Hi, 60year old male here, AF new diagnosis and stroke survivor.
Has anyone insight into how a pacemaker works or when it starts working if your heart rate goes high?
Mine went to 127 and I was near passing out, clammy, sweating, very pale face.
The hospital doctors explained to me this episode wasn’t bad enough to trigger the pace maker into action. Confused. It felt bad. Is that correct how a pacemaker works or does the pacemaker need tweaking?
Hi. , I was diagnosed with tachycardia, bradycardia and heart pauses . I have a pacemaker to prevent my heart from going too slow (brady)and pausing , if my heart slows to below 60 the pm will bring my heart rate back up . I’m also on bisoprolol for the tachycardia as my pm is to prevent slow heart rate and pauses . As far as my understanding goes the pacemaker doesn’t prevent a fast heart rate (tachy). Hope that helps
I’ve recently had a pacemaker fitted and my kicks in at 60 bpm but I was told that pacemakers do not stop your heart rate from going high. My pacemaker was also for Tachy/Brady syndrome.
Hi, I have a pacemaker which was fitted as I was having multiple heart pauses followed by bradycardia. I also have SVT which I take medication for as my pacemaker was never going to help with the problem. If I remember right my pacemaker is set at either 161 0r171 bpm so when my heart rate went past that the recorder would kick in and automatically record the episode of fast heart rate. The PM has its own inbuilt recorder with a limited amount of space to record anything that may need looking at. Perhaps that's what they meant?
Ah I see yes thankyou for your reply
Hi Laur. Pacemakers only work to stop your heart going too slow. I have mine set at 70 but many have it at 60. It doesn’t do anything if your heart rate goes high. I’ve often thought why someone hasn’t invented one that can interrupt if u go too high. Obviously a reason why it can’t be done b
Thanks for your reply, I didn’t know that, yes it would be a good invention.
My pacemaker does not control my rapid AF attacks it just stops it going to low and sending me into cardiac arrest again
Ah I see, thankyou for your reply.
Hi Laur12345 ...just as others have mentioned, the pacemaker is designed to stop your heart rate going to slow rather than too high. I have an ICD implanted which is both a pacemaker and a defibrillator. In my particular case, the pacemaker side is set to 40bpm which is very low as the main concern in my situation is my heart rate going too high which is where my defibrillator comes in handy. My defibrillator is set to 190bpm, so if it goes over that for a solid minute, my defibrillator will first try to work out if it is just caused by something like exercise as it recognises what is a normal or abnormal rhythm and if so will try to get the hesrt back into a normal rhythm and if that fails, will shock my heart back.
Thankyou, I’m beginning to understand now, thankyou very much for your reply. All the best.
I'll throw a complication into this.
My pacemaker was set to 60-BPM for 18-years. Obviously not the same one.
Early this year I started to get the old pre-pacemaker symptoms of bradycardia (complete heart block) including a palpable pulse as low as 30-BPM.
There were falls etc., and generally feeling unwell.
Clearly, when a minimum is set to 60 (since raised to 70) BPM and you go lower by a significant amount, something is wrong.
It's not helpful when the cardiology people say the pacemaker is working fine.
It turns out, I'm now getting about 100 ectopics (PVC) per hour.
I haven't had a convincing explanation yet, but my theory is that the pacemaker is including the PVCs in it's timing calculations and creating pauses when there shouldn't be one.
Right now, I'm having the PVCs subdued by the maximum dose of 10-mg Bisoprolol daily.
After nearly 9-months of trying to get an answer, finally I'm sitting in front of the pacing man in October (2023) and hope to get an expert opinion.
I have to say, not impressed by the slowness of the process, lack of communication including reassurance, and the effort that patients have to put in to just get things moving.
Hi Laur12345, Reading your OP, I think your pacemaker is working within normal parameters. Although I have a pacemaker for a different reason (Complete Heart Block), mine will be operating very similar to your own. I also have AFib and AFlutter and have had cause occasionally over the past 10 years to have the settings changed.
Whilst a pacemakers role is predominantly to ensure the minimum of say 60/70 bpm, there is also a maximum level at which it will cut-off, a fail safe in some ways. I think this is what the doctors mean by not triggering. Your HR simply wasn't high enough, and it depends on what you were doing at the time.
In your position, which I've been in, I'd enqiure with the Pacing Team and ask about "Tracking Rate" and what settings you're on. It could well be that its an AFib problem so that should also be investigated.
Thankyou very much for your reply, and taking the time to read my situation. I appreciate your help and will take it on board. Thankyou.
With heart block, the pacemaker takes what's left of your natural pacemaker output and retransmits it to the heart muscles.It should mirror the AV output.
The software or settings can be tweaked accordingly to circumstances the most common being the minimum rate but there's no reason why it couldn't be done at the upper level.
I've certainly had over 200 BPM with the pacemaker so assumed a level hasn't been set.
As I replied to Laura, there are times when the software can't cope with things like ectopics.
I do some coding with microcontrollers and it should be relatively easy for rogue beats like PVCs to be filtered out.
My view is that if you can't feel a pulse from an ectopic, then it's not doing any good and shouldn't be there.
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