Newbie from NV

Got my PM two days ago. The low end is set at 62 but my HR is staying above 70 - sometimes into the 80s. What is going on? Should I be concerned?

9 Comments

Heart Rate

by SMITTY - 2008-11-08 01:11:42


Hi Michele,

Welcome.

Tammy gave you all the answers to your questions. I'll just add don't be concerned and above all don't try to analyze your heart rate to the nth degree, as many of us have done, only to find out we were being concerned over nothing. That pacemaker has two settings a low and a high. When your heart rate drops below 62 the pacemaker will step in and keep it at that level or above. Should your heart rate exceed the upper set point because of physical activity, excitement or whatever reason, the pacemaker sits on the side line continuously monitor your heart function. The only time it will come on line is when there is an interruption of a regular heart beat or until your heart rate drops below the low set point.

Your heart has a natural pacemaker and the manmade job is just there to help when the natural PM fails to do what it normally does.

Now there is one other thing that you may see from time to time and that is a heart rate below the low set point, which in your case is 62. That does not mean the pacemaker has failed. Before the pacemaker sends an impulse to cause a heart chamber to contract, it check to see if the natural pacemaker is sending one as an impulse from the hearts natural pacemaker and one from the manmade PM arriving about the same time to cause a heart beat is likely to be uncomfortable and maybe even slightly painful. To avoid this happening the PM always checks to see if it is needed before sending an impulse.

This is where things get a little confusing but not dangerous. Sometimes our hearts natural pacemaker will start to send and impulse or send a weak impulse that will not cause a heart beat, but your PM will detect it and not send an impulse because it thinks the heart is sending one. I like to describe this as the hearts natural pacemaker faking out the manmade PM. This happens to me every day and as a result I have many skip beats each day and although the low setting on my PM is 70 it is not uncommon for me to find a heart rate in the mid-40s for a few minutes to several hours.

What I'm trying to say is first; don't think that your heart has to depend entirely on the pacemaker to beat, unless you are 100% dependant on the PM. In which case I'm sure your doctor would have told you that is the case. Second, don't be concerned if you do not find a perfect heart rhythm all the time. As I mentioned above, our heart natural pacemaker has a mind of its own and it will sometimes fool that manmade job. Only if you find a grossly irregular heart beat that lasts for more than a few minutes do you need to be concerned.

I wish you the best,

Smitty

welcome!

by tcrabtree85 - 2008-11-08 01:11:47

Hi Michele,
Welcome to the pm club. I hope the people on this site will make you feel right at home. I will take a stab at your question and am sure you will get a lot more answers. Your heart is still working on its own at points I am assuming. When your heart decides to drop below 62 your pm jumps in and helps your heart get back in sync. Also, when your moving around your pulse can also rise. I don't know what your heart condition is but I am sure with the help from many on here some of your questions can be answered.
Right now you need to sit back and relax and enjoy watching all the movies you can and recover. Don't worry so much at what your pulse is doing but let your body heal from the surgery. That was one thing I had to remember after getting my pm.
Take care and ask as many questions as needed.

Blessings,
Tammy

Reply to Smitty

by Michele - 2008-11-08 07:11:40

Thank you for the replies. I am confused at why my HR is staying in the high 70s when before receiving the PM, my heart rate averaged around 52. The PM will only pace when I get below 62 - is my system going through surgery shock! Shouldn' t I be at around 60 while resting?

To Magster and Michele

by SMITTY - 2008-11-08 09:11:08


To Magster - It is my understanding that our pacemaker will defer to the hearts natural pacemaker and therein is part of the problem. The hearts PM may not send a strong enough signal to cause a heart beat, but the signal will be strong enough that the pacemaker will think the heart is going to beat on its own and wait until next time to see if its help is needed, therefore this can cause our skip beats.

As for where I get my information, first if you are a layman like me you must have lots of free time. Then you need to get a pacemaker that is pure hell for several years while all the times when you ask the "experts" what is going on you are told "I don't know but it is not your pacemaker." Then you find this web site and read and read enough that you can ask some of the many smart people here such as Electric Frank and many others questions, and eventually you get to the point where you say, why heck I can offer something on that one.

In addition I have accumulated a file of many articles on how our pacemakers are supposed to work that I can refer to when necessary

To Michelle - I started to mention that your increased heart rate could be due to what I have been told is heart trauma which is likely to follow any surgical procedure. This has happened to me after surgeries several times, but not every time. As for a resting heart rate, unless your pacemaker is getting fooled by the hearts natural pacemaker once in a while, theoretically, the rate should that of the lowest setting on your pacemaker, plus or minus a couple of beats. For me so long as my heart rate stays high enough to keep me going, even at a slow pace, I pay no attention to it. I am fully confident that my pacemaker will keep my heart rate at a level sufficient to sustain life, regardless of what rate I am counting. If I think my heart rate is too far off base, say 5 or 10 beats I would call the doctor.

The main thing I will offer is don't get too hung up on the pacemaker keeping your heart rate exactly within the settings limits of your PM. While our pacemakers are wonderful and very dependable little devices, there are too many variables that can affect the heart rate.

Smitty

HR Limit

by ElectricFrank - 2008-11-09 01:11:27

Hi,
Without seeing your printout of settings I can't be sure, but here are a few possibilities:

1. Usually for a short time after implant the pacemaker is left at the factory default settings which includes Rate Response ON. This means the pacemaker responds to any movement by increasing your HR.

2. The other is that at only 2 days after surgery your body is healing which can result in an elevated resting HR.

3. Any anxiety will increase HR, and isn't unusual after a pacemaker implant.

My suggestion is to give it a week or so and see what happens.

frank

Thanks Frank

by Michele - 2008-11-09 04:11:32

Thank you Frank - that makes sense. I finally read the Medtronic Owners Manual and read the section re: rate response. Didn't realize that was a feature, but it does explain why my heart rate is up. One day at a time.

Sinus activity

by heckboy - 2008-11-09 07:11:40

If you are like me and have normal sinus activity, your PM will key off of it and pace your ventricle. That's why before your PM, you HR was low and now it is higher. Your low setting means that your PM won't let your HR fall below that number, but it doesn't mean that it won't increase your HR as demanded.

Where in NV?

by auntiesamm - 2008-11-09 08:11:43

Hi Michele and Welcome,

I've had my PM since May 2006 and feel very, very fortunate! Nary a problem with it. Where in NV do you live? I wish you all the best with your pacer. It may take a while to adjust but it will come. I've been one of the very blessed having absolutely no problems since it was implanted. Take care and God bless.

Sharon (So CA)

From Douglas County...

by Michele - 2008-11-10 02:11:20

South of Carson City. We are originally from So. Cal. Thank you all for the words of wisdom. I seem to be doing a little better every day. The palpitations are annoying and will discuss with dr. during my followup appt. So nice to have a support group.

You know you're wired when...

You participate in the Pacer Olympics.

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