Is What You’re Feeling Aging, Or Do You Need a Pacemaker?
Last month, a colleague told me her 72-year-old dad was getting a pacemaker. It came as a shock, since he was fit, spry, and an avid cyclist. His heart rate had always been low, but over time it had dropped to just 33 beats per minute (BPM), which he and his doctor attributed to his fitness.
It wasn’t until the endocrinologist who monitors his diabetes expressed alarm that he was given a Holter to wear for 24 hours to see if he needed a pacemaker. It showed that not only was his heart rate slow, it paused every few minutes for up to eight seconds. When he got that news, he had just returned from a 30 mile bike ride, so it still shocked him that he needed a pacemaker.
But once he got the pacemaker, he realized just how much his heart was struggling. He has more energy, his mind is sharper (his wife had thought he was developing dementia), and even his cheeks are rosier. The pacemaker had literally taken 10 years off his age!
So, how do you know if you need a pacemaker?
- You can’t go by heart rate alone. When the baseline heart rate slows over time, the body adjusts. In trained athletes, fewer heartbeats are needed to maintain the cardiac output (blood flow). In fact, many trained athletes feel great at a heartbeat of 45 bpm.
- Watch for symptoms. As the heart’s conduction system ages, and the heart rate slows to 50 bpm or less, many people have fatigue, malaise, lightheadedness, and even confusion. Some even feel these symptoms at 72 bpm, which is why we used to set pacemakers at 72 bpm. But before getting a pacemaker, you want to make sure your doctor rules out other causes of these symptoms such as the use of beta blockers or a heart block.
- Anyone with heartbeat pauses of 3 seconds or more should be evaluated for a pacemaker. This can be measured, as it was for my colleague’s father, with a 24-hour Holter monitor test.
Like my colleague’s father, I've had many a patient who "felt great" and resisted having a pacemaker put in. I can't tell you how many come in for their follow up check-up to report that they have more energy, no longer need an afternoon nap, and that their head is clearer.
But the real happy ending here is that my colleague’s dad didn’t have a cardiac event from those long heart pauses. If your heart rate is low, and if you have low energy or mental fogginess that you’ve chalked up to “aging,” you want to get a cardiac evaluation—sooner than later.
Now it’s your turn: Have you, or someone you know, gotten a pacemaker and found it made a difference?
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Dr. Stephen Sinatra is a highly respected and sought-after cardiologist and nutritionist with more than 30 years of clinical practice, research, and study. His integrative approach to heart health focuses on reducing inflammation in the body and maximizing the heart's ability to produce and use energy. More About Dr. Sinatra
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