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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can Pacemaker And Of What Kind Can Help 92 Year Old Have Normal Dialysis As The Heart Beat Fluctuates Enormously During Dialysis?

My 92-year old grandma has mainly right-sided (with some left-sided) congestive heart failure, pulmonary hypertension, hypothyroidism, and now end stage renal disease. She tried dialysis for the first time last Monday and did beautifully (she got into the hospital on Saturday, with fluid in her lungs and a ton of fluid buildup in her legs and body)- steady pulse of 65-66 throughout the whole 3 hours, and great blood pressure. They did it the next day but had to stop after 2 hours because her heart rate was fluctuating a lot (it would go from 50s to 40s to 30s back up to 50s...it even hit 32 at one point). But throughout this, her blood pressure was fine. They gave her a day of rest and then tried it again on Thursday- the same thing happened (the heart rate dropped a bit but they stopped it because this time it stayed in the 40s and didn't pop up again completely). Besides these 2 instances, her pulse has been great- anywhere from 60 to 90. They didn't do dialysis yesterday or today. She wants to continue- she wants to help herself and stay alive. We are aware that if she stops dialysis now, she will have very little time. My question is would a pacemaker help this situation and if so, what kind? I have been reading that the pacemaker surgery is not very risky, but what about for a 92 year old? And also, would getting one help the situation so that she could successfully undergo dialysis treatments? My grandma is an amazing woman- she puts all of her faith and trust in God. She is very spunky and determined. I would greatly appreciate a response.
Thu, 9 Jan 2014
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Cardiologist 's  Response
Dear family member,

Thanks for the query. If she does not have symptoms with the losw heart rates, and the blood pressure remains otherwise stable, she may not require a pacemaker. Pacemakers are implanted when the heart rates are slow and the perosn has symptoms of fainting near fainting or truly passing out. It may be a reflex reaction during dialysis, and more gentle runs may be needed.


Hope this helps wish you the best,

Dr Brenes-Salazar MD
Mayo Clinic MN
Cardiology
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Can Pacemaker And Of What Kind Can Help 92 Year Old Have Normal Dialysis As The Heart Beat Fluctuates Enormously During Dialysis?

Dear family member, Thanks for the query. If she does not have symptoms with the losw heart rates, and the blood pressure remains otherwise stable, she may not require a pacemaker. Pacemakers are implanted when the heart rates are slow and the perosn has symptoms of fainting near fainting or truly passing out. It may be a reflex reaction during dialysis, and more gentle runs may be needed. Hope this helps wish you the best, Dr Brenes-Salazar MD Mayo Clinic MN Cardiology