you need a pacemaker

is a 3 second pause during a-fib , reason enough for a pacemaker


3 Comments

Three seconds

by AgentX86 - 2022-09-10 18:17:05

My cardiologist wasn't concerned about three seconds at all.  That was my max for a few years.  He just told me about it and said not to worry, though I did have a Holter test once a year or more. He wanted to keep an eye on my flutter, too.

Consider this, a one-second pause isn't a pause at all.  It's a normal 60bpm heart rate.  A two-second pause is a single skipped beat and a three-second pause, two skipped beats.  If it's only one in a while (say, an hour) it's not a big deal.  I had a near-syncope event and was hospitalized for a few days.  I had a 5-second pause that the nurses just blew off as a lead problem.  They sent me home with an event monitor (theoretically for a month) that found an eight-second pause a few days later.  It was then pacemaker time, ASAP.

Four or five seconds is about where EPs/Cardioloists start recommending a pacemaker.  Restarting the heart relies on chaotic electrical "noise" to come together to start the heart.  A longer pause says that this condition is less likely, so longer pauses are more possible.  Soon, the "normal" pauses are long enough that if luck is against you the heart doesn't restart until you don't. Not good.

Also consider symptoms

by TLee - 2022-09-10 21:16:10

I was the one who told my doctor that I was feeling quite close to passing out on occasion, and that got the ball rolling with 4 weeks on a monitor & discovering 4-second pauses. The symptoms I was having were feeling my vision fading, being unable to focus my attention on whatever I was doing (often my head would wobble or drop), and tingling or numbness in my limbs. Imagine this happening when I was behind the wheel of a car! It was pretty obvious that a pacemaker was needed. You may not have these sorts of symptoms, but what if it happens first at a dangerous time?

Not by itself

by Tracey_E - 2022-09-10 21:36:10

If that's the ONLY thing going on, then no, they would probably just watch. But everyone is different and there are a lot of other factors to consider. 

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