New Pacemaker

I had a pacemaker inserted a year ago following complete heart block. The pacemaker was not expected to work and the heart block was believed to be a one off. At my latest check-up I was told that the pacemaker had working very occasionally so does this mean I do have a problem with my heart? The pacemaker is set at 40.




by SMITTY - 2008-12-18 10:12:59

Hello Juliet,

You ask if the results you were told about during your last pacemaker check indicates you have a problem with you heart? I guess the best answer I can give is to start with a question and that is how do you define "problem." To me a problem is the result of something being broken and has to be fixed. But based on what I see in your message you may have an irregularity with your heart beat, but not necessarily a problem.

Now I'm not an expert on pacemakers but I'll give you my guess on yours and what it is doing. First your pacemaker, like all pacemakers, works 100% of the time. Bu, that doesn't mean it is helping your heart beat 100% of the time. Our pacemaker continuously monitors our heart beat and if it determines that our heart's natural pacemaker is not going to produce a heart beat, the manmade PM will send an electrical impulse to make the heart beat. As I said our pacemaker monitors our heart continuously, but only steps in when needed.

In your case, based on what you were told, the PM is not needed very often, so it is working "very occasionally." However, that can be misleading. We, (at least I know I do) tend to think of our PM helping our heart beat one or two beats then waiting to be needed again, in which case it is working occasionally. Now let's use some numbers to help understand how this occasionally can be different for each of us. Say your normal heart rate is 60 BPM and your PM is called on to provide a heart beat only 3 or 5 times a minute. That makes your PM working just 5% to 8% of the time and to me that is occasionally. But rather than having that PM help coming in spurts let's say your hearts natural PM takes a rest and fails to provide the impulse to make your heart beat for 5 beats in a row and your PM has to do the job. Your PM will, in such case, be working occasionally, or 8% of the time, but this 8% is much more important than one spread out over a full minute.

What I'm trying to say is how much, or what percent of the time, our PM helps our heart is not nearly as important as why it is having to help our heart maintain a steady rhythm. Since few of the people doing my PM checkups are capable of answering that question, I seldom ask them. I have become so cynical that even if I asked and got an answer I would have doubts about its validity. What I do is request a copy of the printout of the checkup and bring it home and do my own interpretation of the results, with help from the good people here of course.

Good luck,


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by ElectricFrank - 2008-12-19 01:12:34

Smitty covered most of it well. Just keep in mind that our heart beats over 80,000 beats in a day. Of those missing maybe 15 in a row will cause you to lose consciousness so all the pacer has to do is fill in few to be worth while.


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