Pacemaker setting

[dazle321]

Advice please.
Some 12 years ago I had my first pacemaker insertion as well as an ABS ablation because I had AF. It was set with a resting pulse of 70.

Back in May I had my 3rd replacement and it to was set at 70. However prior to this replacement I had been walking up to 4ks a day quite easily. Then after the new insertion I was unable to get any more than a couple hundred yards.

I have been back 4 times for adjustments and the resting pulse it is now set at 60.
Before my last adjustment it was running at 90 just sitting and over a 100 if walking.
I went like a limp dishcloth.

Now I am still finding myself getting exhausted and the Doctor says to push myself.
The top chamber of my heart is in continual flutter so the new pacemaker has only
One lead.  Originally I had a dual lead but after heaps of stress my heart went out in the top chamber and nothing can be done I am told.

I worry about it going so slow at 60 and I worry about getting exhausted and pushing myself to really walk far. I am a male aged 70 and consider myself reasonably fit for my age and want to keep active and walk however I am afraid of pushing myself too far.

I have been seriously considering changing Doctors because my current one just doesn’t seem to be able to get the pacemaker set right. It is either too fast or too slow.

I feel in this day and age someone should be able to help set the thing better.

I would appreciate your comments. Thanking you in anticipation.

[Michael J. McWilliams, M.D.]

The first step I would take is to set your device exactly like it was set prior to the change out
-- make sure rate response is turned on
-- make sure it is capturing appropriately

Sometimes people cannot be maintained in normal rhythm and atrial fib is permanent.  Your doctor might be doing everything right -- it is hard to say.  If you aren't sure, rather than changing doctors, you could get a second opinion for another cardiac electrophysiologist.  It is likely not a question that can be answered in a single visit.  They would likely need to make a few changes and see how you feel afterwords as a result of the changes.

I have a had 1 or 2 cases similar to this.   Patients told me that they didn't feel the same after a device change out and I could never figure out why.  Changing the rate response settings on your device might help.

Good luck and I hope this helps.

[PikaPika88]

Mine one doesn't set right not because of changing the new pacer.  My fourth pacer implanted in 2002.  All the time fine until 2005, it suddenly went wrong and keeps very wrong.  My doctor unable to find fault and unable to set it right like before.  He told me all in my head............. Well, the site is getting sharp pain in certain position.  It is the pain at my pacer site, not in my head.  The ventricle pacing which is like an express train.  Again it is not in my head.  Now I'm really hate my pacemaker.

[dazle321]

Thank you. I am seeing my Cardiologist on Monday for a stress test so will mention your comments to him, if I may?
And is it wrong to push myself if I feel exhausted?