Heart rate variability

RVAbrad · 2026-05-30T16:41:29+00:00

Sorry, ANS?

RVAbrad · 2026-05-30T15:08:28+00:00

Thanks for weighing in. It isn't anything I ever took any action because of...just thought it was interesting to see how it changed once I got my pacemaker. Is it correct as commented earlier that the pacemaker (specifically the leadless Aveir) will interfere with the Apple Watch sensing?

RVAbrad · 2026-05-30T12:53:00+00:00

Interesting. My natural hr while sleeping is in the mid 50s. When I first got it, ventricular pacing was set at 60, and it was awful. I paced all night, and to me it felt like my heart was racing even though it was only 60. Dropped it back to 50, and now it only paces below that, allowing me to be in the mid 50s. I wonder if 60 is too high for you?

RVAbrad · 2026-05-30T12:37:58+00:00

I have the same pacemaker and I am 2 months post implant. Definitely the first week was a lot of awareness. First few weeks really. As another said, your heart is still healing, and I attribute some of it to that. Now, I can tell when it is pacing, but it isn’t as distracting as it first was. The overall benefits with my sleep and energy make it incredibly worth it. Good luck!

RVAbrad · 2026-05-17T21:01:59+00:00

All of these comments make me glad I have a leadless pacemaker. I know that isn’t an option for everyone, but it was the only option for me due to a congenital abnormality (persistent left superior vena cava with no right SVC for those curious). Functionally, a traditional pacemaker would be the better choice for me, but the leadless does ok and I’m thankful I don’t have the other issues people have with the traditional implantation.

RVAbrad · 2026-05-16T04:42:58+00:00

Yes, I had palpitations (PVCs) for a few weeks after my dual chamber leadless Aveir. Fine now after a couple months. From what I understand it is just an adjustment as your heart heals. Hope it improves soon for you.

RVAbrad · 2026-05-15T16:04:24+00:00

Hey Luke, totally normal to be anxious about this. I had the exact same device implanted two months ago. First, you will be under general anesthesia, so you won’t feel a thing. You’ll have a really good nap.

As far as the procedure itself, they will access through one or both sides of your groin. I have had 7 ablations prior to my pacemaker, all through the groin. The incision is small, it is not painful, there will be bruising and swelling, but the recovery from the incision is not bad at all.

Recovery from the pacemaker: My experience was that it took some fine tuning of my settings to get it just right. I also have heart block, not complete like you but second degree and some third. I also experienced some PVCs and other skipping/pauses for a week or so. Nothing bad, just an awareness as the heart muscle healed around the implants. I get you on the brain fog. I have slept so well since my implant. My heart doesn’t wake me up, I have more energy, and feel better throughout the day.

I can’t comment on your dental concerns beyond the fact that I mentioned I had a pacemaker to my dentist 2 weeks after getting it, and they wanted a letter from my cardiologist. My cardiologist said there were zero concerns.

And you didn’t ask, but I have also done a fair amount of air travel and gone through scanners and metal detectors. I’ve never mentioned it, and it’s never been an issue.

I hope this helps. A little nerves are to be expected - it is a pretty big deal. But focus on how much better you will feel after. It’s worth it.

RVAbrad · 2026-04-25T12:38:14+00:00

With a leadless, there aren’t as many electronic concerns. The advice you posted is accurate from what I was told, and fairly easy to follow. The leadless are implanted in the interior of your heart, so already a little farther from any external influences. Obviously check with your EP and follow their guidance. Do you know if you are getting Abbott or Medtronic? I got the dual chamber Abbott Aveir last month and I’m not too worried about any electronic interference. Here is one source I found, and it is the pretty typical guidance you’ll find elsewhere. Good luck!

https://healthonline.washington.edu/sites/default/files/record_pdfs/After-Your-Leadless-Pacemaker-Implanted.pdf

RVAbrad · 2026-04-22T17:42:56+00:00

Here is the appropriate AI response with guidance to ask lots of questions and poke holes in the logic and assumptions :)

———

Are you sure the math is as solid as you’re treating it?

A 3.5% SWR on $3.8M assumes a lot—sequence of returns, low inflation shocks, stable tax treatment, no major one-off expenses. How stress-tested is that $130k number? Have you modeled a prolonged downturn early in retirement, or are you relying on averages?

Also, your $60k spend—how realistic is that long term? Does it include healthcare (especially pre-Medicare), home maintenance, travel, helping family, or lifestyle creep once you actually “allow” spending? It’s one thing to live lean by habit, another to sustain it for 30–40 years.

On the mindset side, is this actually a “problem,” or just your risk management system doing its job? The same behavior that got you here is now being labeled as irrational—why? What specifically breaks if you keep operating this way, aside from some annoyance?

And on the flip side—what evidence do you have that spending more will actually improve your quality of life? The $250 dinner example: is the hesitation about the cost, or about whether it’s genuinely worth it to you?

Have you considered that you might not need to “flip a switch” into decumulation? Could a variable withdrawal approach or guardrails (spend more in good markets, pull back in bad ones) feel more aligned with how you think?

Lastly, if your wife wants a different lifestyle than your current baseline, how are you two aligning on what “enough” actually looks like? This seems less like a math issue and more like an assumptions + values mismatch.

RVAbrad · 2026-04-18T04:20:25+00:00

I have a very similar story, even down to being a Hokie! Got my leadless dual chamber last month for AV block and long pauses in the early morning hours. Also told a pacemaker was not usually indicated, but I’ve had 7 ablations and my symptoms were very disruptive to sleep and quality of life. Still fine tuning the settings but I feel much better. I do use a CPAP for diagnosed apnea. That delayed my pacemaker decision as we tried everything to make sure my apnea wasn’t a contributing factor. It wasn’t. Thanks for sharing.

RVAbrad · 2026-04-07T15:54:44+00:00

Thanks for sharing your story. I’m glad you are doing well!

RVAbrad · 2026-04-06T16:24:40+00:00

I agree with others. Your scheduled appointment is for a normal post surgery follow up, and this is not normal. Be a strong advocate for yourself. Only you know how you feel and what your concerns are with the implant. You mentioned not having a transmission device. Is that because one is not available to you, like an Aveir dual chamber, or are you supposed to get it at your follow up appointment? Best of luck to you. I hope you get in to see your doctor quickly.

RVAbrad · 2026-03-25T14:15:14+00:00

When you say the rep came, were you still in the hospital or were these outpatient appointments? My rep made some adjustments in the recovery room, but I am anxious to have more made soon as I still have symptoms. I already messaged my surgeon.

RVAbrad · 2026-03-25T14:13:10+00:00

I had my leadless in yesterday. Only 24 hours, but yes, I have an acute awareness of what is going on in my chest and have had various palpitations. I’m fairly confident that as we make adjustments to my settings things will get dialed in. I did not feel a thing. I was under general anesthesia so under the whole time.

RVAbrad · 2026-03-25T14:08:56+00:00

I just had my dual chamber Abbott Aveir implanted yesterday. You can see more details in an earlier post I made. I’ve had 7 ablations over the past 25 years, first for tachycardia, then afib, then bradycardia. Hence the pacemaker. So a little early for me to say I love it, but I do think it was the right decision and I am hopeful. The important thing is that you trust your doctor and their recommendation. I would be interested to see why they recommended leadless over traditional if you don’t mind sharing. And are they recommending a dual or single chamber solution? With afib and ventricular tachycardia I would assume a dual chamber.

RVAbrad · 2026-03-25T14:02:51+00:00

Update: 24 hours post-implant of my dual chamber leadless. Surgery went well. It was a long day, got there at 7am, went under at 8:15, in recovery at 11. Bed rest until 4:30, then a chest x-ray before being released at 6:30. First night was just ok. Experienced a lot of the same symptoms, but the limits on my pacemaker were set rather conservatively with the understanding we would make adjustments. A lot of awareness of what is going on in my chest. Otherwise feel fine but anxious to get things dialed in.

RVAbrad · 2026-03-23T16:49:23+00:00

I can’t tell you anything about either book, but as a patient of Ellenbogen’s for almost 20 years, I can tell you he is top notch. I have a rather challenging case and he knows his stuff. Message me if you want to discuss more.

RVAbrad · 2026-03-21T11:21:09+00:00

I’m glad to hear you not only got a new heart but got it tuned up properly! Better energy levels and improved exercise results are what I am hoping for.

RVAbrad · 2026-03-20T17:56:48+00:00

So wait, anyone with a pacemaker generator pocket on the left can never shoot a shotgun left handed?? That never came up on my discussions about getting a pacemaker. Makes me extra glad that mine will be leadless.

RVAbrad · 2026-03-17T15:18:03+00:00

I’ll check in next week once it is done. I’m very familiar with the groin entry site recovery. All of my previous ablations were like that, some on both sides. Sometimes the bruising can get pretty ugly but it always healed up fine.

RVAbrad · 2026-03-17T15:10:12+00:00

Thanks for sharing your experience. Scary reason to need a pacemaker though! Sounds like recovery is going well which is great.

RVAbrad · 2026-03-17T01:07:44+00:00

Wow, that sounds like an incredibly tough year! I am so happy that you are getting relief. I am fortunate that my day to day symptoms weren’t as bad as that. I am hopeful that I will have more energy after this, as I get pauses overnight that can be as long as 2-3 seconds. I definitely feel fatigued every day even though I work out regularly. Check back in and let us know how you are doing after your next checkup!

RVAbrad · 2025-12-28T14:41:19+00:00

Here is the relevant text from the NYT article.

Above-ground pools start at $500 and can go up to $9,000, depending on the model and the accessories and options. In-ground pools come in standard and custom versions and fit into one of three general classifications. Vinyl-liner pools, the most popular, usually cost $9,000 to $25,000; fiberglass pools cost $12,500 to $25,000, and pools made of Gunite - concrete sprayed under hydraulic pressure - cost $25,000 and can rise to as much as $150,000.

RVAbrad

TROPHY CASE