Pacemaker set at 60, pulse 40?

I'm 70 and am very athletic, (well, I was in the past).  Got my PM in 8/17/17 and an ablation on 11/14 for AF and flutter. Why is my heart rate so slow still?  Are there undetectable beats occuring?   The PM is set at 60 but my pulse is 40 to to 44 much of the time.  Today I walked a brisk 1/4 mile and it the pulse was 48.  Then I ran 2 miles in 20:30; it wasn't easy. After the run it was about 100 and quickly dropped to 60.   I was hoping after the ablation my heart would be normal.  Oddly, sometimes when I'm resting my pulse is 72.     The doctor told me I still have the A fib and it may take a while to disappear.  I'm taking Flecainide.    He said just go about your normal activities.  I feel very good tonight after the run but I can tell things aren't right yet.  Any thoughts from some of you experts out there. 

3 Comments

call them

by Tracey_E - 2017-12-20 11:30:09

Either the settings are not really at 60 or one of the leads isn't pacing. It also possible if you are in afib that it's just hard to count and your rate is actually higher. Take note of what time you noticed the lower rate so they can look on the interrogation report to see what the pacer was doing at the time. 

71

by gleesue - 2017-12-20 16:06:12

I'm an old active guy too. I paly tennis, golf, hike, kayack, bike, X-country ski, coach soccer etc. If I'm not doing one of those activities, I work out 5-6 times a week. I got my PM in August 2012.

One thing you need to remember, you don't have a nornal heart any more. But, you still have a good heart. As TracyE indicated above, if your PM is set at 60, it can't go any slower. So something is up if it seems to be going slower.

As far as the ablation. I've had 6. I had 2 in 2016. They can't always find all the bad spots in one ablaton. Some can be very hard to find. As far as still having A-fib and it may eventually dissapear, I have never had that experience after an ablation. Sometimes it has dissapeared and come back, thus the 2 ablationa in 2016. I have been great sonce fall of 2016.

I take Flecainide. It is one of the better durgs as it doesn't have al the side effects of some of the other drugs. My EP gave me that because I was so active.

I'm a little slow right now. I got a new hip installed about a month ago. However, I will be back to all my activities very soon.

God luck and keep us informed.

Jerry

Thanks

by Adrian II - 2017-12-21 01:23:31

TracyE, you sure know a lot about this stuff. I noticed you've had the implant since 94 so you're not new to the topic.  Yes, perhaps the af makes pulse hard to accurately count. The EF says the pm is working.  Thanks for being so consistent with your very informative and knowledgeable responses.   Much appreciated by all. 

Jerry,   I think my doctor was trying to promote a positive attitude regarding the ablation but I think I'll be back for another.  I've never heard of someone having 6 ablations and hope it doesn't come to that for me.  The procedure wasn't bad but I had to stay overnight due to low BP and an inability to urinate after the anesthesia.     Thanks for informing me of your ablation history,      Adrian

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