Pacing rate question

On June 30 I went in my first device check since getting my pacemaker on May 28. I was satisfied with answers I received at the time from doctor and the rep. As I  was advised here, I got a copy of my summary. I was told that my base rate is 70 and also told that the ventricle apex lead was pacing at 93.7% and the atrial appendage pacing 5.9% of the time. The doctor said this demonstrates my problem was LBBB and 3rd degree heart block and also said my SA node seems strong. The more I’ve thought about that number the more worried I became. Does the high ventricle rate mean I could quickly become pacemaker dependent ??

I’m still trying to learn ! Thanks for any explanation and for your patience !!







by AgentX86 - 2020-07-05 15:55:52

There is a difference between being paced at even 100% and being dependent.  In your case, it's possible, if your heart block becomes complete but I'd argue that the difference between 94% and 100% is insignificant. If your heart only beat 6% of the time you'd be in a world of hurt. One could say that you're already there but there are a lot of other things to consider. Is your AV slow or completely blocked?

Even if you are "dependent", does it make any real difference? There are usually ectopic beats that will take over if your heart rate falls too low. When your pacemaker is interrogated, they usually test for this (the awful feeling like you're in a rapidly descending elevator). Ask your EP.

Pacing rate question

by Sisterwash65 - 2020-07-05 16:14:33

To answer your question about whether my AV is totally blocked...I’m not sure. I’ve been told I had first degree heart block ( early in the day I got my PM ) and also told I had 2:1 conduction , or a slow response and then that I had total AV block. I asked him if I went from 1st degree block to 3rd degree heart block that fast, and he said yes. I guess saying you’re pacemaker dependent is just scary to me. But as I said, I’m still trying my best to learn all I can.

Im very grateful for this technology and I feel SO much better. 

Thank you for your input, AgentX86 !




Thanks for the update

by Gemita - 2020-07-05 16:24:42

Hello Sisterwash65,

I am glad you had a good consultation and given some answers, even though these answers lead to further questions for you.  The important question to ask is "how do you feel"?  I hope you are feeling better with the pacemaker, despite the news that you are being predominantly paced in the right ventricle.

If you are feeling well and have confidence in your doctors to take good care of you, I wouldn't be overly concerned.  Many folks here are 100% paced in the right ventricle alone and do very well.  A minority may go on to develop adverse problems and lowering of ejection fraction which can be associated with right ventricular pacing, at which time your cardiologist may offer an upgrade of your system to support both of your ventricles.  But I would certainly not spend time worrying about something that may never happen to you.

Continue to enjoy your life

Pacing rate

by Sisterwash65 - 2020-07-05 17:50:20

Youre so right, Gemita. I feel SO much better with the pacemaker. At my device check at 5 weeks in, I felt nothing...Not a twinge, not the elevator dropping sensation. Nothing ! I’m probably over analyzing everything but I think I have to educate myself...This site has been very helpful and I appreciate every comment.

Thanks again...

Pacing rate

by AgentX86 - 2020-07-05 19:01:57

Just to be clear, the "elevator drop" sensation is something that some feel during the dependency test when you have your pacemaker interrogated.  You wouldn't feel this outside of the device check. If you don't feel it, you're probably not dependent.  The device tech usually (should) warn you that it's coming.  It really feels weird but as long as you're expecting it, it's not a big deal.  It only lasts a second or two.

Pacing rate

by Sisterwash65 - 2020-07-05 21:28:53

Since this was my first device check ( I’m 6 weeks in with my PM !) I didn’t know what to expect. I was told they just “ tweaked “ it a little to preserve battery life. So I suppose they didn’t check for dependency, if there is such a thing. I was told that my projected battery life is now 15.8 years !! On my Medtronic app it says 11 years. At any rate, I just turned 73 so I hope the 15.8 is correct. 

You are all so helpful. Many thanks.

Dependency teest

by AgentX86 - 2020-07-05 22:52:18

Oh, there definitely is such a thing!  I am dependent (with no escape rhythm).  Every time I go in for an interrogation they test for dependency  I hit the bottom of the elevator shaft.  The tech always says "now this may feel a little funny".  She's not wrong.

dependent is just a word

by Tracey_E - 2020-07-06 09:40:49

I was born with 3rd degree block and have paced every beat since 1994. When they've tested, my rate on my own has been anywhere from 20 to 60. Would I die if the pacer suddenly failed? No.  Would I feel really bad and be at risk of passing out until it's fixed? Yep. The heart wouldn't just stop, it would go back to doing what it was before you were paced. Do I worry about the pacer failing? No. It's a high tech computer, much more dependable than my heart and it has never let me down. It is a bit  of a mental hurdle to get used to the thought but we are dependent on computers all the time. Every time you get on a plane or in a car, you are trusting a computer. Pacers failing is virtually unheard of. I had a lead go bad when it was 10 years old. We kept an eye on it but didn't fix it for another 5 years. I'm on my 5th device. I have always been able to choose my time for replacement. They don't suddenly stop, there is always a lot of warning and built in cushion. 

My doc's office only tests for dependency if it's time to replace. What my heart does on its own when it's time for replacement determines how they handle the surgery. They've always used an external pacer during surgery that will pace for the few minutes it takes to switch out the old with the new. 

It's not uncommon to go between 1st, 2nd and 3rd degree block so it's possible you were in 1st degree one time they wrote it down and 3rd degree another. It often progresses to 3rd degree, that is normal. As much as you are pacing, it sounds like you are there now. 

The important thing is you feel good! If you feel good, then you are pacing the right amount. Many of us here have paced 100% for years and are thriving. I know it's hard, but try not to get caught up in the numbers. There is no one magic number that's right. 

Pacing rate

by Sisterwash65 - 2020-07-06 13:55:19

Wow, Tracy... never knew you could be born with it. Your history and others that have commented is helping me " wrap" my brain around my new reality. I told my doctor and my daughters  that I thought I had PTSD from this whole experience. Some form of it anyway . It was just so out of nowhere. Other that 2 fainting (almost ) episodes months apart, I didn't really have symptoms, fatigue, breathlessness, lightheaded - until about 5-7 days before. I knew about LBBB but had that for years. At any rate, this website has been a godsend for me. 
Slowly but surely I'm getting there, thanks to you all !


by Tracey_E - 2020-07-07 09:57:46

PTSD is real and we've had other members deal with it also. Cut yourself some slack, it's ok to not be ok with it overnight. They talk about the physical healing but not the emotional. If time and starting to feel better don't help, don't hesitate to find a professional. Sometimes even one visit will help a lot. 



by Sisterwash65 - 2020-07-08 21:43:01

Just saw your comment, Tracy. I’m already feeling much better about having a pacemaker and understanding the entire process more. I’m very grateful for my doctors and their actions on my behalf. I have spoken to my 2 daughters and my 2 sister’s and friends about the whole experience. They are good listeners and have helped tremendously....As has this forum. 

oh good!

by Tracey_E - 2020-07-12 10:37:37

Glad you are feeling better about things! Yay support system.

Feel free to message any time you want to chat with someone who's been there.

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