Is this Normal?

I'm 6 wks post op now, have a dual chamber pm. My atria is paced 1% and the ventricle at 48%. My rate is set at 130. I still need alot of education, and my understanding is limited at best. I still feel tired most the time, feel challenged to walk faster, feel SOB when I try. Feel some chest pressure when I exert still (but it's not as bad as it was) I keep being told I'll feel like a "million bucks" but it hasn't happened yet. How can I tell what's post op recovery and what's a wrong setting on my pm?
Thanks, Janet

5 Comments

Being new to your PM

by maryanne - 2008-09-01 03:09:45

Great questions......Being 1% paced in your atrium is awesome...and 48% in the ventricle is good.....now I don't know why you got your PM...was it for heart block? or Sick sinus syndrome? or what....knowing some of that is helpful. As for your rate....a resting 130 bpm is high....do you know if you had a Sinus tachy or Atrial fib before you got your PM? If your increased heart rate is a new thing since the implantation then adjustments do need to be made to your PM....if you weren't in Atrial fib the PM could have put you into that rhythm and that can be treated and should be treated.

So sorry I haven't given you much insight....other than asking you questions....but you should talk to the doctor about the increased heart rate and how you still feel SOB.....and well it's know wonder you do...your resting heart rate is 130...I would be feeling short of breath myself....

Please keep us posted....and if you can answer any of the questions I asked you I would be happy to give you more information if I can.

Normal Or Not

by SMITTY - 2008-09-01 04:09:24


Hello Janet,

If you want an uneducated opinion, I'll say at six weeks your post op recovery should have come and gone. Mine lasted about 2 weeks. If all soreness from the surgery is gone, then post op recovery should be gone too. That is not to say that you should not follow your doctor's orders especially those regarding the leads.

As for knowing what is a wrong or right setting on our pacemaker, unless you have specific symptoms that you did not have prior to getting your pacemaker, then knowing is almost impossible. It really takes a PM checkup to know if the settings you have are the best ones for you. Getting the best setting is at best a trial and error proposition and sometimes it takes several tries to get the best one for a particular person. The doctor took his best guess when he implanted you PM and made the initial settings. Many times this initial setting is good enough, but many times it is not. We are all different and we all have different requirements when it comes to a PM.

I would love to know who told you were going to feel like a million bucks. Many PM recipients do feel better, especially those with very low heart rates, but many of us notice little or no difference in the way we feel. We may notice a difference in our heart rhythm, but as for feeling better no.

Deliver me from trying to discourage you, but to be truthful I cannot think of a single instance where someone said a PM helped their SOB. I've had my PM for eight years and my SOB is worse today than when I got it. I don’t think that is the fault of my PM. My SOB is from a cause my PM does not treat.

I think all a PM is supposed to do is give us a better heart rhythm. Or in some cases keep a person’s heart beating all the time. In your case I would say the ventricle beats were not keeping up with atrium beats and the blood flow to your entire body was less than needed. With the PM the ventricle and atrium are working more is sync as they should. Of course this increase blood flow may make a person feel better, but that is not always a given. My suggestion is that you see a doctor for the symptoms you listed.

You said "my understanding is limited", well welcome to that club we have all joined. While I'm no expert by any stretch of the imagination, I have been looking for answers to questions about my PM and those of others for a few years and I have learned of many sources from which I can get help. So if you have a specific question post it here for all of us to take a shot at, or send me a private message and I'll see what I can find.

I wish you the best.

Smitty

me, me, me Smitty!

by Tracey_E - 2008-09-01 06:09:46

the pm helped my sob and made me feel like a million bucks. :o) I can't speak for other conditions, but those of us with blocks really do feel a whole lot better with the pm because our hr was so low without it. It's not giving us a better rhythm, but a faster one, and that can do amazing things for your energy level. It all depends on why you needed the pm in the first place.

When my pm was set at 130 and my atrial rate was getting up higher than that (mostly at the gym), I got sob. They turned it up to a max 160 and tweaked a few other settings, and I rarely get sob now. That's not a bandaid that will magically cure everyone, but it made a huge difference for me.

130 Rate

by ElectricFrank - 2008-09-01 06:09:57

I think your 130 rate you mention is your upper rate setting. This may be part of your limited ability to exercise. Have you had a checkup yet? Be sure and ask for a copy of the pre and post programming session. There are several of us here that can help interpret the readings and make suggestions.
As for what to expect at 6 weeks depends a lot on why you received the pacemaker and how long you needed it before the implant. If you went for several weeks or months your body was getting along on an inadequate supply of blood which affect a number of organs of the body. It can take a while for them to recover.
I was fortunate to have the knowledge to know I needed a pacer and was able to put on pressure to get it within a few days of my AV block. I chose to have it implanted with a local anesthetic and was awake when they turned it on. I knew immediately all was well. But keep in mind I wa in good physical shape before the block occurred and the pacer compensated for the block. So the only recovery I had was for the incision and pocket to heal.
One suggestion I have is to ask the EP or cardiologist why you aren't feeling better. Don't settle for a quick pass off. Ask specifically if there is another problem and what to expect.

frank

Pacemaker

by SMITTY - 2008-09-01 09:09:39

Tracey,

If you will look in the 3rd paragraph of my comment I think you will find the following.

"Many PM recipients do feel better, especially those with very low heart rates, but many of us notice little or no difference in the way we feel."

It is my understanding that heart block is a major cause of low heart rates because the heart's natural pacemaker is unable, for whatever reason, to get the impulse it generates to the heart chambers.

Smitty

You know you're wired when...

Your ICD has a better memory than you.

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