I had a pacemaker fitted in November 2020 for third degree heart block. At my first pacemaker check I asked the technician about the pacing, as I had seen posts from others in this group with a pacemaker.
I was told “ 100% for the atrial and 55% for the ventricle”.
I haven’t a clue what these numbers mean.
Can anyone explain?
I don't have a pm but I am inquisitive about this subject and hopefully someone will answer soon.
If the P wave cannot pass the AV Node at all then you have complete heartblock.
This to my mind is a problem for the ventricles and the atrials will carry on as normal. Why pacing is needed 100% for the atrials is beyond me.
What was your heart rate with complete heartblock?
Did your ECG show regular P waves with irregular PR intervals? This should happen when you have two heartbeats with total heartblock.
I ask as I'm worried that I may also have total heartblock at times.
My heart block came as a complete surprise. I collapsed and became unconscious for a few seconds......no chest pain, breathlessness or any other symptoms. I called an ambulance as my oximeter showed my heart rate was 22! After 4 days in intensive care, while they attempted in vain to raise my heart rate, a pacemaker was fitted. As I have explained on this forum before, I was never offered a follow up appointment other than the pacemaker check. I only asked about the pacing, as I had noticed others reported on it. I had no heart problems (to my knowledge) before the sudden third degree heart block.
A pulse of 22 can only be total heartblock as 2'nd degree would halve your normal pulse to 2.1 ratio.
I felt faint with a pulse of 32 but it could be 2:1 block as my normal pulse is double that at 65 bpm. I'm not sure if I fainted or fell asleep much quicker than normal.
This happened 3 times but seems a bit better now.
The only way I knew something had happened was I fell from a horizontal position to the floor, in other words....I did not crumple. Had a very nasty ‘egg’ on my head for a few weeks afterwards. My husband tells me he heard the noise when I fell, and found me in a confused state. He asked me what I was doing on the floor, and I insisted I wasn’t on the floor. If I hadn’t had an oximeter, I don’t think I’d have phoned an ambulance, because apart from the very sore head, I felt fine.
Sorry I meant to say that I fell from an upright position to a horizontal one
Frightening when that happens.
I wonder why they tried to raise your heart rate over 4 days when doing so is impossible.
Your normal pulse did not go past the AV Node so trying to increase it's rate is futile.
The 22 pulse you had was the emergency pulse generated just below the AV Node to pulse the ventricles cannot be increased.
Perhaps they stopped your Beta Blocker or Flecainide during the 4 days to see if that was the cause. If so then a pm would not be needed. An ablation would have been sufficient.
You should ask your cardiologist about this next time you see him.
I haven got a cardiologist. If I did, I would ask if there was any reason why my heart block happened. I saw an anaesthetist recently as I am due to have surgery due to a rare type of stomach cancer, and he was very surprised that I haven’t been informed about the reason. During my time in hospital I had my thyroxine reduced slightly, but continued on my calcium channel blocker and angiotensin meds. I was put on an atropine drip which gave me hallucinations, so I didn’t have any ability to ask questions. As soon as I had the pacemaker fitted, I was discharged back to the care of my GP. Due to Covid restrictions and telephone consultations being enacted (which I really dislike) I’m still baffled as to what caused it.
My late husband had total heart block, it happened out the blue, collapsed on the bathroom floor and blue lighted to hospital for immediate pacemaker. He did have a silent heart attack some years before the block but no reason given for the total block.
Hi I have a pacemaker it’s been fitted 2 year and I have the dual one which means iv got the pasting leads going in both venticals I’m still having difficulty trying to learn about it my self stil but when I found out about my congenital heart block I was put on ecg for 74 house at home to see how it was effectin my day to day life results were my heart was not sending the correct messages so I was then put on another ecg machine while on a treadmill to see how it affects me while exercising and as I was needing more energy my heart was slowing down and stopped for a few sec as it missed a few beats and my consultant doesn’t no how I haven’t passed out av had the op now but struggle with it mentally and physically
Hi Arrowe, I think there’s a number of causes for heart block. Heart attack, Fibrosis and Infection. So I’m not sure if you’ll get an answer.
I had an ablation for AF and developed heart block a month or so later.
I fainted twice and once woke up under the ironing board. Luckily no damage done.
My problem was the AV node no relaying to the ventricles. So I had a dual lead PM fitted.
My PM is programmed to keep my HR about 50 and cover any delays between the Sinus and AV nodes.
So 3% Sinus (when I’m sleeping) and less than 1% AV usage. So the battery should last 11 years.
I’ve almost forgotten about it and I think it has actually helped my AF which was thankfully resolved due to the ablation.
Hope this helps.
Thank you for your replies Ridley and Boris. However, I must confess I’m still confused. Does this mean my pacemaker is pacing throughout the day when it comes to the upper chamber?
The atrial usage will depend on your natural Sinus. It it’s too slow then technician may set it to something a little quicker. Mines set to 50 BPM, so when I sleep and my natural rhythm drop to below 50 mine Atrial lead fires and ups it to 50.
When there’s a delay between my Atrial relaying the signal to my Ventricles the Atrial lead fires filling the void.
The PM clinic will tweak this to suit individual cases.
My understanding would be that your natural pacemaker is not working and the pacemaker is doing that for you, with the 100% pacing of atrial, it is setting the pace, the 55% ventricle, means that 45% of the time, your ventricle is working fine, but pacemaker is required for the remaining 55% of the time. I'm slightly different, I have heart block Mobitz type 2, my heart rate prior on PM was falling to 27 BPM, My Atrium paces at 20% so it only gets used when my heart rate falls below 60bpm, (usually when I am sleeping) my ventricular paces at over 99% . It measures any delay between the atrial and ventricle and takes over. some of my atrial pacing is also when exercising, my PM is set to react and can increase my heart rate if my heart doesn't do it on its own. I hope this helps explain.
Also I have never had an explanation why I needed the pacemaker, my heart pump etc is all okay, only my electrics don't work, and I am not on any medication either.
I did however start taking magnesium as a supplement, after reading about this from Dr Gupta
Workings of pacemaker 
Pacemaker check today, help please with explanation
Living with a Pacemaker 
Pacemaker
