First implant.

Hello All,

Had my first implant of a backup pacemaker for long term Bradycardia which l had for around 15 years. Procedure went well and the physical healing is very good, but l still feel tired although l am pacing at 50 which is much better than the low 40's l was getting before. I had lots of symptomatic ectopic beats before being implanted and the idea was to get the heart rate up and then use beta blockers to control the ectopic beats which are still happening and actually seem a little worse since increasing the beta blocker dose. Who knows, perhaps it will all settle down in the end. I do feel tired at times, l expect that's normal though.





by AgentX86 - 2022-04-27 21:05:04

Welcome to the club.  I hope you find the information you're seeking here.

I'm not sure what you mean by "backup pacemaker". A heart rate of 50 probably isn't high enough but it may be just an interim step.  Have you discussed this with your EP?

Your EP seems to have a reasonable plan though it may take a higher resting heart rate for it to work.  You might need some sort of antiarrhythmic too.  It's good that he's trying to get away without them but it may be necessary.  Antiarrhythmics are toxic to one degree or another and it's best to avoid them.  If they're necessary there is a ladder of eficacy and toxicity.  Moving slowly up that ladder is the way to go.  Not getting on the ladder is better.  Your PM will give your EP another tool to keep you off the ladder or at least find safe(r) drugs.

IMO, you're in good hands. It would be good to ask him what his long-range strategy is.  Education is good.

Getting adjusted to it all

by Gotrhythm - 2022-04-28 13:22:53

All pacemakers are "back up" in the sense that as long as the heart beats above a certain preset rate, the pacemaker will do nothing. It only paces when the heart rate, in your case 50 falls below 50.

Technically, any heart rate below 60 is still considered bradycardia. But the only real test of whether your resting heart rate is high enough, is how do you feel? Since you're feeling tired, maybe a higher resting rate, say 60, would help you feel better.

Re: ectopics. I and others here, have a long history with them. Based on my experience as a patient, not a doctor, I think it's important when you say symptomatic to make the distinction between making you feel anxious and fearful, and those that actually interfer with your ability to, say, walk.

One good thing about having a pacemaker is that you even though you still may feel an ectopic beat it doesn't mean your heart is going to stop. In the past the ectopic might have been scary, but now it doesn't have to be. Why? Because your pacemaker is on the job. Anytime the next beat doesn't come exactly when it should, the pacemaker is going to kick in.

My experience with anti-arrhythmia drugs is that all of them have the side effect of tiredness. And none of them totallly eliminate arrhythmias. They only reduce the number. I have had ectopics that would literally bring me to my knees--have to sit down before I fell down. A certain amount of "tiredness" was an acceptible trade off to have that happen less often.

A well adjusted pacemaker can give you a better quality of life than you have enjoyed for some years. It can be more than just not-dead but actually good, really alive.  Getting the pacemaker tuned just right for you can take several tries. My base rate had to be changed three times before we found the one where I felt not just okay but really good. Think of your current base rate of 50 as a starting place.

Stay with it.

Oh, and welcome to the club. :-)



by PacedNRunning - 2022-04-29 04:10:16

Ectopics are common after implant due to the heart being irritated by surgery. Give it time. My low limit is 50. Nothing wrong with 50. The more your heart can do, the better. The beta blockers may make you more tired. 

different beta blociker?

by BOBTHOM - 2022-05-03 14:37:16

Different beta blockers can have different affects.  I tried several including Metroprolol and Carvedilol and finally settled on Bisoprolol, no more runs and no more immediate need for a nap.  Now I just have to take it early enough so my overnight heart rate doesn't drop to low, speaking of which, it's that time!  Talk to your doctor about the possiblities.

Good luck!

You know you're wired when...

You run like the bionic woman.

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At age 20, I will be getting a pacemaker in few weeks along with an SA node ablation. This opportunity may change a five year prognosis into a normal life span! I look forward to being a little old lady with a wicked cane!