Need A Pacemaker?

[ajw4790]

Hi all!!!

I need your expertise! I recently had a really long meeting at school about accomodations and how to stay in the program. Anyways, I mentioned after the meeting I was going over to get a 30 day event monitor. Then, they kinda flipped out (b/c they are in the medical field) and asked if that meant I was gonna need a pacemaker? I told them that it hadn't been mentioned and this was to look for arryhthmias. They said the only time they really knew of people having the monitors was to determine the need of a pacemaker.

So, anyways... I was just wondering b/c many of you have a pacemaker, what makes the drs. determine the need for a pacemaker?

Also, b/c even more of you have had this testing without getting a pacemaker, was that the purpose of the test? That isn't what it is always for right?

Thanks again for your help!!!

[morgan617]

No, it's not just for a pace maker. It's to look for any kind of arrythmias that people feel, or make them symptomatic. It could show the need for a pacer, but it could a zillion other things too.

There are lots of irregular heart beats that could mean anything from nothing to life threatening and everything in between. Until you catch whatever is bothering you, no assumptions should be made. I do have a pacer and got it because of what they caught on an event monitor, but I've had event monitors multiple times in the last 15 years and have only had the pacer 1 year. Hope that helps. Just make sure you push it when you feel something, even if it just seems minor, because then you have a record.....morgan

[Sophia3]

Just curious if the folks you spoke with are in the "medical field" why on Earth would they leap to the conclusion of a pacemaker?

As Morgan said, any event monitor can mean they are looking for scads of things to be wrongs, especially arrythmias..NONE which will be helped by a pacemaker. Many want to try and figure out the tachycardia they have and see if a beta blocker might help, or other medication.

pacer only helps bradycardia issues (VERY SLOW HR) or pauses in the heart.

Morgan IIRC, went thru years of hello with cardiac stuff before they found she had very long pauses..along with bradycardia.

So don't let folks think any monitor means pacemaker UNLESS YOU YOURSELF have very low HR. And remember, Many in the "medical field" know zip, zilch, zero, nada about ANS problems, period.

Sorry if your friends upset you...Most of us have high HR issues but some folks have the complications of both..some drug induced..others positional induced...they stand, HR jumps high then takes a plunge.

So, good luck in getting info on your results.

[pat57]

I have the bradycardia during NCS events,and I was offered a pacemaker. Never had a 30 day monitor either. Had a 3 day monitor and TTTs.

[taylortotmom]

My doctor and I discussed a pacemaker for a year before deciding to try it. It was a last-ditch effort to help with at least some of my symptoms. As others stated, it only helps with the bradycardia but the biggest benefit to me is it tracks ALL my heart rates so we can see exactly when my heart goes nuts. For example, I have had several periods of my heartrate staying in the 170 range for a few HOURS at a time over the past few months and it is all documented by the pacer. The pacer can do nothing about it but it is nice to have a tracking system in place- if that makes sense. It is not the end-all be- all by any means. However, it does help with mornings as my bradycardia was getting so low at night I woke up feeling like a truck had hit me. So the pacer definitely helps with that by stimulating my heartrate as I sleep. It's just another tool. Many people (especially, those unfamiliar with dysautonomia) thought I would be "fixed" with a pacemaker- if only it was that simple.....

Carmen

[Dawg Tired]

I'm like Carmen. Everyone thought I would be "fixed" by a pacemaker. My heartrate was dropping into the lower 20's at night. But it does nothing about the frequent tachy's except record them.

[morgan617]

Carmen, my doctor did the opposite...he said over and over, it wasn't going to "fix" anything but my brady. I was told to have NO illusions it would help any of my other problems.

Mine also tracks fast rates, but they had it set so high, it wasn't. They lowered it a bit the last time I was in. Or said they did...I don't really trust them. morgan

How ever out of all the times I had an event monitor, there was only one time it indicated the need for a pacer, but it was very significant need. The others showed my tachy rythyms, and no brady ever. I was wondering about these medical people too, except I think you are having big drops in your rate, right? Sorry, brain fog. There are two people on the board right now with low heart rates. If it was you, that's probably why they assume it's for a pacer. I'm so sorry, I'm confused between the two people. redfacedmorgan

[doctorguest]

Like others, I am wondering why these "medical people" are jumping to such erroneous conclusion about the need for a pacemaker? They should know that a 30-day event monitor is used for a variety of reasons, including to capture episodes or arrhythmia that the patient is experiencing, but that is not being captured by routine EKG or a Holter.

[Steve]

I get "irregular heartbeat" warnings when I take my blood pressure while standing. Not on every reading, but on about half of them if I stand for about 10 minutes. I was never sure what to make of these warnings. First, I have doubts about how accurately a $50 blood pressure monitor can detect irregular heartbeat. Second, I am not sure exactly why irregular heartbeat is a problem, especially as it is related to POTS. I do understand that an irregularly beating heart does not pump blood through the body efficiently. But does that mean it exacerbates tachycardia? Or does it mean that the pulse remains the same but each beat does less? Maybe I completely misunderstand how this works. I would appreciate it if someone can explain.

[morgan617]

grarduh,

Irregular heart beats can be anything from just an annoyance to something not pleasant at all. When you think of how many times the heart beats in your life, you have to expect there will be a few irregularities occasionally. Everyone has them, but not everyone feels them.

It depends on the type of arrythmias, as to whether they are cause for concern or not. If you have no symptoms except for feeling one once in awhile, personally, I don't worry about it. But if it causes you to feel faint, grey, sick, short of breath, or doesn't stop, it needs to be checked out. Sinus tachycardia, in and of itself, is normal, under certain circumstances, but having it constantly is not and can cause significant fatigue, etc.

When you heart "skips" a beat, it typically means that a beat popped in there too early. You don't usually feel that beat. There is a tiny pause while the heart resets itself after that early beat, but it's a long enough pause for it to "overfill" so when that next beat happens, the heart is pushing out more blood than normal and that's when you feel it. Premature beats can originate in many different areas of the heart, and that can determine whether it's serious or not. The only way to know is to go on a monitor and find out exactly what is going on.

That's very simplistic, but hope it helps a bit. btw, bp monitors won't really tell you much, except for your bp. Mine won't even do that if I'm having a lot of arrythmias, and I paid a lot for it... morgan

[Steve]

Thanks for your answer, Morgan. It's hard to tell whether my arrhythmia makes me sick, as standing makes me feel sick anyway. And although I have noticed that irregular heartbeat warnings are more frequent when I feel worse, my heart rate is usually also higher in these situations. Maybe I just have to observe my readings more closely, so that if there are any patterns I'll be able to recognize them. There was a day recently when my heart rate was only a little above 100, but I felt terrible anyway. The only abnormality was a lot of irregular heartbeats. If that happens again I'll be paying attention.

[Guest tearose]

My body rejected a PICC line after six weeks so I shutter to think of ever needing a pacemaker!!!

Once in a while , my PCP, for lack of knowing what to do with me, has wondered if going to a pacemaker to deal with low rates would help and then he could also give me a beta blocker to help the high rates. (I have shown some bundle branch block so I am not a candidate for BB's...Does anyone know what bundle Branch block is about?)

Anyway, doing this pacemaker is such a permanent thing, think it out slow and carefully!!

I have wished they would invent a temporary, outside the body, back up-pacemaker so people could see how it would be before implanting the real one. I suppose once they re-wire you, there is no removing it.

hope you get tons of good information to help you make this serious decision,

tearose

[morgan617]

Tearose,

A bundle branch block is an electrical problem. You can have a right BBB or a left BBB. Sometimes they are just a normal variance in someone. (For instance, I have a Q wave, which is usually indicative of having had a heart attack, but I haven't, so it's a normal variant for me)

The right and left ventricle usually squeeze at the same time, although they have very different jobs. When you have a BBB, it means they are not squeezing together, for a variety of reasons. It can be "normal" or no problem, to serious. RBBB's tend to be more benign than LBBB's, although left ones can also be very benign. They can be a sign of certain types of lung or heart problems. There is quite a bit of variability there and you have to know which type you have.

It shows up on an EKG with that big pointy spike not being narrow like it's supposed to, and it will actually have a "notch" in it. We used to call them "rabbit ears" but I'm not sure if they still do. They are very common however. It's important to find out why you have a BBB and what kind you have.

Hope that helps. btw, my pacer was one of the very few things I have absolutely no regrets about getting. It does what it's supposed to and does relieve one significant symptom for me. Only that one thing (I don't get big drops in heart rate and rates of 30 and fall on my face any more from it) but I knew that was the only thing it was going to help. Now I fall from other things, but I know my heart rate is not going to bottom out anymore. Pacer over broken ribs any day! morgan

[ajw4790]

Thank you all for you useful replies!!!

Sorry it took me a while to respond with the board acting up and well ya know feeling crappy, doing errands, dr. appmts etc...

But, yeah that was pretty much what I had thought, but figured that I should check after the questions I had been asked and things I had been told.

I don't think they meant anything by it etc. They have great knowledge in their field and know particular settings better than others and are probably more used to seeing older patients in cardiac rehab, and those in acute care in the hospital. As physical therapists they have some knowledge of these tests, but not as much as those who prescribe them and use them on a daily basis.

I do think they kinda jumped to conclusions, but I think they were looking for info. on what the future may bring.

Anyways, thank you so much for your responses! I feel better now, because I definitly do not want to think about a pacer at this point!