Bpm going under 60 update

heart rate

by new to pace.... - 2024-02-13 12:57:34

Thank you Lavender for this explantion, as when i sometimes use that finger method i do see the occasional 59,58 and have wondered.

new to pace

Not surprised by their answer

by Gemita - 2024-02-13 13:34:16

Lavender, thank you for the update.  How are you feeling now?  I hope you are recovering.

I didn't think a few bpm below the lower rate limit would worry them, but to say they are only worried if it goes into the 40s and stays there wouldn't give me much in the way of reassurance or a proper answer.   

I get it though about some home monitors not being accurate, but a good blood pressure monitor will give a fairly accurate blood pressure and heart rate reading.  My heart rate certainly still drops into the 40s and stays there on occasions when I check my neck pulse.  I know from my symptoms too when things are not quite right.  Ectopic beats can most definitely adversely affect cardiac output if they are frequent and prolonged.  They are inefficient, ineffective heart beats, for which the pacemaker has no answer.  

As long as you are alright, that is what counts though Lavender

What counts

by Lavender - 2024-02-13 17:33:16

It's so true that how we feel is what counts. I was satisfied with the nurse's explanation. Even the ER dr said that pulse oximeters can be affected by many things and be inaccurate. My pulse ox reads maybe, lets say, 92 oxygen on the right pointer finger then reads 95 oxygen on the left pointer finger. I actually think it's pretty accurate on my bpm. 

I'm just happy to know that going below 60 this way isn't a concern. 

Thanks for asking about my health-the RSV has been nasty to handle.  I called the pcp yesterday to see if anything more could help me. They confirmed that no meds help the progress and reiterated to take Tylenol, salt water gargles, cough drops and stay upright as much as possible as lying down causes more coughing. 
 

I am on day eight of symptoms. I think I have rounded the bend. My throat isn't sore and the mild fever is now gone, but I'm coughing a lot, have a headache and had not much sleep. I can hear the mucus rattling up and down in there. I'm expecting on being completely well soon. 🙏🏻

"Low" BPM

by piglet22 - 2024-02-14 06:21:05

I wonder if there is a truly accurate way of measuring heart rate?

I suspect that a full ECG is probably the gold standard, but even that involves some mathematics to arrive at a rate from pulses.

I've had a year now to see and feel the effects of a wandering heart rate, often 10 or 20 point's below the set base rate.

With a base rate of 60, now 70, I would start to take notice if it fell at any time say 2 or 3 points below and would certainly start to be concerned if I started to see 5 or more points below.

After all, the pacemakers job is to maintain a minimum rate which in theory it can do with great precision.

What does put a spanner in the works is how it decides to maintain that rate.

If you are 50% paced, I take that to mean that half the measured pulses are natural and half are synthethised.

If some of those natural pulses are ectopics, this can upset the timing of the pacemaker.

I'm now very sensitised to unusual heart rates and always go for wrist first, then oximeter, then BP monitor.

The oximeter starts off well, but it struggles after a while as it tries to average the erratic pulses.

The BP monitor I have does three readings 60 seconds apart and averages them. The individual readings can be quite different for pressure, but the rate is pretty consistent.

I suppose at best these are indications.

If a trend develops i.e. unusually low across the three methods, then that needs more detailed investigation.

At some point and some spare time, I might have a bash at explaining timing mechanisms as used in electronic devices and how they impact on how we feel.

Yes please Piglet

by Gemita - 2024-02-14 07:26:19

Yes please Piglet!  I know that Rate Hysteresis can temporarily allow both atrial and ventricular paced rates to fall below the programmed lower rate set limit;  that A-V Conduction can delay ventricular pacing, and that PVCs can reset cycle timing and delay atrial pacing, just to name a few possibilities, so to be told that our lower rate limit can never go lower, is plainly misleading.

I am working hard this end to put together something for our FAQs on "pacemaker‐mediated arrhythmia which includes all abnormal rhythms in which the pacing system plays a major role".  Maybe we could place your "timing mechanisms as used in electronic devices and how they impact on how we feel" into our FAQs also?  We desperately need some guidance and more understanding about this.  This question comes up time and time again and our doctors are clearly not giving us adequate answers, although in fairness, the more I search for answers, the more I realize that so much can affect our electrics, both in our devices and in our hearts. 

average, etc

by dwelch - 2024-02-17 03:14:51

The rate is not going to be exact, on a beat by beat basis at your lower limit it is not going to be some exact thing, it will be an average over time.   We dont work perfectly with these monitoring devices and they have their own issues.  So a beat or a few even sustained for a while is not an issue, it is somewhere between normal and/or error in the mesurement device you are using.

Do it the old fasioned way, 60 seconds on a clock, no cheating no 6 or 10 second counts, fingers on wrist or neck for the full 60 seconds.  count it out.  Even there within one or two is within expected mesurement error.

If measuring yourself without one of these devices (or with a proper ekg) and it is sustained fives or tens low sustained for minutes or longer periods of time.  Then call someone or go somewhere and keep measuring as you go to have data when you get there (if for example it rights itself).