pacemaker

I thought a pacemaker would control pauses in my heart beats while sleeping. If I get a pause of 2 seconds, is my pacemaker malfunctioning?

4 Comments

pacemaker

by tarsha - 2014-02-09 01:02:39

Thanks. You have helped me to relax. I won't worry about this happening 1 time in 6 months.

Sincerely and God bless,

Tarsha

Sometimes the self diagnostic will result in a pause you can feel

by heckboy - 2014-02-09 01:02:45

I would only notice if I was resting on the couch or in bed.

Pauses

by IAN MC - 2014-02-09 12:02:23

Hi larsha As someone said on here recently, a pacemaker cannot forecast the future .It doesn't know when you are going to have a pause and then magically prevent it from happening. But once a pause has started it can put in extra beats or it can maintain your HR at a level higher than that at which pauses occur.

A 2 second pause is absolutely nothing to worry about.

Ian

Malfunctioning PM?

by donr - 2014-02-10 08:02:21

That depends - (How's that for a waffle?). Medtronic has a feature called MVP - Managed Ventricular Pacing - you host a BS device that may or may not have that feature.

Stop & think about it for a few seconds & ask yourself a question. That question is - If this had happened during the day when I was awake, would I not have reported it as "I skipped a beat."?

A two second pause is exactly 1 missing beat at a HR of 60.

There can be several explanations for this situation. Short of capturing the event on an ECG trace, it is difficult to determine what happened.

Question: Did your PM show some sort of ECG trace for the event?

Here are the alternatives for you:

1) The PM failed to detect the missing beat for some reason. You have not told us what your pacing % is, so we have no idea how many opportunities it has had to fail in this manner. IF this is the case, it could be serious, because it could happen again for more than one truly missing beat.

2) The PM successfully detected the missing beat & sent the pacing spike, but the heart failed to capture it & the beat hence never took place. This is an adjustment issue & easily corrected by tweaking something.

3) Your BS PM HAS a feature similar to the MVP I mentioned in the opening para. That's no big deal - that's what it is supposed to do by design.

Discussion: I read about the MVP algorithm late last week when looking up MVP to answer another question. The description in a Medtronic web site showed an ECG illustrating how & why it worked & there was an obvious flat line in the trace for exactly one beat.

Remember what I said earlier - if you noticed it, you'd say you skipped a beat & go on about your life, not particularly worried. The Dr. says "Your heart STOPPED for 2 seconds" & you get excited - rightfully so. BUT - BOTH descriptions describe the exact same incident, but from different viewpoints.

AT this point, neither you nor the Cardio know what happened because you have NO trace showing events at that time (Assumption on my part). A PM ECG trace would show whether it generated a pacing spike or not.

Apnea would probably not cause a 2 second pause, it's a breathing interruption, nor would a correction of the breathing pause restart the heart if it was stopped - that takes electrical stimulation.

Inga gave you another explanation in your other thread - a long AV delay. If the PM has an AV delay programmed in that is too long, it is possible for this to happen because when the beat went missing, the PM was still waiting to send its spike, when there was some electrical activity in the heart that the PM sensed & it inhibited itself from generating the spike.

Hope this helps you understand what MAY have happened, because at this point we cannot tell what DID happen.

Don

You know you're wired when...

Your old device becomes a paper weight for your desk.

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