Still SOB after 6 wks

Hi, I'm new to this site and have found it so helpful to read about other people's experiences. I had an AV Node ablation and PM implant 6 wks ago. I've had 3 adjustments done and I am still SOB while out walking for exercise. At my checkup yesterday the Dr asked me if I think the PM is speeding my HR up too soon when I exercise or do I think it's not speeding it up soon enough.

I didnt even know how to answer that question because I dont know how I would be able to tell. Also, is it normal to have to get several adjustments to your PM before you feel "normal" again? Can anyone shed some light on these 2 questions for me?
Thanks, Cathy

5 Comments

treadmill

by Tracey_E - 2010-11-11 04:11:15

Ask to get on a treadmill while hooked up to the pm computer. It will tell him quickly if your rate is getting high enough fast enough. I've done that several times when trial and error didn't get it.

It's perfectly normal to take a few tries to get it adjusted correctly! Young active patients make the pm work a lot harder so it can take some time to get it fine tuned.

Questions

by SMITTY - 2010-11-11 06:11:04


Hello Cathy,

Welcome to the Pacemaker Club.

Let me take the last question first. "Is it normal to have to get several adjustments to your PM before you feel "normal" again?" No it is not normal, but not abnormal either. It just happens to some people but usually the problem is mostly due to the people that are trying to do the adjustments. A pacemaker has literally thousands possible combinations of settings. The initial ones were the doctor’s best guess and it is not uncommon for those to have to be tweaked. By the third try I think you should be doing better than apparently you are feeling.

As for the pacemaker speeding up your heart rate, did the Dr explain to you how and when your pacemaker will speed up your heart? I don’t claim to be an expert this subject, but I have had dual lead pacemakers with the rate response feature for 11 years. I have seen what it can and cannot do and learned a little about how it works. So for my following comment I’m going to assume you are in there dark on rate response and if I’m wrong I’ll apologize right now.

Using an accelerometer your pacemaker can detect changes in your physical activity. When it does this it can speed up your heart rate, based on what it thinks your needs are right now or what it anticipates it will be in the next few seconds. Like every thing else on a pacemaker all of this is adjustable. For example, mine is set to normally wait about 15 to 20 seconds after my activity increases before it starts to increase my heart rate. And then it increases it based on the amount of activity the accelerometer detects.

To give a little idea what this means is, say I get up from a deep sleep during the night to go to get a drink of water, the rate response will not kick in immediately and start increasing my heart rate. However, say I hear our pooch is about to upchuck on the floor and I jump up and start running to get him outside in time, the rate response will kick in almost immediately so that I don’t fall on my face because my heart rate is too slow to support my sudden increase in activity. Once the rate response starts it will take my heart rate up to about 120 before it goes into a wait and see mode. Let me repeat, mine stops at 120 BPM, yours will be whatever your Dr thinks is best for you. This and all of the other numbers I have mentioned are adjustable and your Dr is the one to tell you what and why you have the settings you do.

There is one thing I do from time to time more so to satisfy my curiosity that my rate response is working. I will check my heart rate and then I will tap on my chest a couple of inches from my pacemaker for 20 to 30 seconds. I don’t beat my chest like I’m Tarzan, but I tap it hard enough to feel a slight jar. Then I’ll check my heart rate again. All this tells me is that the rate response must be working, which is all I was looking for to start with.

I know I haven’t solved any of your problems, but possibly this will help you have you have a little better understanding of what the Dr is telling you.

Good luck,

Smitty

My experience....

by Pookie - 2010-11-11 06:11:14

I have a dual lead Medtronics Enpulse since November 2 of 2004. It took my EP and PM Tech until this past April to figure out why I was so short of breath when I tried to do anything....like walking up stairs, sweeping the floor, doing the laundry, talking a shower, making the bed, etc. So - I guess I fell under the abnormal category of having my pacermaker tweaked... a lot.

My answer was in the Rate Response feature. In there, there is something called Optimization. Mine was ON for all of those years and usually, for most people, being ON is fine. But there are always exceptions to the rule, and I happened to be one of them. Since then, all of my problems have disappeared.!!!!!!!!!!!!

As soon as the PM Tech turned the Optimization OFF the shortness of breath went away and the thumping and pounding of my heart also disappeared. I finally have my life back.

I know very little about pacemakers but I truly believe, with every iota of my being, that most times we feel only as good as our pacemakers are tweaked for us. We are all different (even though we may have the same diagnosis).

Just something to think about and perhaps discuss with your EP or Cardiologist or whoever "tweaks" your pacer.

Take care,
Pookie

This is good info

by lanew - 2010-11-12 11:11:20

This will be something I will have to do or check on when I see my Cardiologist in two weeks, may be I do need to be tweaked. thanks guys.

Still SOB

by TalkinCardio - 2010-11-13 01:11:46

Thanks everyone for your input. I now know that I need to keep going back to get tweeked until I get it right for me. I was beginning to think I would just have to settle for being SOB, and it was really getting me depressed. I also think I am going to try and learn more about how my PM works so that I have some knowledge of the different settings and what it is capable of.

Cathy

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You run like the bionic woman.

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