Need for rate response

Is there a electrophysiologist cardiologist out there who can explain to me why my heart decided to not pick up as it used to and therefore the rate response had to be turned on?  Had the dual lead PM implanted in Feb. 2017, and this was done a few months ago.  I asked what this meant and was told, "it means it is a good thing you have a pacemaker." All that has done is create anxiety on my part that is causing me to seek some counseling on accepting the situation.  But I still would like to know the "why" about this. Anyone?


I, too, have a "Why" question,

by IAN MC - 2018-04-19 10:30:58

Why on earth should you have increased anxiety because you need Rate Response switching on ????

You, like most of the pacemaker population , have developed "chronotropic incompetence " and now need RR to manage it

C.I. is not life-threatening , It is no big deal. Save your anxiety for really worthwhile things

Sorry if this sounds harsh  but I don't know where you are coming from.

Try Googling chronotropic incompetence . It happens when you get older. Drugs like beta blockers, and amiodarone and digitalis can cause it.  A malfunctioning sinus node is a common cause. It is very common to have a PM installed and not need rate response initially but then to need it after a few years. This is because electrical problems can change with time,

There is no way that your EP / cardiologist could answer your question with any degree of certainty.

You are where you are .

I suggest that you celebrate having a pacemaker instead of wallowing in  self-pity with" Why me " type questions.


electrical problems

by Tracey_E - 2018-04-19 11:02:54

Electrical problems just happen and we rarely know why. It's pretty common for electrical problems to come in multiples, many of us have more than one thing going on. It's all electrical, not structural, and we already have the pacer to fix it so as Ian said, no big deal. 

electrical questions

by ellenmary - 2018-04-19 12:11:35

Wow, if I wanted a harsh response, I would be on Facebook.  Ian, one smart thing you wrote was that you don't know where I am coming from.  Therefore, don't judge me. 

I grew up with a mother with serious heart issues and subsequently was with her when she died many years later. But the anxiety stems (yes, diagnosed by a mental health counselor) from growing up with the fear of her death from age 4. Exacerbated now with my situation.  Heart problems run in the family, but no one had a pacemaker. 

Yes, I feel very fortunate to have this device that saved my life after cardiac arrest, but that does not mean that I am not scared when things feel slightly off or different.  I am not on any meds that would affect this, the RR was turned on only a few months in. 

This is not a pity party. I allowed myself one of those for 1 week after the PM was put in during an emergency situation. This is not "Why me?", but "Why" the electrical system changed so quickly.   I am under the care of a cardiologist for slight mitral valve prolapse, again no meds, and am aware that the structural and electrical systems of the heart are separate.

And I have been curious and asking "Why" about things since I began talking at age 12 months. It is part of who I am, a retired professional counselor who understands the difference between a question and a concern. I would take the time to understand where the person's questioning is coming from before making my diagnosis.

I just read a very scientific paper on CI. Never heard of that before, so for that information, I thank you.

TracyE, thank you for your brief and kind response.

It is what it is.  ~Ellen.

Coming to grips with pacing

by Gotrhythm - 2018-04-19 12:56:14

Why on Earth it can be so hard to get the kinds of complete answers that we long for from cardiologists? I don't know. I remember pressing the EP. Why were they saying I needed a pacemaker if, as I had repeatedly been told, there was nothing wrong with my heart? Why wouldn't the pacemaker help with palpitations? I walked around in a perpetual state of frustration--unsatisfied with half-answers--until I discoverd Pacemaker Club.

Here's what I learned over time. Although there are many possible causes for eletrical problems, in the absence of damage say from a heart attack, rarely is it possible to pinpoint the exact cause in any one case. All they can say with certainty is that statistically, incidence of electrical problems increases with age. In other words, electrical problems can occur at any age, but are more likely to occur in older people.

Here's something else I learned. Electrical problems don't get better on their own. Generally, they get worse over time. Since my diagnosis seven years ago, I've added a couple of new arrythmias. What that means is, if I didn't already have a pacemaker, I would really need one now. LOL I suspect that's what they were trying to tell you.

Good news! Both I and you do have pacemakers. If new rhythm issues crop up--no worries. Tthey are easily dealt with by a few computer keystrokes. 

Today's pacemakers are miracles of reliability. As long as the heart is capable of beating, the pacemaker signals will keep it going. From time to time, the settings may need to be adjusted to accomodate changes in our condition, so that the heart can be helped to function optimally, and we can feel the best we can.

I've had my issues with my pacemaker. But more and more I find comfort in the knowledge that as long as my heart is capable of beating, the pacemaker is not going to let it stop.

Does this help?

Coming to grips with pacing

by ellenmary - 2018-04-19 13:37:51

Thank you, Gotrhythmn!  Very complete and compassionate answer!  Yes, it did help a lot! This is what I have come to expect from this website and am grateful it exists.

And I see that you also questioned "Why" at times.  It seems normal to me to do so, in spite of what one person wrote to me. The lack of forthcoming information from the cardiac people can be difficult. I found just the opposite after breast cancer, was given almost TOO much information and resources! Perhaps it is a space in the continuum of cardiac care that needs to be filled.

Again, thank you so much!  ~Ellen.

Why is my electrical conduction system failing ?

by Selwyn - 2018-04-23 13:39:15

Never ask a specialist a difficult question! They aspire to be all knowing. Very few will admit to not knowing ( unlike family doctors! ).

There are many different illnesses, traumas, and inherited problems, that can damage the conducting system of the heart.  Age is perhaps one of the commonest conditions ( as we age we gain more fibrous and fatty tissues, sometimes with deposits of protein), followed by blood supply problems ( e.g. ischaemic heart disease). Viruses, infections, autoimmune disease, tumours, etc. all affect some people. The list goes on for conducting disorders....

I had an enlarged heart for years put down to excessive exercise by a cardiologist, now, 10 years later diagnosed with a cardiomyopathy- my Mother had a pacemaker, my Dad died from heart disease aged 56. Blame it on the parents? ( That's what my son says!!)

You ask the right question from the right people, you don't necessary get the right answer! 

( As you have found out!)



Why why why?

by ellenmary - 2018-04-23 15:24:13

Thank you, Selwyn, for your very compassionate and informative reply! I truly appreciate it, this is why I joined this group.  Take care!


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I'm 35 and got my pacemaker a little over a year ago. It definitely is not a burden to me. In fact, I have more energy (which my husband enjoys), can do more things with my kids and have weight because of having the energy.