reduced stamina result of pacemaker?

I am a 78 year old woman who has had a history of a-fib for 30+ years. when medications no longer controlled my rate I had a partial ablation and a pacemaker installed. Now I find that, though I feel much better mentally, I find that my stamina has decreased significantly. Before the pacemaker I could ride a bicycle 10 miles, now muscle fatigue stops me after 2. I used to run the elliptical stepper at 10+ calories per minute for 30 minutes and now I am down to 7 or 8 for 20 minutes. Is this a trade-off for feeling better in general, or will my stamina eventually return? My pacemaker is set at 70-110, supposedly, but I note that my rate does not exceed 90 even after extreme exertion. Am I just not facing the normal aging process?

5 Comments

PM & Stamina

by SMITTY - 2011-12-10 05:12:32


HI Gerry,

I'm closing in on 83 at a rapid rate (so it seems) and feel that I can speak as an authority when I say there just ain't no such thing as a "normal aging process." Some of us age faster than others but no part of it is normal.

I've had a pacemaker since 2000 (I'm on my second one now) and while I know they are wonderful inventions, some people get better results with theirs than others. That is usually because the settings on some are "tuned" better for some than for the others. Based on what you say about your decline in stamina I will say the settings on yours need fine tuning. You certainly should be able to ride a bicycle as far now as you were before you got the PM. The settings you mention are pretty much normal for senior citizens. But those settings should not limit your activity.

In case you are not familiar with just what they do, the low setting is the one which tells the PM to not let you heart rate get lower than this. The upper setting is the one that the PM will continue to step in and help maintain a regular heart rhythm until it is reached. At that point, the PM becomes a monitor and continues as a monitor until your heart rate drops below that number.

You say your heart does not exceed 90. That was a problem I had after I got a PM, but the PM was not at fault. My old and tired heart imposed that limit on itself. My heart disease was diagnosed in 1982 and it has been continuous patch, patch, patch since then.

With our PM comes something called rate response which is a feature that lets the PM monitor your physical activity and then increase your heart rate to some point. My upper limit is 120, but I doubt that I'm anything near the physical condition you are. If you want to know if your rate response is on, first check your resting heart rate. hen tap on your chest firmly, but not hard about 3 or 4 inches from the PM for about 20 to 30 seconds and then check you HR. If the RR is on your heart rate will have increased significantly.

Now with all that said, I suggest that you contact your dry and tell him exactly what you have told us. Also, ask if the rate response is turned on as having it on or off is optional. If necessary put that Drs phone number on speed dial and let him know frequently you are not satisfied. If all else fails change Dr.

I wish you the best,

Smitty






A Couple Comments

by donr - 2011-12-10 07:12:05

Gerry: You didn't say how long you've had the PM. I think that could tell part of the tale. If it was just last week, the situation would be dramatically different than if it were a year ago. You'd be more fully recovered from the effects of the surgery. Face it, at age 78 (I'm 75) iut takes a bit longer to get over just the surgery, no matter what the procedure was.

One clue to the cause is that muscle fatigue gets you & limits your distances. That tells me that your muscles don't get enough oxygen to keep them going. Surprise - your heart was messed with, so it obviously isn't pumping at full efficiency. That could be caused by some tweaking needed, as Smitty said.

You had a "Partial Ablation." No telling EXACTLY what got ablated & what its effects a may have been. You say that your HR doesn't go above 90, but your PM is set at a max of 110. By golly, that supports the observation that your muscles lack oxygen at high exertions - your heart won't get to a high enough rate to supply it. Beats me why? The partial ablation, perhaps? But that has a problem - your PM is set for 110 as a upper limit. It should be taking you that high before cutting out on you.

You have a problem that a good cardio should be able to address & solve for you. In my experience fixing things, when they don't work immediately after being fixed. you re-visit the last thing you messed around with. To me, that's the settings on the PM as a start. That's the simplest explanation & easiest to tinker with. If that doesn't work, go to the next more complicated issue.

Good luck.

Don

another possible cause

by IAN MC - 2011-12-11 06:12:22

Hello Gerry

Do you take statins to reduce your cholesterol by any chance ? Muscle fatigue and stiffness can be caused by statins and these effects can come on some time after starting them.

I had to stop taking simvastatin because of muscle fatigue ( like you I had a PM fitted after partial ablation )

Ian

Natural Heart Function

by Terry - 2011-12-11 08:12:00

Next time you have a battery chang, you might want to check on getting a natural ventriculat paced contraction, yes pacecd. Pacemakers can provide efficient heart function:

http://PacemakerPatientAdvocacy.com

There are doctors around the world who can do that and more of them all the time.

All the best to you,
Terry

Statins

by Tattoo Man - 2011-12-14 04:12:43

Hi Gerry, Ive read the comments above and was struck by IAN MC s observation. Ive just been looking at the info leaflet that comes with my Statin...I'm on 80mg Atorvastatin daily (also 150mg Aspirin) and get non -accidental bruising and muscle pain, I'm 61 and running fit, but tire easily...pretty certain that I dont have pre PM stamina. Ill ask my Doc, a smashing bloke, also a triathlete, about Statins and get back when I can.
Thanks Ian.

Take care all

Tattoo Man

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