akinetic heart

With a compromised left ventricle from  a myocardial infarct, my heart rate has dropped from a "normal" for me from about 55 to 44. Is a pacemaker indicated?. I am 77 years old and weigh 168 lbs.I take Prinivil, Coreg, Zorcor, Zetia and    Aldactone. Any information will be appreciated....Thank you....Frank

[Dr. Kokil Mathur]

Hi
Thanks for writing to the forum!
Generally a heart rate below 40 is considered harmful and is not sufficient to carry out body circulation. The need to insert a pacemaker depends not only on heart rate but on several other factors. If your low heart rate is causing some symptom, then yes it is an indication. Symptomatic atrioventricular conduction defects, sinus node dysfunction as in sick sinus syndrome are some of the prime indications. Your cardiologist is the best person to guide you regarding this. At your age a heart rate of 44-55 is good enough to allow you to lead a normal life. However if you have symptoms you should consult your cardiologist. Also your medications reduce your heart rate to some extent. This is done intentionally by a cardiologist to take the burden off the heart to some extent.
Hope this helps. Please let me know if there is any thing else and do keep me posted. Take care!