Do I need a pacemaker?

Q The speed of my heart runs about 28-42 beats per minute while I'm awake. I feel fine, but I think this might be too slow. I take Atenolol for high blood pressure. I'm fatigued often. Do you think I need a pacemaker?

A A pacemaker is a device used to regulate slow heart rhythms. The device consists of a battery encased in titanium, and usually two leads are attached to the upper (right atrium) and lower (right ventricle) chambers on the right side of the heart. The leads can sense the heart rhythm and fire an electrical signal, causing the muscle to contract at a certain rate.

What are indications that you need a pacemaker?

1. Heart too slow, producing symptoms such as passing out, dizziness, and fatigue.

2. Diseases in the "wiring" of the heart, causing it to go too slow, often called "heart block."

3. The body requires medication that must be taken, but also slows the heart.

In your situation, stopping Atenolol might help you feel better and alleviate the need for a pacemaker. If, however, after you stop Atenolol, the heart remains slow and you have symptoms, a pacemaker might be an option for you.

James L. Marcum, M.D., EA. C.C., is a behavioral cardiologist with the Chattanooga Heart Institute. His book Heartbeat is available at www.adventistbookcenter.com.