Can a pacemaker conk out?

Hi all,

I am a 56 y.o male cyclist and runner.  On Feb. 25 of this year i had a Medtronic Azure dual lead PM implanted for 'weak electrical signal'.  Resting HR was set at 60 BPM. (on my own I would drop into the mid 30s).  At my six month checkup, the nurse/technician dropped the sleeping HR to 50 and raised my upper limit.  All was well.  No more lightheadedness, more energy.  Last week I noticed a couple of 'small pings', not painful, but noticeable right at the implant site.  Yesterday, the uphill part of my cycling commute felt too hard.  This morning on my run, I felt slow and my max HR could not get up past 128.  I'm paced 96% of the time.  Just now sitting on the couch my Garmin (admittedly not the most accurate reader) said I was at 43 HR.  What does this all sound like to you all?  I will be following up with the clinic on Monday.




Highly, Highly unlikely

by AgentX86 - 2020-10-03 15:19:42

Anything made by humans may fail but it's a lot more likely that we, ourselves, fail. Did you count your pulse manually? Did you notice anything strange? Never trust any watch, or any device,  if you think you have a medical problem. Count it yourself.

That said, my bet is that you have an arrhythmia goi going on. I'll go further out on a limb and guess that you're having PVCs. It could be Afib but my guess is PVCs. Neither are an emergency but you need to be seen in soon as possible. Arrhythmias are the leading cause of stroke.

Maybe more than one issue going on ?

by Gemita - 2020-10-03 16:29:43

Hello John,

The 'ping' sound that you heard certainly needs checking if this is intermittently occurring.  Any noise from the device could be significant for battery or lead problems, so your doctors should be made aware of this.  

Your low heart rates on home monitoring could well be due to PACs (premature atrial contractions) or PVCs (premature ventricular contractions) which are real heartbeats but are often too weak to be picked up by home monitors.  Ectopic beats can certainly trick our digital monitors into thinking our heart rate is slower than it really is.  I usually check my neck pulse manually although ectopic beats are not easy to accurately assess heart rate.  As AgentX86 says, I would tell your doctors about your difficulties so that they can check for heart rhythm disturbances.  

My doctors have reassured me that my pacemaker will not allow my heart rate to fall below the set minimum limit of 70 bpm even though I am frequently getting heart rates in the low 40s bpm recorded on my home BP monitor due to my arrhythmias.  Certainly I am very symptomatic when this occurs and I will need to ask my doctors if any adjustments to settings can be made to relieve some of my symptoms.  I suggest you do too.

Pacemakers are generally very reliable if successfully implanted but you may need some adjustments to your settings if you are struggling to get past 128 bpm.  I would ask what your maximum upper heart rate is set at?  I would also want to know what your "sensitivity settings for rate response" are and whether rate response is "on or off"?  They should be able to adjust your settings to improve your exercise capacity

Can a pacemaker fail?

by Selwyn - 2020-10-04 09:34:18

Yes! Although rare, pacemakers can fail and are more likely to show up with a fault within the first few months of implant.  Leads fail.  Serious electormagnetic interferance can be a problem.

Pacemakers have many safety features including a default end of battery life mode.   It is very unlikely you would have an intermittent fault from a unit, though lead problems can be intermittent with flexing. 

You are right- an electronic pulse counter is not necessarily reliable. By 'pings' I trust you mean a sensation ( rather than a sound) - these are likely to be muscular and are more likely with anxiety. 

We do have regular check ups for a reason! It won't do any harm to have a check up, if only for your reassurance. 

You know you're wired when...

Jerry & The Pacemakers is your favorite band.

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