Heart Rate Drop

For 3 1/2 years I have had heart rate drop while exercising. Started out I would be training in the 140 to 155 bpm's and it would suddenly drop to 55 bpm's. This progressively got worse over the 3 1/2 years. Finally got a pacemaker on October 15th of this year and I am down to walking for 6 weeks. Unfortunately as soon as I walk up a slight incline after 40 minutes of walking my heart rate drops as it did pre pacemaker days. This has been a long haul to convince doctor's I had this problem and to finally get a pacemaker and find out nothing has changed is very frustrating. I will get my 6 week check-up Nov. 24th and then on Nov. 26th they will fit me with a 24 hour Holter and have me do some training to see what shows up and maybe get an idea of what adjustments can be done.


First Post

13 Comments

oh and I forgot.....

by Pookie - 2010-11-17 07:11:06

welcome to the club.

We're here to help and support you in any way we can.

Just remember to ask your EP or better yet - call the manufacturer of your pacemaker to see if it has the Rate Drop Response feature. I know my Medtronic Enpulse does not have that feature.

Good luck:)
Pookie

Same experience

by Heidiglassmeyer - 2010-11-17 07:11:13

Hi Peter,

I had the same thing happen post PM. When I would exercise and reach my upper limit the PM would push my HR down right in the middle of my workout. This would leave me SOB and my legs felt like I had 100lb weights on them. Once my HR went down it would slowly climb up and as soon as I reached the limit, down it went again.

I posted here and it was either Smitty or Electric Frank who responded and suggested I needed an adjustment to my upper limit. I first went from 135 to 150. Then went back again and had it changed from 150 to 180. Since then I have not had that issue while exercising. However with my situation it was a trade off. I am on meds to lower my HR due to tachycardia so with the new setting my HR will still run high even if I am not exercising. At least I am able to exercise at the level I want to. Hope that made sense.

I would suggest discussing with your PM rep. Mine did the adjustments while I was on a treadmill to make sure I was happy with the settings.

Best of luck to you,
Heidi

Found it!!!!!!!!!!!!!!

by Pookie - 2010-11-17 07:11:31

Thought I'd post it here in case anyone else is experiencing the same.

Ask about rate drop response
Comment posted by bowlrbob on 2009-12-09 02:56.
Ask your Dr. if setting the rate drop response might help you. How this works is the pacer detects your hear rate going down too fast. Then it kicks the heart rate up for a prescribed amount of time. This stops the dizziness and syncope.

To give you an idea in my case my EP set my heart rate up to 70 bpm. Then he turned on the rate drop response. When my heart tries to stop the pacer kicks my hr up to 100bpm for 2 minutes. Then it goes back to 70. This has worked for me for 4 years now. The 70bpm keeps me from getting to tired. Normal hr is 72.

They try to keep you lower to increase battery life in the pacer. But i vote for quality of life over battery life. Bowlrbob

Hope this helps,
Pookie

Rate Drop

by Pookie - 2010-11-17 07:11:47

Hi.

Sorry to hear you are having that issue.

I specifically remember it being discussed here before, as I remember asking my EP if all pacemakers have the Rate Drop feature built in and he said NO. However, if you go into SEARCH (top of page - right side) and type in "rate drop", I'm quite certain you will find some helpful information.

But I do remember one particular guy and his was fixed somehow...just don't remember.

I'll go see if I can find his posting. - if I can, I'll copy and paste it for you and send it to you in the form of a private message.

Pookie

Peter1

by Peter1 - 2010-11-17 08:11:10

Thanks for your comments. I would like to further add that just prior to getting my implant I was down to exercising at 70 bpm’s as my heart rate would drop at 100 bpm’s. At the present time it is dropping at about 107 to 114 bpm’s , down to 60 and returns to about 104 after I stop and wait for 20 seconds, I learned to do this over the past few years, but there can be what I call brain fog (lack of oxygen in the blood) as well as nausea if it is repeated to many times in one outing. I am sure we will be able to adjust the pacemaker after the Holter test as my EP Cardiologist was well versed in heart rate drop and said I could return to playing non-contact old-timer’s hockey this December. I am hoping this is just another minor bump in my 3 ½ year journey.

Could it be the heart rate monitor

by johnb10000 - 2010-11-18 02:11:15

I read somewhere that some home heart monitors may pick up both the pacemaker pulse and the heartbeat so it shows half the heart rate.

I see this occasionally when exercising on a treadmill. Sometimes I see 55 to 55 on the treadmill heart monitor when my heart rate should be 100 to 110.

My pacemaker only paces about twelve percent of the time.

Could it be the heart rate monitor reply

by Peter1 - 2010-11-18 03:11:23

Thanks for your comment. I have used my monitor for about 7 years, about 3 1/2 years ago the heart rate would drop and I could feel the twinge in my heart and my calf muscles would tighten. All the doctors made the same comment so I sent the monitor away and they said there was no problem with it. I also recorded my exercise for many years and knew exactly what was happening. But you are right in that many monitors give false readings. It was how the heart rate drop would affect me after my exercise that made me conclude it was not my monitor.

Thanks again for taking the time to respond.

Same experience reply

by GinaB - 2010-11-21 06:11:56

Hi,
I am 2 1/2 weeks post PM placement. I first realized I had a problem due to my heart rate monitor and after many tests, it was determined I needed the PM. Basically my heart rate would drop from 127 to 74 during exercise and would come back up after I stopped exercising. This went on for years. Now that I have the PM I was really excited about exercising and seeing my HR go up and stay up a while. I went to the gym today however and I'm getting the same thing! Sometimes my monitor showed my heart rate was as well as 35 which I know is not possible. I have a theory about what's going on but I really want to talk to a rep or my doctor and have them adjust it so this won't happen anymore. It would be really great if it could be done on the treadmill! I asked for a treadmill test to see if I really am still having this problem or if it is the monitor not being accurate. I think it might only be picking up on the beats created by the PM and not my own because the PM beats are much stronger. I feel them sometimes.

GinaB

by Peter1 - 2010-11-21 09:11:43

GinaB

Your situation seems similar to mine. On Nov. 24th I am going for my 6 week check-up and then on the 26th of Nov. they are going to put fit me with a 24 hour Holter monitor. I will do exercises and they should have a good indicator of what happens when I put stress on my heart through exercise. I do have to say that my monitor does not work 100% since the PM implant. It still indicates heart rate drop, but more importantly I can feel the drop coming on and I do not feel as good after the exercise. I have every indication that they can adjust the PM to accommodate people who are still very active. I am a senior and my EP Cardiologist tells me that I should be able to continue playing non-contact +55 hockey very soon. By the way the +55 means players over the age of 55.

I am sure you will find a successful solution, just like I am sure I will.

Thanks for the encouragement

by GinaB - 2010-11-22 01:11:58

Thanks Peter1. I was really upset about it yesterday feeling like I may have gone through surgery for nothing. My husband is trying to make me feel better about it saying that it needs adjustment etc. but it's nice to hear it from people who really know because they have had the experience. Thanks for being positive and saying I will find a solution and you will too.

Frustrated

by GinaB - 2010-11-30 01:11:05

I had my treadmill test today which totally confirmed what I have been saying. My max during the test was 120 then it would drop into the 80's and continue down in the 70's. I was glad to see I'm not crazy but upset that it's happening. I did this test in my cardiologist's office, not the EP because the EP is 2 hrs away. The tech called the doctor in after my treadmill and as soon as he saw me he said the pacemaker is working perfectly. I said that's fine but something needs to be adjusted because I'm still having the rate drop. He told me that my heart throws an extra beat once in a while and that is why it drops. Hello! That makes absolutely no sense at all. Shouldn't my heart rate go up if there are extra beats! He said he didn't have the info about what my settings are so I will have to try to get them from the EP but basically he's saying that I have 2 problems and the pacemaker treated one of them so I just have to live with the drop because it is being caused by the extra beat, not because of any of the pacemaker settings. I'm frustrated this is happening and I'm frustrated that I am having such difficulty getting help. The cardiologist says they will interrogate the device on Dec. 22.

Follow up

by Sabclt - 2014-11-30 04:11:17

Hi! It looks like these posts are more than four years old but if any of you are still on this site I'd love to know how you resolved the issue of your heart rate dropping while exercising. I unexpectedly had a pacemaker put in 7 weeks ago due to complications with aortic valve surgery. I'm a 44 yo female and desperately want to start exercising normally again. Having to get the pacemaker at all was frustrating enough so now experiencing my heart rate plummeting while exercising (going from 145 or 150 to between 55 and 70) is beyond frustrating. Any input is appreciated!

Pacemaker Adjustment

by Peter1 - 2014-11-30 05:11:35

I have a very sports minded cardiologist and each time that I was at the Pacemaker Clinic telling the nurses I was still getting heart rate drop while playing hockey they would contact him and he would approve an upward adjustment. I had pretty good records of my heart rate while playing hockey prior to the pacemaker as I would wear my Polar monitor periodically while playing and knew I would hit at least 163 BPM'€™s. Over several months I had the pacemaker adjusted at least 7 times and I stopped having heart rate drop and it is set at the maximum. Unfortunately I cannot remember the maximum but I think it is 175 BPM and will cut out before that as a precaution. For example when I first got my pacemaker it was set at 120 over 50 and would cause a drop at 112 BPM. I do not know if this will help you but in my situation my Cardiologist felt there was no issues with making the adjustments. I no longer play hockey as I had an on ice accident and have spent the last 3 years recovering from a concussion. I am in full exercise mode, but no more hockey, to many concussions, by the way I am 73.

Good luck.

Pete

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