Adjusting to new pulse

Hi,

Just got my first PM (am in early 60s) Wednesday. Was bradycardia ("normal" pulse rate 45-50) but asymptomatic until Holter monitor showed sleeping rate low 30s and 3 second pause and my cardiologist said I need at PM.

So now for 2 days my pulse is near 80 and slept OK but how long does it take to get used to your new pulse rate? I'm aware of more heartbeats but did like my old slower pace also. Play tennis and did get rate up to 80 but now that's my new "normal". Takes getting used to.

Thanks,
RTR

4 Comments

Welcome

by SMITTY - 2009-12-11 05:12:10


Hello Pacer30Bob,

I take it this is your first posting so welcome to the Pacemaker Club.

If you are like me, you may have times you will never get used to the heart rate of 80. When I got my PM in 2000 (at age 71) I had a natural heart rate of 55 to 65 and because of something the doctors saw they thought I needed a PM. I'm serious abut that, I never knew exactly why I got a PM, but in later years I did need one. Anyway, the low setting on the PM was 80 and like you it meant a heart rate so much more than I was accustomed to that it did bother me, especially when trying to sleep. So I asked for it to be turned down 70, and then later to 65 for reasons I'll not try to go into here. Somewhere along the way one of the cardiologists thought it would help a shortness of breath problem I was having and it was reset to 70. Didn't help my SOB but the 70 was not uncomfortable so it stayed there for several years and in July '09 it was increased at my request back to 80. Another long story there that I have posted previously. Anyway, one of the first things I noticed was the 80 setting was again noticeable, but the higher setting has benefited me so much I am glad to put up with the little annoyance.

The reason I have told you all this is that for some the settings, especially the first one, is not necessarily chiseled in stone. If you are having discomfort from the higher setting I would suggest that you talk to the doctor and see if he will agree that a lower setting would be alright for you. In addition to the higher setting of 80 my rate response was also turned on so that if I did try any physical activity that called for a higher heart rate, the RR would kick in and help out.

One more word about the initial settings on your PM. Many of us find that the original settings will need to be changed anywhere from just a little to very significant changes. While I cannot prove this, it has always been my opinion that the first settings are at best the doctor's best guess based on what he knows about your needs. Those settings are not necessarily the best for a person, so I would recommend to anyone with a new PM that if they think something could be better talk to the doctor.

Good luck,

Smitty

Thanks Smitty

by pacer30bob - 2009-12-11 10:12:08

Smitty,

Thanks. I have a Medtronic with a lower setting of 60 which my cadiologist says is my "base" when sleeping. . .better than the 33 I had with a 3 second pause last week. I talked with him about the 80-85 seeming high after my walking around 45 and he said, "Welcome to a normal life". So I'll wait and see how I adjust. . .didn't mind the old 45 bpm but then I hadn't passed out while driving which my docs say was possible before the PM.

Pacer30Bob

Why 80bpm?

by golden_snitch - 2009-12-12 09:12:53

Hi there,

what surprises me is first that you got the pacer because of a low heart rate at night - a pause of three seconds is not an indication itself, according to guidelines has to be longer than 4.5 seconds - while being absolutely asymptomatic, and second that your minimum rate has been set to 80 bpm. A normal resting heart rate should be somewhere between 60 and 80 (in children it's faster), and I don't see the reason why you would need it to be 80bpm. Most people have 60bpm, I would say.

So, if you keep saying that you liked you slow pace, too, and didn't have any limitations due to that, there really is in my opinion no reason to keep you at 80bpm all day long. Let the heart do as much work as possible on its own. But by setting the minimum rate to 80, your heart hardly gets a chance to do so. You'll end up being paced 100% in the atrium although you were feeling fine with your own, slower heart rate. Doesn't make sense, does it?

If I were you I would ask your cardio again to have the rate lowered to 60 or 70.

Best wishes
Inga

Thanks Inga

by pacer30bob - 2009-12-13 01:12:26

I do have the lower setting at 60 and that is what I see lying down in bed. Walking around it's 80-90 and I'm getting used to it. My docs said that the 3 second pause was the threshold. . .I guess I wouldn't want to see what 4-5 seconds would produce. . .especially if I'm driving. I'll have my first check next week and see what the "tune-up" shows.

Thanks

Pacer30Bob

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Your signature looks like an EKG.

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