainide to hand but that is working less and less

Rate Control

by Gemita - 2022-10-30 10:18:30

Di, I was also on Flecainide until it didn't work for me either.  My doctor told me to drop it and to increase the beta blocker.  I see you are on a low dose of Nebivolol, 1.25 mg so may be your doctors might look at increasing this to 2.5 mg, but please ask.  Do you have difficult symptoms or do you think you can wait till tomorrow and then ask what you should do?

Rate control

by DiD - 2022-10-30 10:51:06

Episode yesterday afternoon until early morning , but fine now. Will ring EPs secretary tomorrow 

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