Pacemaker Hypertension

I had a Medronic Atapta pacemaker implanted on Aug. 7. Within 4 hs. my BP began to rise and and peaked at 202/90 14 hrs. later. I was given additional med. to bring my BP under control and discharged. Since then my BP which has become hypertensive is being treated with a combo of Lisinopril and Norvasc but the results are erratic. I asked the cardiologist what is causing this hypertension, since before the implant my BP was generally 140 or less systoic and 70 or less diasystolic without medication. His answer was less than satisfactory. Has anyone had this kind of in crease in BP after having an implant?

AAF

8 Comments

Increase In Blood Pressure

by SMITTY - 2009-08-22 01:08:18

Hello AAF,

No I haven't had this problem, but I've seen the question asked here before. My cotton patch logic says the increase in BP is because we have a pacemaker our heart is now pumping more blood through the same blood vessels and for what ever reason those blood vessels had redesigned themselves to handle the available blood volume being pumped. Now that you have a pacemaker it has you heart beating faster, thereby pumping more blood through those same blood vessels and back pressure, or resistance to flow, has increased which causes an increase in blood pressure.

To put this in numbers, let's say you had a heart rate of 55 and ejection fraction of 60% (this ejection fraction is considered normal for most people) before you got the pacemaker. That says your heart pumped about 120cc of blood each beat, or 55 X 120 = 6,600cc, or about 1.75 gal/min.

You get a pacemaker and we will say your heart rate is now 70, and the ejection fraction will remain the same 60%. Your heart pumps the same 120cc blood each heart beat, but the heart rate is up so it is now 70 X 120cc, or about 8,400cc, or 2.22 gal/min. That is a 27.3% increase in blood flow through those same blood vessels and my thinking is that could be the reason for an increase in blood pressure.

I had a procedure (called an EECP) where pressure on my legs and abdomen was used to increase the flow rate of blood being returned to my heart. I was to get the treatment for 1 hour each day for 35 days (I couldn't stay with the treatment that long but that is another story) and I was told that this treatment would increase the size of the blood vessels and may lower my blood pressure. To me it reasonable to think yourr BP may return to what it was prior to getting the PM before long..

Is all my thinking correct, I don't know, but it may provide a question for your doctor.

Good luck,

Smitty

Lisinopril

by Island Girl - 2009-08-22 04:08:52

I was given Lisinopril to get my blood pressure down from the150's. Instead of bringing the blood pressure down, it sent it up to the 200's. I stopped taking Lisinopril and my blood pressure dropped back down to the 150's. Lisinopril had the oppositie effect on my blood pressure. I was then put on hydrochlorithazide and my blood pressure went down to the 120's. Then I got a pacemaker and my blood pressure dropped down to the 80's & 90's. I no longer take blood pressure medications and it is at a normal level now.

Pacemember Hypertension

by AAF - 2009-08-22 05:08:56

Thanks to Red1958, Smitty and Island girl for you replies. They were helpfull. I left out one piece of infromation. Prior to the implant my resting heart rate during the day had fallen to the mid forties. A few years ago it was generally around 50. I had them set the lower rate to 50 and they set the upper rate to 130. The pacemaker is a dual chamber model as well as being rate adaptive. I was prescribed the Lisinopril when discharged, but when my BP failed to respond adequately, Norvasc was added to effect greater reduction. I have only been on the dual medications for 4 days and there seems to be some reduction although still erratic. I will be seeing the cardiologist to review the results on Aug. 25. I was not symptomatic prior to the implant, although when climbing a flight of stairs I would not be breathless, but would be breathing fairly hard. Now I can climb those same flight of stairs without any increase in my breathing rate.

AAF

BP with pacer

by ElectricFrank - 2009-08-22 09:08:17

I've noticed that my BP has a wider range since I got the pacer. It can range into the low 200's/low100's at times and then a day later be down in the 80's/50's. I've taken the approach to avoid taking meds to control it. It just leads to chasing it around with meds.

Since yours is staying higher than before the pacer I wonder if it is due to your having higher cardiac output since getting the pacer.

frank

Bp

by Red1958 - 2009-08-22 12:08:22

My bp rose for about 6 months and 1 day went so low about passed out .Now im always below nomal and mornings its about 95/50 give or take a little.Been on same meds since implant. Coreg,benicar and lipitor

Jer

my Adapta

by mendedheart - 2009-08-23 01:08:52

I had my Medtronic Adapta implanted on March 23. This was my second pacer- first one Medrontic Kappa which lasted seven & half years.
I loved my Kappa but the Adapta not as good.
It took over two months & four visits with my Electrophysialogist & two factory reps to work the settings for me. My heart was beating to fast, pulse 120 resting & bp high. I knew my settings were not right for this didn't happen with my old one. The Adapta has new features & they set the new pascer fineally with my old settings after two months . My vital signs were lower & dropped the bp & heart rate beats back to normal. I don't think this new high teck pacer is better then my past Kappa one.
But I would if you- keep after them to change to obtain your correct settings instead of changing your meds.
Any questions write me-pacerpat@socal.rr.com

Mendedheart from CA

Good Advice

by ElectricFrank - 2009-08-24 01:08:26

Good advice mendedheart! There is too much starting people down the road of one med after another while actually just trying to compensate for poor programming..

frank

Pacemaker Frequent Urination

by AAF - 2009-08-28 02:08:07

Hi all. It's me again. My blood pressure is slowly coming under control, but I have developed another situation. Since the implantation I have been urinating very often particularly at night. So much so that I have lost about 5 lbs. I am 78 ( soon to be 79 ), 5' 7" and before the weight loss 161.5 lbs. The 5 lb. loss has reduced my weight to 156.5 lbs. which was my weight when I was 16, and I have never weighed more that 172 lbs. I brought this to the attention to the cardiologist and his explanation was because my heart rate is sigificantly higher this is causing the generation of a certain hormone which is triggering the increased urination and that after my system is fully aclimated to the increased cardiac activity urination rates should return to their previous levels. Has anyone had this kind of experience after their pacemake was implanted ?

Thanks for your help. AAF

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A properly implanted and adjusted pacemaker will not even be noticeable after you get over the surgery.