heart rate too fast

I had my pacemaker fitted in May 2022 and it only cuts in when necessary as in if my heart rate drops too low, but I feel as though generally my heart rate is too fast even when doing normal walking. Any thoughts?


Heart rate too fast

by AgentX86 - 2023-03-15 14:27:00

Welcome to the most exclusive club noone wants to join.

To give you a good answer we need to know more about you and your pacemaker. But I can try a guess. You probably have rate response turned on and set improperly for you. We're all different and what's perfect for one is totally inappropriate for another. Rate response can be tricky to get right.

Rate response is a feature of pacemakers to try to replace the function of the heart responsible to increase heart rate during exercise, when the body needs more oxygen. Often the sinus node is compromised, by a condition known as "Sick Sinus Syndrome", or SSS.

A pacemaker is needed to make the heart beat faster and often it needs to replace the function of the pacemaker that regulates the heart rate. Since pacemakers don't have access to the information that the sinus node woul have, in particular the blood CO2 level, the pacemaker has to guess.

Medtronic pacemakers use an accelerometer to measure your movement. The more movement it detects the faster it drives the heart. This movement has to be correlated with the actual oxygen demand. Pacemaker "settings" are used to make the connection.

It my guess (above) is correct, then you just need to contact you pacemaker technician and makes an appointment to modify these settings to match your needs.

too fast

by Tracey_E - 2023-03-15 14:29:42

What do you consider too fast? Sometimes a perfectly normal rate feels fast when our rate has been abnormally low for a long time. Mine felt racy all the time for the first few months, but in reality it was at the low end of normal. But it was still almost double what it was before so it seemed fast.

Two things I can think of.

Your profile doesn't say, do you have heart block? If so, the atria was always going faster but the signal wasn't getting to the ventricles so your rate was always low.  Now, the pacer is making sure the ventricles beat every time the atria does, so it can be quite a bit higher. 

If it's going too fast when exerting, it's possible you've got rate response turned on and it's too sensitive. RR senses when we are moving and raises our rate for us. It has different sensitivity settings and it's common to take a few tries to get it so it's just right. 

heart rate too fast

by jamiewestie - 2023-03-15 14:41:20

Thanks guys that was useful. I had the pacemaker fitted because my heart rate had dropped to 28bpm and would not rise. I have always been fit and my resting heart rate was around 48-55bpm and could top out at 180 or so and drop back to around or below 120 in a about 90 secs.According to my consultant my heart muscles were in great condition but the elecric signal to the heart was breaking down.. From what you guys have said It may be that the rate response is set wrong.


by Tracey_E - 2023-03-15 17:00:20

Bradycardia (low heart rate) is a symptom. Different things cause it. If it's heart block, then you primarily pace ventricle and may not need rate response. If it's coming from the atria, then you'll mostly pace with atrial lead and may or may not need rate response, depending if you need the pacer to get your rate up on exertion. If you have av block, your sinus node- the part of the heart that sets the pace- is likely working normally so you just need the pacer to make the ventricles keep in sync with the atria. "Signal breaking down" could mean several things, but my best guess is the signal between the atria and the venricle, which is heart block/av block. 

Eating right keeps the arteries clear. Being fit keeps the heart muscle strong. Electrical problems just happen, usually at random and without warning, often in an otherwise perfectly healthy heart.  

too fast a rise time and too high max HR could make one uncomfortable

by brady - 2023-03-16 17:33:28

There is a scientific answer to your question.

I had run into the same issue and I had done the following.

I use an apple watch and the heart analyser app to monitor my heart rate 24/7. The watch checked the heart rate every few seconds and the app plots out the HR over time.

To check the performance of the rate response, I walked up many floor of stairs up and down over many days. After each time, I checked the plots on the app and noted the rate of rise from the rest heart rate to the max heart rate. The rise time should be reproducible for ex one day to the next.

I also did it before and after rate response adjustment by the Abbott engineering.  When the rate of rise was too  fast, I went back to him and asked him to slow down the rate of rise.

You could do the same if you feel the rate is too fast to make you uncomfortable. Just ask your EP to slow down the rise time. Beside the rise time, please also check the max heart rate setting in the generator. Too high max HR could also make u feel uncomfortable. One size does not fit all.

The base rate  is what you EP feels that is good for you, typically 50-70bpm and for max HR rate, the formula is

"To estimate your maximum age-related heart rate, subtract your age from 220. For example, for a 50-year-old person, the estimated maximum age-related heart rate would be calculated as 220 – 50 years = 170 beats per minute (bpm)."


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