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What is done for Bradycardia and Tachycardia syndrome- if pacemaker -
Heart Rhythm Conditions | Last Active: Dec 1, 2025 | Replies (22)Comment receiving replies
Here's another little tidbit where pacemakers can help those who need them. Many of the "newer" pacemakers have settings that can be useful to limit the number of atrial fibrillation episodes in patients with pacemakers who have paroxysmal A-Fib. The settings program the pacemaker to pace such a patient up to a HR of 75 ( maybe a bit higher in some patients) when there is an episode of A-fib, with the idea of outpacing the Afib and stopping the episode. It may not work all the time, but I have paroxysmal A-fib and was informed that I have this setting turned on on my pacemaker. I wondered if I had it, I'd sometimes feel the familiar flutter and the "being in a falling elevator" feeling, sometimes a slight shortness of breath that sometimes accompanies my A-fib episodes ( I don't always feel them) and would feel/hear ( through my pulsatile tinnitis) a strong, regular faster ( than my usual 60 at rest) heartbeat that seemed to end the arrhythmia. Most of my A-fib episodes are short anyway, a few seconds to a few minutes, but it seems the pacemaker outpacing the A-fib makes most of them even shorter. I guess I'd have more longer episodes if it were not for the pacemaker.
There's also the monitoring function that comes with pacemakers/ICDs. These days they're generally paired with a monitor ( which can be a device that sits on your nightstand, or even a phone app) that your pacemaker communicates with via Bluetooth. This monitor sends reports from the pacemaker periodically at a frequency set up by your provider or your pacemaker clinic- generally every 3-6 months, or if one of the pre-set parameters is out of range ( indicating a potential problem with your heart or the pacemaker system, leads...). Your provider gets these reports and can monitor your heart/pacemaker at any time. So they know what's going on with your heart anytime they check. That's how my A-fib was picked up.
Of course those functions alone are not reasons for getting pacemakers, if otherwise you have no need for one. But for those that do, these functions can be valuable.
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@marybird -- Thanks for replying, Mary -- and sorry for the delay in responding. Had no time and then had trouble logging in.
It's critical that I get my heart rate up, and I do that in good-weather months by pretty strenuous work outside. That setting you mentioned on the pacemaker wouldn't keep my heart from going above that just because I was working hard, would it?
There are a lot of similarities between your conditions and mine, but I have so many that I feel like a science experiment:
4 arrhythmias: AFib, bradycardia, PACs, SVTs
diastolic dysfunction: heart failure with preserved ejection fraction (HFpEF)
severely enlarged L atrium and enlarged R atrium
I take Eliquis, Spironolactone, Losartan, and Atorvastatin
And I'm 80, although people say I don't look or act my age (thankfully)
I've probably forgotten at least one key condition or factor, because it's just overwhelming. It started with noticing purple toes in 2010 then bradycardia by around 2014, brief blindness episodes starting around that same time (finally know, after pushing for "WHY?" for 11 years and a brain MRI in 2026, that's related to not enough blood getting to the brain because of heart problems). Heart failure diagnosis in 2016, and the heart rhythm doctor told me then that I'd probably need a pacemaker in about 5 years. So I've avoided it for nearly 10 years.
I've had an implanted heart monitor (loop recorder) since 2/2025, but it's my Fitbit that picked up the first AFib reports. I recently had 2 more serious AFib episodes, again that the Fitbit recognized but didn't send confirmation until hours later. I sent screenshots to the Heart Rhythm Clinic and asked them to verify on the heart monitor whether this was real or just a Fitbit error. It was real, although Fitbit showed higher than the heart monitor readout. But I've been waiting for clarification / verification from them for a week now.
I'm in a remote area, not the best place to be for best medical care. Plus, I couldn't even get an appointment for the neurologist at another medical center to tell me her assessment of the MRI because Medicare will no longer cover telehealth appointments, and I can't drive to where she is, an hour away, because of the risk of blindness episodes, serious AFib, or stroke.
So far, the best info I've had to consider about risk factors and for my decision re: whether to agree to a pacemaker and yet another Rx med or two is a long Q&A with Gemini, Google's AI. 31 pages when transferred to a Docs file! (NOT just the limited version that people see in searches, but the more in-depth version at Gemini.google.com.)
Hearing from people here who've been through this helps, too, and I greatly appreciate the details you provided.