Cyclist going in for Pacemaker: Expectations?

Beginning of August, going in for Boston Scientific Essentio L131 Pacemaker for Bradycardia (tapping low 30's @ night, has hit 40 during day) & occasional HR stops (3s). I have seen my HR tap low 160's a couple of times this year while MTB'ing.

59 years young: My cycling (road & MTB) are all done using Power Meter's. I started to notice the last 3yrs my ability to recover was noticeably declining (along with Training Load I could handle) since I use Power Meter on all my rides and use Analysis Software,,, where I was able to ride 8-9hrs a week or so without planning and now, have to plan to get 4-5hrs in. Lots of fatigue during day (mainly in quads) even with good sleep according to my CPAP #'s and MTB rides really hinder my recovery with the Aenorobic efforts.

Nuclear Stress Test & Echocardiogram all looked good. I wore a Holter Monitor for 30 days.

Any words of wisdom with Pacemaker? Any settings any cyclist could share to suggest to my Dr? I shared with Dr my cycling and only setting he mentioned was since I was an athlete, he may set my Low Pulse to 50 and told me the device had a "springboard" in it to sense running movement and it monitored my respiratory to increase HR. 

I did google "Utah Mountain Biking Pacemaker" and found a real helpful article on Pacemaker Settings.

Thanks in advance 


Road cycling is more of a challenge for CI than MTB

by crustyg - 2023-07-28 18:51:57

There are contributors here who report that the accelerometer in their PM does a fairly good job to raise the HR for SSS+CI patients, it's smooth road cycling that's a challenge.

Both Essentio and Accolade have BostonSci's Minute Ventilation which uses breathing to feed into Rate Response and raise the HR to support the muscle oxygen demands of road cycling uphill.  I can't give you a feature-by-feature comparison between them, but I'm fairly sure that your local BostonSci rep could.  Ask your EP-doc why Essentio and not Accolade.  Cost will be a factor.

Lower rate limit of 50BPM makes sense - that's where I started.  Made sleeping a little easier, 50 gentle beats instead of 40 thumps in the chest every minute.

You'll probably start out at nearly factory default settings, with a good opportunity to get your device set up, or 'tuned', for you at 4-6 weeks post implantation. Make sure you get a sensible maxHR.  If your heart muscle is healthy and your coronaries are clear you should be aiming for 155-165BPM maxHR.  If you are lucky you can get your device properly tuned for you on a static bike, otherwise send me a PM and I'll share my settings with you.

There are some other keen road cyclists here who have SSS+CI and have BostonSci PMs, and we have similar settings and are very happy with the results.

Best wishes, and (nearly) welcome to the club that no-one volunteers to join!

Welcome to the club

by Aintgotrhythm - 2023-07-30 22:49:50

Hi twobigwheels,

I just got (two days ago) the identical PM (a Boston Scientific L331) implanted. No words of wisdom on settings although crustyg was kind enough to provide me with his settings via PM.

I'm a road cyclist and, like you, my HR had been dropping to a low of 29 with pauses up to 5 secs. I was more or less asymptomatic until early June when my HR fell to 40 during a ride.

I've yet to do any riding. I'm cleared to ride indoors one week post implant but not outdoors for two months pending a PET scan (you can read about it in my other post) so I can't help with settings but wanted to welcome you to the club that nobody wants to join!

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