Pacemaker installed last week - I have some unanswered questions

I am still a newbie too

by karensoftball - 2024-11-03 18:13:54

Welcome, I will put some insight in but there will be more seasoned members giving thoughts also.

I have had my device for a little over a year, I am 43. My first setting adjustments didn't happen until my one month check. Pacemaker settings are different for every person and our care teams put a lot of thought into what those settings should be. 

Be very vocal about how you are feeling with your team. They use both data and your symptoms to make decisions about your settings.

Shower wise, I used port covers that I bought off Amazon. They are plastic with adhesive on the outside. Cancer patients use them to cover the IV port when they shower. Worked pretty good for me, helps with holter monitors also.

I started to get active again after my one month appointment and then really got back into my normal vigorous exercise a couple months after. I am able to do more now with my PM. Likely because I was so fatigued for so long before I got it.

Good luck to you!

Hope this provides a few answers

by Gemita - 2024-11-03 18:18:28

Barry, welcome.

Our pacemakers are usually implanted with basic “factory” settings and these settings will be adjusted over time depending on our symptoms and needs.  My settings were not adjusted until the sixth week and even then, my electrophysiologist said he would prefer to wait a few months for further fine tuning.  They clearly don’t like to go rushing in, since many of us adjust to our settings without too much in the way of intervention. 

If your systolic blood pressure goes to 180 you may need medication adjustments.  Having a higher heart rate can certainly affect our blood pressure at the start of pacing, but it usually settles, unless you have something else going on like a heart rhythm disturbance that can adversely affect our blood pressure.  If you have symptoms of dizziness, you should let your doctor know.  Dizziness can have many causes, not necessarily related to your pacemaker or heart.  Causes might include sudden changes in blood pressure and/or heart rate caused by arrhythmias and other electrical disturbances, dehydration, anaemia and low blood glucose.

To get an appointment a month after your operation sounds good to me Barry.  Not sure that you would do better anywhere else in the UK.

The lower rate called the Base Rate should be set according to the needs of the patient.  If you feel good at 60 bpm, then leave it at 60 bpm.  You could ask to have it turned down to 50 bpm if you feel that rate would be closer to you own natural heart rate.  You could ask about having a 50 bpm setting at night and 60 bpm during the day when you are active?  Your body will take time to adjust to pacing and it may take several attempts to get those settings adjusted to suit you.

I was told to keep my wound dry for 7-10 days until wound was fully closed.  The steri-strips should ideally be left in place to come away on their own.  Did you not receive a discharge paper giving you instructions on how to look after your wound?  

Finally, there is no reason, even at 77, why you shouldn’t be able to swim, ride your bike or work out in the future once your heart has settled and got used to being paced and once your settings have been adjusted to suit your activity.  This may take time.  Some members ask for an exercise test so that they can adjust your settings to suit your needs. 

Welcome!

by Lavender - 2024-11-03 20:17:22

Here in my area, you get a wound check a week after pacemaker insertion. The steri strips are to stay on until they fall off and not get wet. I took tub baths, sat in the bathtub and washed from the chest down. I washed my hair standing over a sink. 
 

I too had AV block and had been fainting which led to the pacemaker three years ago. 

I was very used to a lower heartbeat and when they put in the pacemaker it was set to 70 bpm. I didn't like that-felt like my heart was racing and it made me anxious. They had turned it up until a month later and the leads could bed in more. Then it was turned down to 60bpm-where it is now. I got used to this. 

No adjustment was made on my pacemaker settings until I had it five weeks. How you feel will settle in. You can go back to all your normal activities once you're okayed by your dr-usually at the six week mark. 

welcome

by Tracey_E - 2024-11-03 21:32:12

Glad you found us!

They may do a wound check sooner, but they don't generally mess with the settings for at least 4 weeks. That gives the heart time to heal and get used to being paced. 

With av block, the minimum setting on the pacer is usually irrelevant. Our sinus rate is normal, but when in block the signal wasn't getting through to the ventricles. The pacer will watch, every time the atria beats, it will give the ventricles a chance to beat then send a signal to make it beat so the heart stays in sync. My resting rate was in the 80's for a long time after I was first paced. It was all me, my atria had always been going that fast, but with the block my pulse was always lower.  You can ask them to turn down the minimum rate, however you may still find your rate is a lot higher than you think is normal for you. 

It may feel crazy fast now, but the heart will settle down and it will start to feel normal again. 

Once you heal, you should be able to do whatever you did before! Follow your doctor's instructions on when it's ok to work out again but give it at least 4 weeks before swimming. You want the incision to be well healed before getting in a pool/lake/ocean. 

Steri-strips, they should have sent you home with instructions. I was able to shower, just told not to linger.

Thanks for all the good advice

by bg02478 - 2024-11-04 18:18:35

Thanks to all:

I made a few phone calls this morning, and all the replies I've received above from the forum seem to right on target and very helpful.

My wound is healing well, and I now have an appointment to review the settings of my pacemaker later this week.  So I feel much better about my situation.

I did a little light exercising an got my pulse up to 65 bpm, so the pacemaker is doing something right.

 Thanks again to all of you for the encouraging replies.

Barry