Pacemaker 100%

I received a pacemaker 5 years ago at age 70. I had about 4 fainting spells prior to the pacemaker. After receiving the pacemaker I had no change in my lifestyle. I am a land surveyor and still work everyday and do quite a bit of walking. Went for a pacemaker check this past Wednesday and the doctor told be the pacemaker was working 100%. I was told originally the pacemaker would just keep my heartrate from dropping below 60. I had a heart cath last year with 2 stents. Have to go next week to have an echocardiogram. During this whole time I have never experienced any chest pain or shortness of breath. The only symtoms that I ever had were the fainting spells prior to the pacemaker.


Don't let your percentage paced bother you

by crustyg - 2020-10-31 13:08:14

Fairly sure you've got Sick Sinus Syndrome, and as your natural pacemaker (the sino-atrial node, or SA-node) was failing you needed a PM to keep prevent your HR falling below 60BPM - which keeps your BP up, which keeps your brain alive.  And your heart, but the brain is more important.

And now, whatever process is damaging your SA-node (probably fibrosis), it's got worse and now your PM needs to fire 100% of the time to keep your HR up.

Two things:

1 Being paced 100% of the time does *NOT* mean that if your PM were to stop you'd die.  In the extremely unlikely event that your PM were to stop, and your HR fell to something low - 40BPM, 30BPM, who knows - you'll feel terrible until you lie down and someone can fix your PM or turn it back on again.  Your EP-tech *may* even have got you to sit down and actually stopped your PM for 20-30s at your checkup to see what your natural rate is.

2 Being paced 100% of the time with good leads has very little impact on the battery life of your PM - and unlike the batteries in a flashlight, your PM won't just work normally and then suddenly fail => you keel over.  It has a series of steps to try and keep you going as the battery voltage falls.  And that nice EP-doc of yours will probably notice that there's less than a year of battery life left and plan to replace the box.

Perhaps not the most useful thing to have told you 'you're paced 100% of the time' without explaining why this doesn't matter tuppence.  I'm also paced 100% of the time and have been out cycling up mountains today.  And without my little box my resting HR is about 28BPM.  Who cares!

Relax, and enjoy life: your little box is doing a great job.

So what?

by AgentX86 - 2020-10-31 17:54:07

You're paced at 100% now and weren't before. You were told that your pacemaker would keep your heart rate from falling below 60bpm. That's exactly what it's doing. OK it has had to take over more frequently over time and now has to do its thing 100% of the time. It's designed to do just that.

The only question that I'd have is whether you're chronotropically competent. That is, does your heart rate increase normally with exertion. If it does, you're good to go.  If not, then the pacemaker has a little more work to do. It needs to figure out how much it has to increase to maintain your oxygen needs. Depending upon how active you are, it might take some fiddling with the pacemaker settings.

Your (reason for your) stents could have something to do with this but likely not. As for no symptoms of heart disease,  I had three arterial grafts (the fourth wasn't worth the time on the heart-lung machine). The only symptom I has was shortness of breath with exercise, which I just chalked up to my Afib acting up.

You're doing fine. Don't worry and live life.

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