High BP after implant - does it go back down?

I had a Boston Scientific PM implant 3 days ago.  61 yrs old.  Sick Sinus Syndrom.  Otherwise good health.  Have my whole life had good BP - always around 120/80.  Never any BP issues.  Since implant surgery 3 days ago, my BP is spiking to 170/100.  Doctor has prescribed lisinopril.  Has anyone who has experienced a post implant BP spike found that it returns back to normal and they can get off BP meds?  I don't want to be on BP meds unless I have to.


6 Comments

Hopefully yes your blood pressure will settle and you can reduce or stop your meds

by Gemita - 2022-12-12 14:23:09

Hello Jordan,

Several members have reported a higher blood pressure reading immediately following their implant.   Sometimes after having such a low heart rate for such a long time and then suddenly having our heart rate set so much higher, can affect blood pressure too.  As we get used to pacing, everything should settle.  Also after an implant, we have to remember that our hearts have been traumatised and this may initially adversely affect heart rate, rhythm and blood pressure.

I had tachycardia initially and needed a beta blocker to control this.  My husband after his pacemaker noticed an increase in his blood pressure, although he already suffered from high blood pressure.

Your blood pressure spiking to 170/100 needs watching though but I am hopeful that it will settle as your heart settles and gets used to being paced, especially as your blood pressure is usually so good.  Are you taking three readings:  morning, lunch time and then evening?  We can all get spikes in blood pressure at times and unless these readings are consistently high, these higher readings may just be a response to early pacing.  I am sure everything will settle quickly since it is still very early days.  I hope everything goes well for you 

Thank you

by gdjordan - 2022-12-12 16:10:52

Gemita, after I made my post, I read through some of your's and others' comments on similar posts.  This is helpful.  We'll see how it goes!  I can see that this forum is going to be a godsend.  Thank you and everyone else who posts on this forum.

Has your resting HR changed much?

by crustyg - 2022-12-12 17:56:50

I discussed this issue with my EP-doc - large (actually enlarged) athletic heart used to beating around 42-45BPM.  His answer: "yes, a PM can increase BP and cause 'hypertension'".  It's one of the reasons why folk who live perfectly OK with a resting HR in the 40-50BPM range should NOT suddenly be paced at a lower rate limit of 60BPM.

I don't see your previous resting HR and your new LRL.  Has it changed much?

But at least you weren't prescribed a beta-blocker!

Big change from prior resting rate

by gdjordan - 2022-12-12 18:11:48

Prior resting heart rate was usually high 30's to low 40's.  New low setting is 60 bpm.  I initially talked with the doc about possibly setting initial low rate at 50, but he said he has all of them set at 60 initially and then can adjust.  At the first settings adjustment opportunity, I anticipate talking with him about going down to lower setting of 50 bpm

You need a better EP-doc

by crustyg - 2022-12-13 04:17:35

Any doctor who takes a one-size-fits-all approach to PMs needs a rap across the knuckles from the medical regulator, IMHO.  You should have been started at 50BPM.

Time to move on and find someone who actually cares about each individual patient.

Yes you may need a better EP

by Gemita - 2022-12-13 08:20:49

There is always a lot of truth in what crustyg says and the gentle approach doesn’t always get the best results.  I suppose it depends how aggressive you want to be at this stage, 3-4 days after your procedure and whether you trust your EP?  If you think you can work with him and be an equal partner in your care from now on, then keep him on your side, otherwise you may wish to move on. 

There is no doubt though that healing following implant/fixation of leads can cause difficult symptoms for some of us and often factory settings are left initially until our doctors can see the results of pacing and what needs to be optimised to suit the individual.  They left mine at 60 bpm for the first couple of weeks, then increased to 70 bpm.  Thankfully there was no increase in my blood pressure which has always remained low.  Conversely, my husband had an increase in his blood pressure following implant, even though his initial lower rate setting was 50 bpm.  We both have pacemakers for bradycardia and syncope.  I also have tachycardia/bradycardia syndrome which at times continues to cause wild fluctuations in both my blood pressure and heart rate, although my pacemaker has helped immensely to stabilise this.

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