no help with getting fitter

Hi I'm new to this group though I had my pacemaker fitter is 2008. My problem is that the lack of information I can get about exercise and what I should expect from my pacemaker. I know it is an "on demand" type but to be honest even though my check ups have said everything is fine with it, I never seem to be able to get it to increase from the 60 bpm it is set at and consequently get out of breath very quickly. Can anyone give me advice or suggest where I can receive some advice? The gym I was a member at when I had the pm implanted didn't seem to want to know and the only advice I got from the specialist nurses at the hospital was "well you can run a marathon now, but you could train for one in 12 months."

Help . . please.

11 Comments

Rate response

by joem18b - 2011-01-21 03:01:57

I had a medtronic for 9 years that behaved the way i wanted it to. My new one behaves differently. I don't want my pulse going up when I walk across the parking lot to my car, because then I get in and sit there with my pulse up. So with my old and new pacemakers, I had the settings adjusted so that wouldn't happen. With the old pacemaker, end of story.

With the new one, however, now when I walk up a flight of stairs or do something that involves stress but not motion, my heart thuds. It doesn't speed up but has to pump more blood. I like to climb stairs for exercise sometimes, so I waggle my left arm as I do it, but that doesn't help much.

I jog maybe 8 miles a day, seven days a week but my histogram looks pretty much like a spike at 55 (or maybe I had it turned up to 60. Can't remember.)

I don't think my device has a response to breathing, just to arm motion (?).

I've been in to the clinic several times, but I don't want my heart rate going up every time I blink, so I end up leaving the settings more or less as is. Very annoying when I pick up a grandchild or anything else a little heavy, or go up the stairs to a bedroom.

My old device paced all four chambers and this one, only two, but I don't suppose that has anything to do with it.

reprogramm

by heartdoc - 2011-01-21 06:01:32

Since you have a device with a rate adaptive mode, you should be able to get it programmed so that it does what you need. There are multiple different things that can be adjusted: Sensitivity, threshold, rate and duration of heartrate increase and decrease; and these often can be set differently for different times of day (so your HR doesn't increase too much if you get restless while asleep, but still responds to activity during the day). It may take some time to get it right, but it certainly sounds like it's not adjusted properly now.

Hello from Poole, Dorset UK

by Loopy Lou - 2011-01-21 08:01:41

Hello! where abouts are you?

Where I live we have a cardiac rehabilitation centre attached to our hospital. They should be able of offer you all the help and advice.... failing that wait a while to see who responds to this. We have many fab people whith buckets of advice!

Good luck! xx

Get it reset

by sunnyak - 2011-01-21 10:01:00

I complained about the same thing and the Medtronic technician set my pacemaker to 80 bpm. Much much better.

May Need Rate Response Turned On

by SMITTY - 2011-01-21 10:01:48

Hello Solitair,

Welcome to the Pacemaker Club.

Most pacemakers have a feature called Rate Response. This is part of the pacemaker that can detect physical activity and increase the heart rate as it deems necessary to give an increase in blood flow which often times will prevent the symptoms you have. If your's does have a Rate Response, I suspect it is not turned on. Doing this is something the person doing your checkups can do (with your Dr permission) in a few seconds. I suggest you check on this.

Good luck,

Smitty

Are you on any meds to slow HR?

by AmyS - 2011-01-21 11:01:37

Just wondering if you take anything to help lower your heart rate. The pacemaker can't slow your heart rate down or keep it from going higher, but medication or your natural slow heart rate can. Your heart rate cannot go slower than 60 beats per minute because the PM won't let it, but it can certainly go faster if it's physically able to do so.

I don't know a lot about the drugs that lower heart rate because I don't have a condition that warrants them, but having read a lot on this site about Beta-blockers and others, I understand that they are used to slow an out of control fast HR. It's time consuming, but you might read a little here and see what that's all about.

If your heart rate is slowed by meds or its physical condition, then they should be able to increase the HR on your PM so that you will feel more energetic and your heart can keep up with your activity level. There are settings that can be turned on so that when you exercise, etc. the HR will go up.

LImited HR

by ElectricFrank - 2011-01-21 11:01:51

A lot depends on what your cardiac condition is that resulted in needing a pacemaker, and what the settings are.

I keep seeing posts that someones pacemaker is set to a fixed value. This is almost never done with modern pacemakers. There are plenty of options such as upper/lower limits, and rate response with all sorts of settings. These can be used to manage almost any condition, but it takes skill to optimize the operation.

Just from reading posts here in the last several years I am noticing a dramatic increase in the incidence of incompetent, unethical, and careless programming of pacers. They have gone from an exciting hi tech device handled by professionals to another medical profit center. With comes a quick and dirty diagnosis that will satisfy the insurance industry followed by implant and forget attitudes.

frank

Rate response

by joepeh - 2011-01-21 12:01:08

In my case, my PM responds to JOGGING or even BOUNCING along a rough road while riding in a vehicle. It kicks in to high gear .... around 90 BPM. It DOES NOT kick in when I am doing simple fitness work with exercise machines for upper body or leg muscles.

PM & Rate Respnse

by J.B. - 2011-01-21 12:01:42

Here are a few more details on the features Smitty and Amy mentioned. If your pacemaker has the rate response turned on it is called being in the DDDR mode.

Rate-responsive pacemakers can use several technologies to determine the optimal heart rate, but two in particular have proven quite useful. One of these technologies is the activity sensor, sensors that detect body movement. The more the patient’s body is moving (so the reasoning goes) the faster the heart rate should be. The other is the breathing sensor, which measures the patient’s rate of breathing. The faster the breathing, the faster the heart rate should be. Either of these technologies allow rate-responsive pacemakers to mimic the moment-to-moment changes in heart rate seen in patients with normal cardiac electrical systems.

Thanks and info

by solitair - 2011-01-24 02:01:00

Thanks for the many responses all. This gives me things to ask my cardiologist when I see him in April. Loopyloo, I live in Cheshire so Im not sure if your centre could help. If I get desperate, I may try a call though.

Now the info part.

My PM was fitter as I had permanent atrial fibrillation. When it first started I was give beta blockers which controlled the condition well but after 7 years on them I began to notice the palpitations again. While the doctors tried to find a medication to control it my heart rate gradually raised itself to 150 bpm while resting. 3 cardioversions and two years later they decided a PM was the option. Things have been a lot better since the fitting but I have lost a lot of fitness during the intervening time. I'd just love to be able to start walking fast.

also

by solitair - 2011-01-24 02:01:46

forgot this - I am no longer on med for the condition just warfarin.

You know you're wired when...

You name your daughter “Synchronicity”.

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