heart rate adjustment

I recenly had my first pacemaker check-up. The technician said she was going to adjust the rate. Did not tell me what the re-action would be. I felt immediately, desperately ill - like I was going to drop dead there and then. She saw my re-action and presumably just dialled it up again. Is this normal. I felt fortunate that I was in the rooms of my cardiologist but I don't want to go through this again. I mentioned my re-action to the cardiologist but he didn't make much comment.


No Comment

by Rivithead - 2019-06-12 07:58:58

Get a new doctor.

Feeling I'll during PM interrogation

by AgentX86 - 2019-06-12 13:19:11

This is fairly common and the tech should have warned you that it was coming. What they're doing is testing for an "escape rhythm".

Essentially they run your heart rate down as low as 30bpm to see if something takes over from the pacemaker. Most people have several sources of pacing, which will take over if the primary pacer fails. They're looking for this response. Because it causes problems,  they're only allowed to test down to 30bpm but even there some have an extreme reaction. I tend to liken it to a free falling elevator. Hope this helps and you'll be prepared for the next time. Sit back and enjoy the roller coaster. 😃

What AgentX86 Said

by CatDad - 2019-06-12 21:32:51

While clicking several different settings during an interrogation, my tech calls this "the icky one"; I call it the Kryptonite setting. Yes, it feels like the floor dropping out from under you. But I've always been forewarned.

elephant on your chest

by dwelch - 2019-06-14 01:19:54

I had a tech use the term feels like an elephant is sitting on your chest. 


"the icky one" is not a bad term for it either.  

If this is your first checkup and your first pacer then how long have you had this without a checkup?  should be one day of or next morning, one in a few weeks one in a few months then annually.  at least thats what is typically done in the US, not sure about how its done there.  Point being if you just got this a few weeks ago which your profile indicates is not the case I wouldnt expect you to be used to it that quickly and essentially turning off the pacer to see what your body does on its own, you wouldnt notice, if it were only a few weeks old, thats how it worked up to this point without a pacemaker.

But once you get used to it however long that takes, weeks/months, yes there is the icky test that some techs will ask if you have a history of passing out or falling over, depends on what they have you sit in/on.  I had one good practice that used reclilers, like you would have in your house, you cant fall over or out of that.  My current  place its just a plain old uncomfortable not even sure what to call it, not specific to heart docs you see this in every office, but they have the back tilted up and a pillow, easy to fall over and off of if you get too dizzy.  In the 30 plus years with a pacer only had one tech once ask if I get dizzy or have a history of falling during the test.

I have had techs that dont warn you and techs that do, I have gotten over the anger at the techs that dont.  Then tend to do the race your heart up not long after the turn off the pacer one, so you go from elephant on your chest not breathing, fearful kind of a deal to , crank you up and get you breathing heavier.  I have a third lead now so there is another test for that one, the first test in the hospital morning after I felt a sharp short pain, but have not had that since during that test.

I truly wish the techs and the docs could experience what this does to us I think they would be more understanding and give us more warning and a safer place to sit while the test is going on.

Elephants etc

by MissFitts - 2019-06-16 07:12:08

I am always warned (well in the two check ups I have had so  far) that I might feel an unusual sensation when they put the gadget over my PM. Reading this thread, I am  now paranoid because I felt absolutely nothing when they did this. Presumably PM is working otherwise they would have noticed. 😳

Yes it feels terrible. But it isn't a sign something bad is happening.

by Gotrhythm - 2019-06-16 22:03:32

Most people don't feel a thing. But some people do. No matter which group you fall into, it isn't a good or bad sign. Feeling it doesn't mean anything. It's just the difference in people.

The tech who does the interrogation can put a note on your pacemaker's programming that will alert all future techs that you are sensitive. I always ask them to tell me when the test is  coming. Once you know nothing bad is happening, and you know to expect it, it's not a that big a deal.

Take a deep breath and it's over.

If the tech is not willing to warn you, get another doctor. I mean it.


by AgentX86 - 2019-06-16 22:47:32

Whether it feels bad or doesn't, certainly is at least somewhat related to whether one is dependent, or not, and whether there is a useful escape rhythm.  If you're not dependent, you'll probably not feel a thing because your heart doesn't slow during this test much, if at all.  For those of us who are dependent without an escape rhythm (me) the 2-second pause (30bpm), puts us squarely into the pre-syncope territory. Icky, indeed.

Sure, some are more sensitive than others but there is good reason for much of this difference.  They're actually looking for something that makes people feel "icky".  ;-)

All I know is what I felt

by Gotrhythm - 2019-06-18 18:26:58

I'm sure AgentX is right. He usually is. 

But I must say, I felt the icky one, big time, at my first interrogation. At that time I was pacing at 43 %. I gave an involuntary gasp, and begged the tech to please warn me before she did anything else.

She refused. I felt absolutley everything. Speeding up, slowing down. She acted like I was demanding a protocol change that would invalidate every result. When I pointed out that everything was new to me and maybe she could be more sensitive to my inexperience, she got huffy because (she said) she wasn't insensitive--I was. I was heartless for giving her a hard time.

The horror of knowing that someone I didn't trust could manipulate my heartbeat stayed with me a long, long time.

Today, I'm paced at 100%. I still have an escape rhythm. And I still feel the icky one. 


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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.