Lower Settings

Hi All,

New member, but have read some stuff on here while researching. Very helpful!

I got my Medtronic Azure XT in September. I have second degree heart block that advanced to 3rd degree. Thankfully was in the hospital for a different condition when that happened and had CPR done.

My lower limit is set at 50 right now. At the beginning I wasn't really noticing when my heartbeat is lower, but lately I have been feeling like I did before the pacemaker when I get around 60.

I have a remote check up in a couple of weeks. I am thinking of asking to raise my lower limit, does this seem reasonable? I just want to feel better. Should I expect that tests will be run? 

Some background:

My resting HR has normally been around 73, but has dropped to 62/63 the past couple weeks. My Fitbit has not indicated that I have ever gone under 50.

I have been back to full activity since December and work out moderate to vigorous 4-5 times a week. I was trying and successfully have lost some weight. I am sure some of this can factor in to some heart changes.

Thank you for any input. My pacemaker experience is still in it's infant stage!

7 Comments

60

by Lavender - 2024-06-23 23:06:18

Most of us are set with a low limit of 60. Some higher. I would certainly ask to have it raised or at least ask why it's set that low. They can't do that remotely, I believe you need to be at an inperson visit, so maybe give your medical team a call in advance. 

IPG rate

by piglet22 - 2024-06-24 05:19:34

I would agree with Lavender that 50 is on the low side. "Normal" heart rate is quoted at between 60 and 100-BPM, though can be a lot lower for really fit athletes, which I'm not.

I started on 60-BPM base rate which was increased to 70 last year when ectopics started to interfere.

If I saw 50-BPM, I would start to think something was wrong. It has dipped to below 40 recently but that was due to other factors.

It's good to take an interest in your heart figures to get a feel for what's normal for you.

CPR must have been a shock, but undiagnosed and untreated conditions like CHB can be very serious. One of my relatives used to be out cold for 20 second periods pre-PM.

Everyone is different

by Philmtb - 2024-06-24 06:18:52

You should definitely have this discussion with your doctor. Everyone is different and there is no one size that fits all. 

My lower limit was set to 45, which was too high for me as my Resting Heart Rate before my pacemaker operation was 35. This is very low, but is a result of me competing in a reasonably high level of sport all my life. 

Hopefully, you have an understanding doctor. My doctor would not change my lower limit despite the fact I would flat line at 45 bpm all through the night, proving my pacemaker was stepping in too early. Therefore, I had to go to another doctor who examined all my data thoroughly, before lowering my limit to 35. 

The bottom line is that you must make sure you build up knowledge of your own situation as you know yourself better than anyone else. Ask lots of questions and make sure you are treated as an individual.

Philmtb

by piglet22 - 2024-06-24 10:26:48

Your case is exceptional and many patients with heart block would be quite ill at 35-BPM.

I "flatline" at 70-BPM which is reassuring and tells me that the PM is doing what it should be doing, and without it intervening, I would be back down to 40-BPM or less.

By going so low, you might mask underlying problems and at the very least you will need to keep a check over the years and be prepared to have the base rate increased.

Conduction problems can and do get worse over time. Other arrythmias can crop up, again over time.

 

Thank you!

by karensoftball - 2024-06-24 19:40:55

I do have a good care team now and will be reaching out. Thank you for the feedback, always helpful to hear different points of view.

I was diagnosed with 2nd degree 10 years ago and honestly didn't feel that it was taken seriously by that facility. I wanted a pacemaker years ago and they refused to consider it. Thankfully when I was taken somewhere else to treat a different emergency the block was taken very seriously. Then the 3rd degree advance happened and the rest is history.

Very fortunate with how things turned out! My lowest on a 14 day holter was 30 and I definitely did not feel good.

 

Thanks again!

Getting there

by piglet22 - 2024-06-25 11:08:35

Yes, sometimes getting it taken seriously is the hardest bit.

It took me months of debilitating heart block to get the GP to refer me.

I don't know what they gain by it.

His first solution was for me to rub my vagus nerve.

When I suggested that walking up a flight of stairs in the surgery would bring it on, even that was turned down.

Following up

by karensoftball - 2024-06-27 14:11:59

Quick follow up. She had me send in the transmission early. 

Will go in tomorrow to have some tests and adjustments.

You know you're wired when...

You need to be re-booted each morning.

Member Quotes

It may be the first time we've felt a normal heart rhythm in a long time, so of course it seems too fast and too strong.