Pulse rate and pacemaker

When I had my last pacemaker check the technician asked if my pulse was normal or irregular when I was in AF. When I said that it was irregular she raised her eyebrows but made no further comment. It is my understanding that a pacemaker does not cure AF but that it keeps the heart pumping blood steadily while the fibrillation is occurring in the atria. How does this affect the pulse rate? Does the pulse rate reflect the fibrillation or the blood pumping around the body?

10 Replies

  • Hi Patricia 1. I am having similar problem. I feel the AF start and then my pulse rate increases to over 100. This only lasts for 30 seconds or so then drops and is regular. I am also having ectopics. Only had AV node ablation last Oct so presuming heart could be settling. Seen cardiologist who has organised ultrasound and 3 day monitor.

    I know there are different settings but I would have thought the technicians could have suggested something . I hope you can get this sorted and feel the benefit. Keep posting

    Best Wishes


  • I was lead to understand that the PM kept the pulse regular. Pulse= ventricular rate which is paced. Fibrillation in atria can carry on but pulse normal. This is what I have always been told.

  • Hi there Bob, I have a pacemaker and my pulse goes irregular and fast , so I really don't know what the pace maker does.

  • Patricia, have you actually had the AV node ablated following your pacemaker implanted? I didn't think that one was supposed to be aware of an irregular beat following this ablation .

  • No, I have not had the AV node ablated. The pacemaker was inserted for bradycardia and to deal with pauses in the heartbeat when converting from AF to NSR

  • I had my pacemaker implanted beginning of December 2015. Following this ,I had a regular HR and Rhythm. I soon reverted back to fast A/F and Irregular Rhythm.

    Back to A and E Resus once more.

    The Doctors sent me back to Cardiophysiology for PM interrogation. PM doing exactly what it was intended for... Controlling my Bradycardia and allowing for higher doses of medication (Sick Sinus Syndrome). The PM does not influence Arrhythmias ... I am informed?

    Sent to A and E -where they put me on another Rhythm medication. Up to recently, I have had 25 days in A/F... irregular rate and rhythm... NO p waves..... the usual SOB , Retro Sternal Discomfort, Fatigue etc.

    I have had a regular rhythm for one week ,but rate is not controlled yet -still erratic -at times, (when I am at rest).

    I am sure the medication will sort this out eventually.

    I have been offered an Ablation by my Cardiologist (EP).

  • Hi I have just found Pacemaker Plus web site. It is excellent and has an ebook to down load (free)

    It explains all about pacemakers and the different settings. It also has other free ebooks.

    Hope this helps. Best Wishes


  • Thank you Susan. I have found the website and it is indeed very good

  • My understanding is that a pacemaker by itself does not affect the pulse rate or assist in controlling the fibrillation. It is useful however for symptomatic bradycardia. In my case, I was having dizzy spells and occasional faints and a 7 day halter revealed that when I was coming out of an episode of AF, my heart was pausing for between 3 and 10 seconds which was the cause of the dizziness. Since pacemaker implantation 3 years ago I have not had a dizzy spell or a faint, but I still get AF episodes, in fact they are increasing and the pacemaker records their length and frequency. I suppose I am gently on the way towards permanent AF, but the advice of a private specialist EP to whom I went for a second opinion is that I should not consider ablation unless the condition becomes difficult to live with. I am one of the relatively lucky ones for whom the AF episodes at present do not usually trouble me unduly.

    I am of course on Flecainide, Bisoprolol and a NOAC (rivaroxaban). Prior to pacemaker insertion, I had trouble with bisoprolol as I had a low resting heatbeat when not in AF, but now the pacemaker sets the rate at 60 when I'm not in AF.

  • I had my pacemaker inserted two years ago for exactly the same reason as you and with exactly the same result

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