Do I need a pacemaker?

  1. To make a long story short... seven years ago I began to have frequent episodes of tachycardia, just out of the blue and unrelieved by rest or meds (beta-blockers, ativan-because I was originally told it was an "anxiety" issue- etc.). It was found that I had automatic atrial tachycardia and I underwent radiofrequency catheter ablation x2. I have had no more episodes of tachycardia since then but I do have fairly regular palpitations which don't really bother me now that I am used to them.

    Well, after my second ablation the doc told me that there was a chance I might need a pacemaker in the future as my resting heart rate would hover around 55. Now, seven years later, my resting heart rate is around 45 BPM. My blood pressure is fine (usually 120s/60s) and I am not symptomatic. I also run 3-4 miles 3 times per week.

    My question is this: what is the lowest resting heart rate you have known someone to have and that did not need a pacemaker? Is there anyone here who has had a similar experience?

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    About rachel h

    Joined: Nov '01; Posts: 189; Likes: 12
    med/surg RN- mostly med


  3. by   cactus wren
    I have a friend who has a resting heart rate in the low 40`s. He`s an execise freak, runs, bikes, very good shape. IMHO as long as you are having no fatigue, SOB, etc. that you`re good to go..

    Lowest one i`ve ever heard was a patient in er with a rate (documented) of 22...this man was alert, talking..he did get sent to higher facility, did start to decompensate in air, and of course got a pacer...but was good for 5-6 hourd before that, and who knows how long before he came to made him come in..for HA..
  4. by   passing thru
    It seems to me that you need another cardiac evaluation. The palpitations--could you have atrial fibrillation? Could they be the hearts compensatory mechanism to increase coronary blood flow? Are they daily? There's Holter monitors now that you wear for several days at home. With palpitations, I worry about blood clots and strokes. I'd get rechecked. With your history, I'd be in the cardiologists' office every 3 months for check-up and monitoring. Good Luck.
  5. by   rachel h
    These are the exact same palpitations that I have had since the ablation. After each ablation I had to stay in the hospital 24 hours and they have records of these palpitations. I have had two- no probably at least 4 (I can't remember)- holter monitors and more stress tests and EKGs than I care to count. My last eval with my cardiologist was about a year ago- she says I have occasional PACs and PVCs but I'm just more aware of them than someone with a non-cardiac history since I've had this whole tachycardia deal...

    Thank you for your opinion though- I don't mean to sound harsh at all if I did. Just trying to clarify.
    Last edit by rachel h on Mar 10, '03
  6. by   sunnygirl272
    sounds like it may be time for a 2nd opinion?
  7. by   Tweety
    I've not really heard of treating asymptomatic bradycardia in the mid40s. Are you on any meds that might need adjusting?

    Plus the fact that you run, lowers your resting heartrate as well, and you probably have good cardiac output from the running as well.

    Don't know about the palpitations though.
  8. by   cactus wren
    I`ve had "palpations" my entire life, notice them when I`m quiet. PVC`s...documented...occassioal couplets...they go away when i exercise...Cardio says not to worry...just I don`t...

    So, mainly I agree with the...If it ain`t broke, don`t fix it" routine. Now if I ever become symtomatic I`ll gett myself to doc in a hurry. And same if I had low HR with no S&S.
  9. by   LilgirlRN
    You never mentioned your age or if you are on any medications. My mom has PAT and has had ablation therapy too, only to be told that it wasn't what he thought it was. She has some sort of re-entry problem and if he does ablate it she will have to get a pacer, which is something she doesn't wanna do. Right now she's on Dig and Verapamil and it's keeping it all under control most of the time. If you are taking anything that would slow your heart down at all, youmay wanna ask your doc about d/cing it and see if your HR comes back up. However, if it ain't broke, don't fix it. Seems you're doing OK with your HR in the 40's. Running is probably what keeps it so slow.
  10. by   P_RN
    I've had basketball players and some track & field to have a resting HR in the low 40's high 30's. Something about being in shape and being very tall......

    I agree if it aint broke don't fix it.
  11. by   rachel h
    Thanks for all the input. As for my age- 22 next month. And I am not currently on any meds (or anything herbal), cardiac or otherwise. I am not concerned with the palpitations, as my doc says they are normal. And I'm not concerned with getting a second opinion as my current doc is the third cardiologist I've been to- she's the one who actually diagnosed me and did my ablations. The first two cardiologists I saw told me it was in my head and referred me to a mental health clinic for counseling!

    I guess I was just shocked when I realized my resting HR was so low...
    Last edit by rachel h on Mar 10, '03
  12. by   JohnnyGage
    I personally wouldn't worry unless I became symptomatic. I once dated a marathoner. I loved to take her pulse when she was asleep because it would frequently hover around 30. She could run 15 miles and get her heart rate all the way up to 65!

    As for the palpatations, keep an eye on them and if they don't bother you and your cardiologist knows about them, I wouldn't be too impressed. I, too, notice frequent palpatiations that have been evaluated and found to be nothing.
  13. by   BadBird
    Your question can only be answered by a cardiologist, make a appointment for a complete check up, discuss your questions and concerns. I wouldn't worry unless I became symptomatic, many athletic patients have resting heart rates and blood pressures much lower than we expect.
  14. by   dcoxrn
    Just reiterating what others have said and adding a touch.

    Your Cardiologist probably has you on a regular checkup schedule and my thought would be once a year. Make sure you keep to this. Sounds as if you are doing a good job of keeping yourself healthy and being aware of your body and condition. Make sure you continue to monitor your HR and BP. No matter how many doctors, nurses, or psychic healers ;-} one sees, the patients that know what is going on with their body always fare better.

    It sounds to me like you have a good handle on the situation and are doing all of the right things. Keep it up and good luck.


    Donald Cox, RN, BSN, CEN, RCIS
    IM me on AIM or Yahoo! - doncoxrn
    Currently on assignment in New Jersey
    But still calling North Carolina home.

    I feel like my wild oats have turned to shredded wheat.