Inconsistent Heartrate

I am a very active 58 year old woman who received a PM in late February 2020 due to Bradycardia and arrhythmia.  The PM is set to a minimum of 60 bpm.  While overall, I think things are fine, I've noticed lately that my legs are constantly tired and fatigued, I am having trouble catching my breath even after simple activities, my resting heartrate last week was consistently in the low 50's and my heartrate drops into the 40's during the day (it spikes up to 150-200 almost daily)  Due to lockdown here in Spain, I've not been to see the doctor for any follow-up visits since implantation (and they don't do remote monitoring).  I've been trying to get an appointment but (again) due to lockdown, they are very far behind and I've not been able to confirm an appointment.  Can anyone tell me if what I am feeling is normal and/or is it normal for my heartrate to go low when it's set at 60? I am thinking the PM needs to be reset......  ???


what's normal

by Tracey_E - 2020-06-29 09:13:55

It's normal for the heart rate to vary. We have messed up electrical systems, that's why we got the pacers. 

It's normal to need the initial settings adjusted so keep pushing for an appointment. 

It's normal for the rate to go a bit under the minimum. It's not set in beats per minute but rather per second, so 60 bpm means 1 beat per second. Over the course of a minute, it won't be exactly 60, so 55-60 would be acceptable. Two things that can cause a lower number that have nothing to do with the pacer are inaccurate counting and extra partial beats. How are you counting the low rates? Many monitors are not accurate with us so it's best to count manually or use a pulse oximeter. Also, if you having PAC or PVC, little extra beats between the full beats, you'll only be counting the strong beats you feel but your pacer is also counting the little ones you cannot feel, so your number will be low. Or it's possible a lead is out of position and not pacing properly.

I would suggest taking it easy until you can be seen. 

You can't trust a Pulse Oximeter to measure heart rate

by Protimenow - 2020-06-29 13:30:00

In the previous comment, it was suggested that you can use a Pulse Oximeter to get an accurate measurement of heart rate. 

You can't. 

For the same reason that smart watches and activity trackers can't always get an accurate pulse measurement, Pulse Oximeters also fail. Arrhythmias can throw them way off. 

My puse oximeter consistently reported a pulse as low as 36 -- it was probably much higher, but the arrhythmias threw everything off. 

The only good way to detect pulse is fingers on a pulse point and a time source - even then, you may miss weak contractions.

As far as your pacemaker is concerned, be persistent. The PM is something that has to be adjusted hands on. They can't adjust it if they can't put their setting device near the pacemaker.This is one of those things that have to be done in person. it's like 'eyes examined while you wait.'

You know you're wired when...

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