Is it normal for a pacemaker to be set at 60 beats but actually 53?

It's not normal. A pacemaker is an electronic medical device that is implanted in the body to treat certain heart arrhythmias, especially bradycardia. The set frequency of a pacemaker is the frequency at which the pacemaker delivers electrical impulses, while the actual frequency is the frequency of the heart's own electrical signals. It is not normal for the pacemaker to be set at 60 beats per minute, but for the actual heart to beat at 53 beats per minute. This is the pacemaker not working properly or there is a health problem with it. When you notice this, contact your doctor immediately or go to the hospital for an examination to determine the working condition of the pacemaker and the health of your heart. To adjust the pacemaker's setting frequency or to carry out its treatment.