70 bpm Defective or Stuck?

Thanks to Smitty and Joy for your responses.

Smitty, In Toronto, you get whoever is working the pacemaker clinic, so I've seen a few docs and they keep adjusting the settings.

It sure should be going over 72 but doesn't respond to my activity levels.

Joy, I'm only on coumadin, I should have mentioned that but it's not drug related. Thankyou for the suggestion, as it's certainly possible when you're on heart meds. Thankfully, I was able to toss my meds. after my ablation...except for the coumadin. (AFib still happening).

How can I find out if it's the pacemaker....could it really be STUCK on a factory setting?? That's scaring the heck out of me, why doesn't it respond to activity and why do the docs/techs keep saying it's not the pacemaker??

Bionic Beat

7 Comments

Stuck PM?

by SMITTY - 2008-07-26 02:07:18


Hello Bionic Beat,

Like I've said before, I'll never say never about anything a pacemaker can or cannot do. But I will say that the likelihood of your pacemaker having your heart rate locked in on 70 BPM is very, very slim, if not impossible. Pacemakers (I'm not talking about D-Fib units now) do not suppress our hear beat. They simply fill in the blank spots. Unless you are 100% pacemaker dependent, your heart's natural pacemaker controls your heart rate. The PM monitors what your natural pacemaker is doing and if the nat. PM is not sending an impulse to make your heart beat, the manmade job will send the necessary impulse. This is what happens when our heart rate drops below the low set point on our PM. In my case HR would be in the forties, but my PM keeps it at a minimum rate of 70, most of the time.

Most pacemakers implanted today have a feature known as rate response. This unit does monitor the body and heart for physical activity and will increase the heart rate accordingly. However there is an upper limit to which it will take the HR. Again in my case my rate response would not go above 120. Had my HR gone above that my heart would have been on its own.

To answer our questions "How can I find out if it's the pacemaker....could it really be STUCK on a factory setting??" If you feel that you can't believe your doctor, then I think the next best way is to be seen by the manufacturer’s representative and let them check it out. To do that you have to start with a request your doctor. Again, anything is possible, but a PM being stuck on a factory setting would just mean it would not help maintain a desirable heart rhythm about the set point on which it is stuck. I can see no way for it to hold your heart rate down.

Good luck,

Smitty

100% dependent......

by Bionic Beat - 2008-07-26 07:07:46

Hi Smitty,

Yes, I am 100% paced due to a very fast and erratic heartbeat....my resting heart rate was around 165 last year and it went much higher when I moved or got up.

After a few months of that, I was bedridden due to dizziness, very severe weakness and just the horribly fast arrythmia and AFib. I wasn't getting enough O2 to sustain my moving about....and my (previous 2 docs) were only stuffing pills into me. By Nov., I thought I'd be leaving this world, called my EP at a different hospital and asked him to try to help me.

After 2 days of tests, he agreed to the pacemaker and nodal ablation. He did offer me Amiodarone but I declined it.

So, I am much better off than I was but yes, it's not got any variation......and it's set to keep my ventricles paced between 70 and 125.

The histogram shows 70 and 72 beats, since it was implanted in late February. The rate response was put on in May (I think). It's still going at 70bpm.

Yours is for a slow heart beat, mine is for a very fast and erratic heart beat.....but mine is 100% dependent.

That's why I think it's stuck...and I agree it would be weird but I've seen weird before....so have my doctors.

I'm calling my EP on Monday, hope he's not on vacation like every other doc in Toronto.

Thanks Smitty, much appreciated.

Bionic Beat

stuck

by TOGUY - 2008-07-26 08:07:23

I have just read your posting. I feel the same way you do. I too use a hospital in Toronto and never get the same ep doctor twice.Each one has their own idea of settings and I still have not got my right. I have medtronic dual wire and am treated for SSS.I can't climb stairs without getting lightheaded. If you have better luck with one of the doctors please sent me a personal message and I will do the same for you.
TOGUY

PS

by Bionic Beat - 2008-07-26 09:07:18

My previous post, from yesterday has more detailed info about this most distressing situatuation. Thanks.

Bionic Beat

heart rate

by Susan - 2008-07-26 11:07:08

When I first got my pacemaker I had similar issues. What brand/model of pacemkaer do you have?
I assume you are getting copies of your interrogations so you can share them with programmers to verify your heart rate doesn't go over 72. A stress test, as already mentioned, would be a helpful diagnostic procedure. Even during an interrogation I would leave the room and go run up and down a couple flights of stairs and then come back to the interrogation to prove my point.
Ask to consult with a factory rep. or call the pacemaker company yourself and ask for assistance. I found that most drs. don't know the finer aspects of programming (and they sometimes pretend like they do know everything) and even the pacemaker clinicians don't know it all. I found the factory rep. to be the most knowledgeable and helpful (as well as reponses from the company).
My issue was helped tremenously my changing the settings but it took several months of complaining to get it to happen.
SusanD

Medtronic.....

by Bionic Beat - 2008-07-26 12:07:14

Thanks Susan,

I have a Medtronic InSync 3.

I wish I could run up a flight of stairs...lol...that's what I want to do.

With the pacemaker stuck at 70, I can walk up one flight and am tired or SOB at the top.....can't even walk all the way around the block without having to stop.

Yes, the interrogation showed both my increase in activity and lack of response from the pm.

Over the phone, they didn't believe me (again) but the print out shows it clearly.

Thanks for the help....much appreciated.

Wonder if it's the settings themselves.....I don't understand them.

Bionic Beat

Lack of response to exercise

by ElectricFrank - 2008-07-27 01:07:07

You mention that you are 100% dependent so the pacer can keep your HR fixed. One of the features of the Medtronic (probably most others as well) is that they have a fail safe fixed rate they fall back on if there is a problem. A low battery triggers this response. So will exposure to a very strong magnetic or electrical field, but these usually only cause the problem during the exposure.
You described some pretty severe rhythm disturbances before you had the ablation. It is possible that the setting you have is the only one that is safe for you, but if that is the case they should be telling you.
I don't know what your options are in Canada, but here in the states I would be raising all sorts of trouble for them. The suggestion that Susan made of doing some exercise while the EP has you hooked up would at least demonstrate the problem. Even a few deep knee bends or running in place should make some difference in your HR

frank

You know you're wired when...

Your old device becomes a paper weight for your desk.

Member Quotes

I am just now 40 but have had these blackouts all my life. I am thrilled with the pacer and would do it all over again.