Pacemaker and low HR

Some things

by Theknotguy - 2020-01-26 21:24:48

First, the devices such as the Apple watch and Fitbits are notoriously known for not keeping an accurate track of the heartbeat.  So you don't want to place too much emphasis on them.  They're good for a general view but not an accurate recording.  

Second, the pacemaker won't do anything for afib.  If you go into the higher levels of afib the pacemaker will just sit back and watch.  You may feel like you're  going to die but the pacemaker won't be able to do anything.  

I went into afib with RVR.  Rate went up to the 160's and I ended up in the hospital after an emergency run.  

After that I had a conversation with my cardiologist/EP and we worked out a plan.  I'm one of the few people who can feel my afib.  So the plan was, if I were to go into afib with RVR again, I could take extra medication - up to a point - and hopefully that would help me until the EMT's got there.  Fortunately I haven't had afib at that level again but I know what to do. Maybe your cardiologist can make a suggestion.  

My pacemaker has two programs running on it to help with afib too.  So that's another question to ask your EP.  

In the meantime, hang in there.  I'm six years out with my pacemaker and afib.  I lead a "normal" life and do mostly what I want.  So there is light at the end of the tunnel.  

I hope your adjustment to your pacemaker goes well.  
 

Apple watches and other toys

by AgentX86 - 2020-01-26 23:40:14

"Smart" watches, of all types, are notoriously inacurate (the watch can easily slip out of place) and are the rate given is useless if there is any arrhthmia.  The Apple watch may be able to detect Afib (so not completely useless) but it's unlikely to give an accurate rate.  Yes, it's possible for the rate shown by your watch is lower than the pacemaker's lower limit.  The watch is being fooled by your arrhythmia.  \

You're a candidate for a KardiaMobile.  The documentation for the KM notes that they're not for people with a pacemaker but they're still useful.  The KM can send an EKG strip to your EP for diagnostics.  Of course, since you have a PM, you can also initiate a remote transmission to send the particulars to your EP.  If you learn to read an EKG, the strip will help you understand your situation, as well.

Pacemaker and low heart rate, atrial fibrillation

by Selwyn - 2020-01-27 08:36:29

Your pacemaker does not stop you having atrial fibrillation ( in general). Don't be sad! Get some medication to control the AF ( this is either rate control, or rhythm control depending on the meds.) PMs are designed to stop you having a very low heart rate and symptoms ( eg. blackouts and dizziness).

It is early days yet. Tiredness is certainly the after effects of any stressful situation, and having a pacemaker inserted is always a stress.

The base rate for my PM is set to 60 beats per minute. One or two miss counts by me or the device readers ( eg. an exercise watch or Kardia) is neither here nor there. Such devices are only as good as any machine programming and performance.  Sometimes the PM is set to lower the heart rate even more ( eg. during sleep) to save on battery power. If you are inactive, maybe the PM thinks you are asleep!. I believe my PM decides over time when the sleep cycle is occuring, in this respect it has a mechanical mind!!

Do get your rate response ( exercise function to increase heart rate) turned on, if this has not been done. This can be discussed at your check up.

Lastly, welcome to the Club. Do fill out your personal profile as this enables any comments to be more specific ( eg. type of device fitted, your age etc.) 

Welcome

by Ddefalco326 - 2020-01-27 09:59:34

Hi Lexitoo,

Welcome to PM. You asked if this is something to be concerned about, my answer would be yes. The reason I say that is this, this is all new to you, just 3 weeks out. Anything and everything is new, and if you have questions about what is going on, then you deserve answers that put you at ease. I had my pm surgery this past Sept., so I am not that seasoned yet. This club has been a godsend. I have had episodes of low HR, in the 40’s and then goes back up shortly. My dr of course said, “ that must be an error reading, your pm is set to 60”. I know that it isn’t an error, but as long as it quickly goes back up, I am no longer as concerned as I used to be. HR also frequently goes to 58/57, but the pm kicks in and it goes up to 60. I also get the high HR, 196, 160, etc, but not AFib, mostly SVT, PCT, or whatever is the correct acronym. I am too sensitive to meds and it drops my pressure too low, so for now they are just watching it. Fortunately, it does not stay high for too long. We will cross that bridge when necessary. I’ve also had my pm adjusted for rate response, as my hr wasn’t going high enough during exercise classes, once adjusted I am starting to feel less tired. I am now 4 months post surgery, and starting to feel more like my old self ( no pun intended)! I finally am having the energy to do things again. So, my bottom line is this, if you are concerned, then keep talking to the doctors until you are no longer concerned. I have gotten great advice from the members here, Gemita, Crustyg, Angentx86, Theknotguy, to name a few, and gone to my doctors with questions that I never knew to ask. Good luck! 

Your pacemaker is working fine--and your home monitor is probably fine too

by Gotrhythm - 2020-01-27 18:22:50

You need to talk to Teachermom.

All this discussion about what is accurate is fundamentally meaningless.

The bottom line answer is this: If you're getting readings on your home monitor that don't agree with your pacemaker settings, the likely problem is that your heart, not your pacemaker, is throwing in a little, very common arhythmia every now and then, called a PVC or PAC.

Very common. Considered normal. Won't hurt you. Won't hurt pacemaker.

So is it important? Two quesions:

1. How long does it last?

     A couple of seconds or less? No problem

     5 minutes or more, and then returns to normal? You need to discuss it with your doctor

     30 minutes? Go to the ER.

2.How do you feel?

      You feel fine immediately afterward? No problem

      You feel faint, weak, tired during and/or after? You need to tell the doctor.

       You faint, lose consciousness? Go to ER.

By the way: Pacemakers cannot prevent your heart from occasionally beating when it shouldn't. Those funny little PVCs and PACs, are caused by part of your heart beating before it's supposed to. It'a a real beat but it's a very inefficient one and as a result sometimes is too weak to register on home devices. So that's why there are sometimes discrepancies, even when the pacemaker is "working fine."

Thank you

by Lexitoo - 2020-01-27 21:53:59

I appreciate ll the responses and Gorhythm especially. You may have helped me most, as I have had identified PACs for some time. I am quite familiar with the issues of afib and Aflutter as I was diagnosed two and a half years ago and have lots of it in my family.
I am on Tikosyn after a rough initial period after being diagnosed. And like many of us, I surely know when I go into afib or Aflutter as I am very symptomatic as many brady/ tachy folks are.  I have both a Kardia and my apple 4 watch to check rates etc.  My kardia often is confused by my PACs.  However I know little about the pacemaker, so the information you have shared is really helpful and all new.  
 

My normal hr was nowhere near 60 so this feels like an improvement but I still get very tired, though I suspect some of that may be recovering and general de conditioning as a result of the past year.  I will talk with my doctor and again thank each of you for your help and advice.

Learning to live with this is a long process of adjusting.

Gotrhythm

by Gemita - 2020-01-28 01:06:58

Yes Lexitoo and Teachermom should have a chat.  I too found your post very helpful and to the heart of the matter !  The only problem I have with your advice is if we do decide to run to the doctor or ER/A&E with our symptoms what are they going to do about our ectopics?  My doctors usually pat me on the back and say that they will do no harm, try not to worry even though I believe they do harm by triggering other arrhythmias including atrial tachycardia, AF, Flutter and NSVT.  I will definitely be speaking to my EP about this benign condition and whether further control is needed, but thank you so much for expressing so clearly a format to follow

What are they going to do about out ectopics?

by AgentX86 - 2020-01-28 08:47:53

There are two,  well, three things that an be done.

First, they can reassure that they are ectopics - no need for the ER.

They can increase the heart rate to try to overpace the e topics (what they did for me, successfully).

If it's really bad, with a very high burden rate (~30%%) they can be ablated.

The ablation option isn't common because they aren't normally considered dangerous and it is invasive. The first two are essentially free.