Not sure about Pacemaker

symptoms

by Tracey_E - 2023-04-13 08:37:03

A normal heart rate is 60, 50's is cause for concern. Anything under that, I'm surprised they aren't pushing for a pacer. Even if you don't feel it- and it sure sounds like you are feeling it- it's really hard on the organs when they aren't getting enough oxygen. Many of us find out after being paced that we were'nt as asymptomatic before as we thought, we just get used to it.

My rate was in the 40's, then dropped and was 22 when I was admitted for emergency surgery. I never passed out and drove myself to the hospital.  When your rate is that low you are not making sound decisions! It was a bit like being drunk and it never occurred to me how much danger I was in.  I could feel the difference the minute I woke up in recovery. It was like mainlining coffee. 

When you are fainting is too late. Please do not use that as a benchmark. We've had members seriously injured from fainting, then found themselves recovering from an accident as well as pacer surgery. 

Have you had a sleep study to rule ot apnea as a source of the fatigue?

Have you had a holter to see how low you are getting and for how long?

It's ok to take your time making a decision and be comfortable with it, but odds are pretty good you will feel better with a more normal heart rate. 

Second opinion

by Lavender - 2023-04-13 10:15:21

You said, "He is concerned though about my  low pulse rate ... the Cardio has defered pacemaker."

If this is bothering you, you may want more advice from a different professional. I think at the least, your cardiologist can set you up with a thirty day monitor. I had to really push to get one when I had symptoms. Only ten days into wearing it, it caught my ventricular standstill and bought me a pacemaker. 

Low Pulse

by Penguin - 2023-04-13 11:53:44

Couple of things to think about re: heart rates and when they are low / why they may be low: 

1. Does Methotrexate cause a low pulse, pauses or have any other cardiac effect?  

2. Response to Exercise - you mention a stress test every 6 months. Do the results of 36-45 bpm come from this?  If so a max rate during exercise of 45 bpm sounds pretty low IMO.

3. Personal Health / Activity - The very fit and athletes have low resting h/rates in the low 40's and this is normal for them.  Do you fit into these categories? 

4. Sleep - H/rates during sleep can dip pretty low. 40-60 bpm is cited as normal. Did these h/rates get recorded whilst sleeping?  

5. Fatigue - If you're used to being tired as a side effect of your meds, it could be that you're not noticing the effect of a low pulse as well.

6. Symptoms  - There are guidelines which doctors have to consider before implanting a PM. Ask your doctor what the guidelines say in Australia.  Thinking has changed recently and your doctor will have a checklist and will not implant a device unless you meet the criteria.   Perhaps the uncertainty re: drugs / other conditions is part of his hesitancy.

If I was you I'd want further testing via a Zio patch or holter monitor for at least 48 hrs and ideally 7 days to see what is going on and when.  

Tired and sleepy?

by Gotrhythm - 2023-04-13 12:21:54

With a pulse of 36-45 it's no surprise you feel tired and sleepy.

As others have pointed out, medications for high blood pressure can definitely cause tiredness, but so can a low heart rate. Some blood pressure meds will also reduce heart rate.

Are your tiredness problems caused by your heart beating too slowly, or are medications causing them? That's what needs to be sorted out.

Certainly you don't want to get a pacemaker if all you really need is a med change, but if you really need a pacemaker--well, getting one isn't the worst thing that could happen. In fact, it could be the best thing.

Sleepy after lunch

by AgentX86 - 2023-04-13 12:44:42

This sounds like a blood glucose thing.  It's normal to be somewhat sleepy afer a meal.  I sure want to take a nap. It's actually part of our physiology.  After a meal the body wants to shut down to digest the meal.  It's the other half of "fight or flight"; "sleep and digest".

To the degree you have the response may not be a big deal, or may be.  It would be good to get it checked out. I know it happens to me, in spades.  If anything, my blood glucose is low (77 fasting) but it gets me unless I'm physically active.  If I sit down and relax, the snoring comes very shortly.  Fifteen to thirty minutes later, I'm fine. It got embarrassing if I had an afternoon meeting. Now I just fall asleep reading posts in The Pacemaker Club. 😄

nap after lunch

by new to pace.... - 2023-04-13 15:13:35

Could be a food issue.  You might want to keep a food journal: write down everything that you ate including herbs and spices, salt and pepper.  Then avoid those foods for a week.  Put them back in your meal one at a time until you get the nap.

I know i have that nap time most of the time after eating.

There is a quicker way, but insurances do not pay for these blood tests. They are quite costly.  You need to look online for food sensitivity tests for your area.

I have taken then off and on for many years.  They are mostly right on the mark.

Now that i am taking Algal Oil it has lessen my nap time after eating my reactive foods.

new to pace

Some Answers to Q and update

by glemonsie - 2023-04-13 21:52:53

Thank you so much for the 6 comments it was really helpful.

I have the 24-hour monitor every 6 months and it does show average 40 BPM but no other issues and during stress test I will get normal elevation to 150 BPM. Yes I was an athlete so no pulse has been the same for 50 years it's just that it seems to be an issue now because of my 70 year age and I'm certainly generally unfit anyway.

The rheumatologist seems to think fatigue has to do with meds but the cardio seems to think it may be my pulse rate and this is why I have a dilemma and they're waiting more for lightheadedness symptoms to show up because I can't stop taking the meds.

Yes I have also been diagnosed with sleep apnoea 30 years ago which was never medically rectified and of course the classic side-effect of apnoea is being tired but my condition of tiredness dramatically deteriorated  5 years ago when I was diagnosed with PSA but coincidentally Angina started.

Sleep apnea

by Rch - 2023-04-14 01:56:28

Hi

Some of your symptoms like daytime somnolence, lower % O2 , fatigue and hypertension may all in part be related to your untreated sleep apnea. I doubt your low heart rate is causing your fatigue per se given negative stress test with appropriate HR and BP response on the treadmill. Holter doesn't show any heart blocks or pauses. In my humble opinion, PsA which is an inflammatory condition, together with the drug to treat it, could be causing some of your fatigue! I am sure your thyroid levels have been checked! Please address your sleep apnea with your PCP and perhaps start on some lifestyle modifications as the first step!  Hope you will get some answers soon! Wish you well.

Pacemakers for Sleep Apnea

by Penguin - 2023-04-15 03:28:51

Just in case you end up going down the pacing route, a pacemaker manufacturer called 'Microport' (used to be named Sorin / ELA) specialise in PMs for people with sleep apnea. 

https://microport.com/healthcare-professional/cardiac-rhythm-management-home-page/cardiac-rhythm-management/pacemakers#

There are several models and the website should tell you whether or not there is a Microport sales office in Australia to contact for further information. 

(You will need to copy this link into your browser as it doesn't get activated via this forum)