UPDATE!!!Sudden Drop in Heart Rate

Sudden HR drop

by AgentX86 - 2023-08-21 19:05:51

There is a lot more information needed. Since you have heart block and we can assume, for the moment, that your pacemaker is functioning properly. For argument, assume DDD mode (most common) and that you're rarely pacing in your atrium.  That is, your physiological pacemaker has a resting rate of 60-65bpm. If all of this is true, either you aren' measuring your HR correctly, some sort of arrythmia causing however your measuring your HR to give whacky results, or there is something not right with your SI node.  In all cases, measure your HR manually.  Machines sometimes work if everything is right but they're too easy to fool. Your finger and a watch aren't. Your finger can often detect arrhythmias, at the same time.

OTOH, if your pacemaker's base rate is set to 60bpm, most of the above applies but it's not likely your SI node becase a low intrinsic rate will be corrected by the pacemaker.

Thanks for Reply

by heartu - 2023-08-21 19:43:58

My bottom rate is set to 50 and it seems it dips into the 50s when I am asleep. But these 2 occurrences happened during the day, one after a shower, the 2nd, today while at the computer. Felt a bit off, checked my Fitbit and then oximeter. If there is a next time will do the finger on pulse check as you suggested. It's just when this happened I felt a bit off. First time it lasted about 20 minutes before I made myself a cup of coffee and today it just passed on its own. Never happened before.

Could be extra beats

by PacedNRunning - 2023-08-21 21:28:45

Extra beats tend to cause a false lower HR due to the compensatory pause that comes after ectopic. It's the hearts way of resetting that beat that jumped in.  When I see things like this, I take notes. As long as it doesn't stay I know I'm fine. One month I had a bunch and called my EP. He had me wear a zio patch for 2 weeks.  If you are having symptoms I would let my doctor know because our body has symptoms to tell us when things are "off". 

Always be guided by your symptoms

by Gemita - 2023-08-22 04:46:08

HeartU, can I just query your statement you have 1 year and 6 years left on your current device?  Do you mean 1 year and 6 months?  

I note that due to a fall in your ejection fraction (EF), you were given a CRT-D in 2020 to help prevent any dangerous rhythm disturbances as well as trying to improve your EF with synchronised pacing.  I presume you have had an echocardiogram since then to see whether your EF has improved, or whether you might need additional medication to support your EF further?  Symptoms always count for me.  If symptoms cause distress it probably means that my heart is struggling to keep up with my demands and it is time to seek help.

Symptoms should always count especially since you have a CRT-D to protect you in the event of a dangerous rhythm disturbance and you don’t want to be potentially triggering an inappropriate defibrillator shock from a relatively benign and treatable source.  Have you checked your electrolytes recently for example and had other blood checks?   Are you keeping well hydrated?

As to what is causing your symptoms, from your description, I agree it does sound like ectopic beats and despite what we are told, ectopic beats, for example PVCs, can adversely affect the timing of our pacemakers.  I know of two other members who have reported this very problem. From their symptoms alone, they have had to seek emergency help on several occasions.

There is no doubt that a high burden of atrial ectopic beats for example, has been reported to be associated with an increased risk of atrial fibrillation, as well as other atrial tachy arrhythmias and stroke.  Moreover, frequent PACs as well as PVCs may cause cardiomyopathy which is potentially reversible with treatment. 

So go by your symptoms and if these continue to cause concern, contact your doctors for your own peace of mind

Drop in heart rate

by piglet22 - 2023-08-23 08:12:25

Hello

I've been having episodes of low rate and low blood pressure since January 2023, despite a PM base rate of 70-BPM.

Pulse can drop to between 40 and 30 BPM and BP to sub 100/50.

It makes me feel awful.

After a lot of prodding, the hospital has told me I get on average 100 PVCs (ectopics) per hour and my guess is that most of these are when I'm sitting down watching the telly or asleep. The key thing is when I'm active, I don't notice anything. It's when I relax, I do.

The dangerous bit is the likelihood of involuntary falls.

Do check your pulse rate wherever you can feel it reliably. Confirm if necessary, with a decent BP monitor as these use the real changes in your heart's physical activity, not a possibly misleading electrical activity.

You'll probably get the "pacemaker is working fine" stuff, but there's working and working.

The devil is in the detail. If your pacemaker is doing one thing and how you feel is telling you the opposite, get it checked.

You might have to work hard to get it looked at, but finally I have an appointment to investigate "significant PVCs". It took 9-months.

pacing for heart block

by Tracey_E - 2023-08-23 13:10:35

If we are paced primarily for heart block, that doesn't mean we can't also have, or develop, sinus issues. If your rate drops that much at rest, it sounds like that might be what's going on. The pacer can be reprogrammed to adapt.

Thanks

by heartu - 2023-08-23 14:57:42

Thank you for your replies and I will continue to monitor!

Now I Have an Answer

by heartu - 2023-10-12 12:33:41

Apparently I have aFib(continuous) since Monday according to Medtronic transmission. On Eliquis 5mg 2xs per day since Tuesday. Hopefully will see doctor soon to discuss options. 

The low heart rate I was picking up was my pacemaker not allowing my heart rate to go below 50bpm as it is set. I do not feel the flutter because of the pacemaker, but knew something was off.

I probably would have had a answer sooner but it seems the handheld that sits on the monitor was not charging as it was supposed to and had Medtronic replace it. (WARNING IT APPARENTLY HAPPENS QUITE OFTEN SO CHECK YOURS TO MAKE SURE!) I have the Medtronic Carelink Monitor Model 24950.