I recently had a 48 hr cardiac monitor with results of slow heart rate of 37 to rapid heart rate

Ann,

Thanks for your question.  Your family history is very interesting, raising concern about a genetic predisposition to developing a slow heart rhythm and/or electrical heart block. 

I have several questions that need to be answered and discussed with your doctor.  Was the slow heart rate a normal (sinus) rhythm?  Did you have any symptoms when the rate was very low or very high?  How fast was the rapid rate, and was this a normal rhythm (sinus)?  Did you discuss this with your physician?

Pacemakers are inserted when heart rates are very low.  They usually are on stand-by mode and initiate heart beats when rates fall below a pre-specified level (usually around 60 beats per minute).  Pacemakers are also inserted when patients are being treated for rapid heart rhythms, but the treatment causes the heart rate to fall to very low levels.  Placing a pacemaker allows for treatment of the rapid rates, because the pacemaker insures the pulse will not fall below a certain level with treatment.

I agree that this issue should be cleared up before undergoing any major surgery.  You will need the opinion of a cardiologist to help make the right decision for you.  If he/she thinks further opinion from an electro-physiologist is needed, then the cardiologist can make that contact.  It would be ideal if that cardiologist were practicing at the same hospital where your surgery is planned.  That way, should any questions or problems develop, the cardiologist would be available to assist in your care.

I hope this has been helpful.  Best wishes.

Martin Cane, M.D.