Pacemaker

Hello,

Recently my father had a pacemaker implantation like 8 months ago on his first vist to doctor his pulse was 90 and on second vist his pulse dropdown to 70, but now he just fainted and admited in the same hospital they did a regular checkup now the pulse droped down to 60. Doctors conformed every thing is fine with pacemaker working as usual but here we have a question related to pulse dropdown is this going to be an issue? or pulse is based on heart beats.

Thanks in Advance.


5 Comments

Pulse with Pacemaker

by KonaLawrence - 2019-02-09 02:37:10

As always, none of us here can give medical advice.  We are not doctors.  Please ask your questions of your doctor or the nurse at your doctors office.  You may also be able to call the "Contact" number for the pacemaker company.  They employ very knowledgable people.

Having said that...
I see you are in India and I'm not really sure what question you are asking.  It is normal for everyone to have a pulse (heart beats per minute) that changes with exertion.  At rest around 60bpm in normal.  Some people, at rest have a higher rate, maybe 70-90bpm.  A little exercise, like walking, will raise the pulse to 80-100bpm and when at high exercise 120-160bpm.  Depending on age and physical condition.   

A pacemaker only helps the heart when it does not get the signal to beat.  Usually it helps when the pulse tries to go below 60.  If your father needs exercise help it can be set to increase the pulse when he is active.  However this feature will not be turned on unless he needs it.  Many people with a pacemaker can exercise and their pulse increases without any help from their pacemaker.

If his pulse is changing between 60-90bpm it is probably ok.  In fact the pacemaker may not be helping him at all to stay in a normal range, 60-90bpm.  It usually only helps when the heart tries to fall below this range.

Good Luck

Fainting with Pacemaker

by KonaLawrence - 2019-02-09 02:48:29

In re-reading your original question, I see you said your father fainted. Going to the hospital is the right thing to do.

I fainted a couple months after I got a pacemaker for low heart rate (20-30s).  With a pacemaker I felt completely recovered so I was running on a treadmill.  I was lucky I wasn't badly hurt.  When I saw the doctor they checked and said the pacemaker was working fine.  When I told them what was happening when I fainted they ran tests, like forcing my pacemaker to increase my heart rate very high.  That allowed them to see that I have a heart block condition at high heart rate.  To solve that problem, they changed the mode and other settings in my pacemaker.  

Fainting is often caused by slow heart rate.  The pacemaker solves that problem, if it is set correctly.  OR, the fainting is caused by something else.

fainting

by Tracey_E - 2019-02-09 08:33:52

With a pacer, the heart rate won't go below the set minimum rate. This rate can be raised so if we feel better at 70 than 60, it can be set to 70 (or whatever). They can also adjust the settings so that the rate doesn't drop too quickly. Or it's possible the rate drop has nothing to do with why he fainted. Has he had a tilt table test? Look up NCS, that's when fainting happens because of a drop in heart rate and/or blood pressure. The pacer can only fix the heart rate half of the problem. If that's the cause, diet and medication can help level out the blood pressure. Or it could be one of a long list of other things that cause fainting. If the cardiologist says all is ok, go back to his general practitioner. 

Thank you.

by gballa - 2019-02-09 15:22:14

Thank you so much for your information and valuable time you spent.

Pulse/Heart rate

by donr - 2019-02-09 16:21:29

A lot depends upon HOW they measure the heart rate in the hospital!

1)  pulse Oxcimeter - the little device they put opver the fingernail the gives blood oxygen level & pulse.

2)  Check a heart monitor that shows a continuous ECG, &respiration rate

3)  A electronic BP maCHINE THAT GIVES bp PLUS HEART RATE.

4)  A fringer over a pulse point - wrist, neck, ankle, etc.

5 The PM readout.

Each one of these has its failings. 

1)  The pulse oximeter may miss the weak beats of a PVC couplet, giving a falsely LOW hearrt/pulse rate.  If he has enough PVC's he could be fainting, though it takes quite a few.  I have run at 50% PVC's and did not passs out, but felt very tiresd & wanted to sleep. 

4)  A persson may not feel the weak PVC beat, giving a low pulse/hearrt rate., just like a pulse oximeter.    Just before getting diagnosed for needing a PM my wife checked my pulse using fingers on my wrist & came up with 36 BPM, when actually. it was 72 BPM.  She did not sense the weak PVC beat.

2)  the monitor shoould be most accurate of all methods - BUT - if you watch it for a long period (A minute or two) you will  see that the monitor pulse/heart rate jumps around, literally from beat to beat.  The monitor calcullates the HR using the elpsed time between beats, so if you have an irregular HR, it could well give you a low HR for some beats.

3)  thE automatic BP maCHINE HAS SOME OF THE PROBLEMS IOF THE FINGER & PULSE OXIMETER - MAY NOT SENSE THE WEAK PATR OF A pvc, GIVING ERRONEOUS READINGS.

tHE pm READ OUT GIVES YOU EVERY BEAT, SO IT IS MOST ACCURATE OF ALL SYSTEMS.

You did NOT tell us what his lower rate is set at by the PM.  IF the PM is operating properly, his pulse will NOT fll below that rate. The PM is that reliable,.  It's possible that e has a setting that is wrong - like his pacing pulses by the Pm NOT being above the thrershold necessarey for the heart to trigger the beat when the pulse spike  comes from the PM.The PM could be malfunctioning, but that is very rarre. 

This requires some careful analysis by your EP  Drops of the magnitude you mention are noit normal.

Donr.

 

 

 

 

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