Rate Response and UPPER LIMIT Rate of PM
I have a Double Chamber pacemaker since November 2005 (though I have been on pacemakers for the past 16 years), with rate responese function with limits set as 60-120. The rate response function was switched off by my doctor as my atrium can set rates on its own (Has always been). I am 38, located in New Delhi.
Now I was noticing over the past one year that when I climb steep slopes, say on hills or on the great Wall which is really steep, I was having real problem in breathing and my heart goes thump thump at an incredible rate. I have a general slight breathlessness problem, but it is nothing major. I have managed pretty well for the past 16 years with normal activities. My angio done last year was normal.
Anyway I went to my cardio today, he found through the PM test that my upper rate does go as high as 160 which my PM cannot sense (since upper limit is at 120). So now he has first turned the rate response on as he thinks my heart cannot beat enough at higher levels. Second, he has increased upper limit to 140 though apparently the medtronic guys here told him 'over 130 is not recommended'.
He has warned me against certain things. apparently with rate response and upper limit at 140, sometimes even with sitting in a shaking car (say) the PM may think my activity level is high, and beat at 140 which will be uncomfortable etc. Also if the PM cannot pace enough , it will start pacing at half the rate, so when I need 160, it will give me 80, not even 120! However, my cardio has advised me against avoiding strenuous activity (which I in any case hardly undertake so much, I hardly jog or do physical exercises) saying 'pursue a normal lifestyle'.
Question to you all: 1) do you think this will work? 2) Is 140 abnormally high for the upper limit to be set at? 3) How high do your heart rates normally go? 4) What should I expect and prepare for? 5) I have a hypothesis that with age, my heart's ability to go up (rate wise) for strenuous activities is coming down while its ability to generate 60 is coming down too. So now it seems i am on the PM 97% of the time (i.e. my heart rate is below 60 57% of the time, last year it was 75%. What do you think of that?
Sorry for such a huge message. But I really need information. Especially to Question 4. I am pretty normal and healthy generally and do not have much problem with my heart, PM otherwise. My echo is clear.
Thanks a lot (at least for reading through this!!! )