Is it atrial flutter or my pacemaker?

• by mictre
• 2018-12-08 06:02:27
• General Posting
• 997 views
• 1 comments

Hello PM friends!

Hope to get some insight from you more experienced what’s going on here.

Background:

I got a Biotronik Enitra PM in september this year because of SSS/bradycardia. I also have both paroxysmalt atrial fibrillation and atrial flutter, still untreated. 

My "natural" resting pulse is around ~ 55  BPM and below (Before having my PM it could drop to 25-30).

The issue:

When get an arythmia episode (Fibrillation or Flutter?), my pulse ALWAYS stays at EXACTLY 69 BPM while resting/sleeping. It´s especially obvious while sleeping during such episode since there is a perfecly straight line for hours of exactly 69 BPM, which is way above my normal sleeping pulse.

Note that I have seen the same behaviour using several different pulse-trackers. 

My pacemaker’s setting is to kick in when pulse drops below 60 BPM daytime and 50 BPM nighttime. The pacemaker has NO setting of 69 BPM as I understand from my doctor. 

Now my question:

Could Atrial Flutter be behind this almost ”machine-like” regularity of my  resting pulse (69 BPM)?  

In that case it seems to me it’s a relatively slow Flutter and probably around 3:1 or 4:1 AV conduction.

Or: Is the extreme regularity of 69 BPM caused by my Pacemaker  afterall - although there is not supposed to be such setting? 

Thoughts? 

Regards

/Michael