Not keeping to set speed

  • by dalep
  • 2018-06-28 20:45:24
  • ICDs
  • 1491 views
  • 10 comments

Hello I have a 2 lead St Jude set at Miniumum of 6o BPM fitted 2 weeks ago, for the first week and a half all has been fine , and my lower heart rate has been a steady 60 + / - 1

For the last 2 or 3 days its been dropping to 50 +/- 1 instead of 60

I initially thought my Apple watch has having a senior moment, but i tried using a medical grade monitor, same thing.Last night 49 for 30 mins, the 50 for 2 hours, only went back to 60 when i sat up.

I called the hospital and they said it shouldnt be possible, i also am sure it only happend shen i sleep on my right side

Any ideas?

 

Regards

 

Dale

 


10 Comments

Slow Saint

by AgentX86 - 2018-06-28 22:08:05

I would have suspected the watch, too, but since you tested with aseparate monitor, it sounds real.  Did you correlate the time of the anomoly on the watch vs. the monitor?  Can you get this to happen when you're awake (though lying down)?  If so, I'd call your EP to get to the bottom of this.

Call Your Doctor

by NiceNiecey - 2018-06-28 23:24:13

This is not normal; i.e., shouldn’t be happening.  Do you have a monitor yet where you can send a transmission to your doctor’s office?  You’re so new it may not have arrived yet.

Your cardiologist should have you come in and they will interrogate (such a strange word for it) your device and see what’s going on.  

Let us know how you make out!

Niecey

A couple ideas...

by donr - 2018-06-29 02:12:58


... You are wexpecting too much precisiion & accuracy from a biological timer - your sinus node.  Normal heart rate is advertised as 60-100 BPM & floats all over the place in most peope.  Now stick a precise digital timer in there & you want it to be precise beat after beat after beat & accurate (repeatable) beat afer beat.    Why?  you survived for years w/ far less of both.  !) stop matching your HR against an atomic clock at the National Bureau of Standards.  You will drive yourself batty!

Now I can give you a couple good reasons for the 50 HR, all reasonable.  Now were your HR to actually go that far off from the 60 BPM setting you would have very good reason to be concerned.  No PM worth its salt would do that poorly.  I would wager that you are experiencing things called PVC's & PAT's.  Both have premature Ventricular contractions that may be so wimpy that your sensors may not detect them, hence give you a very low count.  Those two arrhythmias are much higher probability than a PM letting your HR go that low.  It is good to take your question to your Cardio, it may uncover another problem you did not know you had.

Donr

 

Biological timer?

by AgentX86 - 2018-06-29 08:37:03

If his pacemaker is set to 60bpm it should be maintaining that floor.  Something is wrong. It may be that he's getting PVCs that the PM is counting but the monitor isn't but these would have to be 20% of the beats. That would be in the "something wrong" category.

Do not blow this off and don't let anyone blow you off, either!

It's very possible..

by donr - 2018-06-29 09:16:40

...for an external sensor that is not sensing electrical data to miss 20% of the beats.  He's only had that PM for 2 weeks, so there is probably no data from a trip to the Cardio & a thorough exam of the PM/body interaction.  F'rinstance, what is his BP?  Have a VERY LOW BP & if he is lying on the side the mechanical sensor is on A REAlly wimpy premature beat could be damped out before it gets to the sensor.  After all, the vascular system is elastic & absorbs energy from the pulse all the way to the wrist.  If he is lying on that arm, no telling what is happening.  One thing that obviously isn't is a quick download of the pM to see what it says is happening elecvtrically.  That's what counts (Pun intended).  Just put a tournaquet on that sensor arm & watch what happens  to the count at the wrist!  86 is correct - don't get blown off by some harrassed ER worker who doesn't know PM's or be capable of thinking outside the box about low probability events.

DOnr

PACs/PVCs

by AgentX86 - 2018-06-29 13:46:36

If he's getting 20% (consistently, or the monitor wouldn't record it) "wimpy" heart beats, it's past time to get to the bottom of it.

Update

by dalep - 2018-06-29 14:09:24

Hello all,

Thanks for the help

To clarify, in reply to donr, no I dont expect it to keep precision time beat after beat, the reason I raised the question in the first place, is because for over a week , it did just that. For the first week and a half it kept my heart rate at an almost constant resting rate of 60, or thereabouts  58 59 , 61 62.

All of a sudden it changed, for it to change all of a sudden , something has happened.

BP has nothing to do with it as the sensor I used to verify the Apple Watch data is not an optical sensor.

Niecey, I am in the UK I dont know if we have those home transmitters here? no one said anything before hand, that said, the fitting was done very suddenly!

The good news, I contacted the cardiologist and I am seeing him on Weds morning to get to the bottom of it. He has asked me to keep the data between now and then to see if it tallys with the pacemaker

Dale

 

 

 

 

Things don't change...

by donr - 2018-06-30 01:47:36


...Suddenly w/o a reason. That is the most telling thing about your situation.  I took many questions such as yours to my Cardio in my first several years; all ended w/ your comment about sudden change & the need for a reason. 

As to my comment about BP - consider the situation if the vascular system were constructed of glass, bone, metal or any other solid, non-elastic material - The heart, as it is constructed, could not function because it is a positive displacement pump & it could not contract to send a pulse of incompresible liquid out into a non-elastic material.  Our BP comes from an interaction between the elastic stretched vessels & the slug of blood sent out by the heart.  As the blood surges down the arteries, its pressure drops.  It has to, or the blood would not flow.  Your Apple Watch is at the end of a long run of arteries.  I am suggesting that if you had naturally low BP, if you were lying on the arm w/ the watch that body weight atop the arm could conceivably constrict flow in the shoulder area to the point that the watch would be sensing little flow, & miss a lot of beats due to a weak pulse.

How do you feel?

by Gotrhythm - 2018-06-30 12:59:53

All your post talks about is the numbers being displayed on your gizmos. Pay attention to the various electronic measures but don't ignore the data from your body's natural biofeedback systems. 

I don't know what could be causing the apparent drop in heart rate. I think it probably should be looked into. But if it's dropped to 50 and you feel bad, you need to (politely) demand attention.

Ultimately the numbers don't matter. How you feel, does.

Lower limit could be a miscommunicated setting...

by BOBTHOM - 2018-07-02 21:26:58

On my ICD there is apparently a lower limit setting at which it will start pacing and bring my rate up to 60 and maintain that rate.  But that lower limit is set to 40 so it won't try to pace me up until my hr drops to 40.  Just another possibility.

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Today I explained everything to my doctor, he set my lower rate back to 80 and I felt an immediate improvement.