Unusual heart rate

Failed a 4mph stress test in under 3 min with severe shortness of breath and exhaustion, led to a cath which was clear, and lung function studies which were normal, next had a cardio-pulmonary stress test, speed set at 1mph which showed heart rate with exercise started normal went from 90 to 110, then jumped to 150 for from 15 to 30 seconds then fell to a resting rate of 80-90 while I was starved for oxygen. Test results were validated three times. I have a medtronic bi v with defib pacer, cardio doctor said he's unaware of pacer setting nor drug therapy to correct,that I have to live with condition. Which leaves me unable to climb stairs nor execise. Anyone with similar problem with a solution?

3 Comments

Unusual heart rate

by SMITTY - 2009-06-08 05:06:23

Hello GC,

I will not try to decipher the results of the stress test you are reporting, but as for the shortness of breath with exercise, I can truthfully say I've been there and done that several times.

I have a Medtronic KDR 703 PM. Had it for 9 years and I will admit that the PM has never done anything for my SOB. So, whether there are settings that will or will not help with that, I'll let someone else tell us that. In my case it has taken bypass surgery, or stents, to help me.

In '82, I failed my stress test so badly that I had bypass surgery a couple of days later. At that time a trip up a short flight of stairs was about like having an elephant sit on my chest. I could rest a few minutes an things would be fine. The results of that surgery were so great that I thought every one over 50 should have bypass surgery as a preventative measure. The good times continued until 2000 and the SOB returned, not as bad as the first time but enough I could say this is no way to live. I was sure I had more bypass surgery in my future but a stent in one of my bypasses did wonders. Then again in '05 and '07 I had more stents. The results haven't been as great, but they beat nothing. Another factor is that I was 53 when I had the bypass surgery, so I'm reasonably sure age has a little to do with the way I feel now.

Now, if I were you and based on my experience I would see another cardiologist. What you have is not likely to correct itself so help from some source is probably going to be necessary. Again based on experience I would not have any faith in my PM helping my SOB. Medicines possibly, but not the PM.

I wish you the best because based on what you tell us I think you can be fixed.

Smitty

settings

by Tracey_E - 2009-06-08 06:06:27

I had a similar problem and they were able to fix it with settings. I always shoot up quickly when I work out, 80 to 150 faster than you can blink. Annoying but harmless so I live with it. I stay around 150-160, occasionally drop to 110-120, then shoot back up again within 15-20 seconds. It didn't happen on the first try adjusting the settings and I'm still not 100%, but I can exercise now. They can prevent your rate dropping off like that, at least my St Judes can. I forget the name of the setting, but it controls the decrease in hr and makes sure you don't drop too quickly. My rate comes down gradually after exercise but I never get a sudden drop. Medtronic should have something similar. If your current doc can't get it right, go get another opinion.

Or ask the Medtronics rep to go higher up, or get the doctor to consult with Medtronics if he does the settings himself. I had another problem once that my doctor and St Judes rep could not figure out so they sent all my records to the engineers. They made me a case study because they hadn't had a similar set of symptoms before. The engineers had a powwow and came back two days later with settings and I've felt good ever since.

Don't give up hope! It seems to me that if the problems are caused by sudden drops, that the pm should be able to take care of it. That's what they do, prevent drops. Some doctors get mostly patients who are older and sedentary so they're not used to dealing with the challenges of someone active. If he's not willing to learn, it's time to move on to another doc.

Suggestion

by ElectricFrank - 2009-06-09 01:06:04

Get a copy of your last pre/post pacemaker interrogation. There are several settings that could be causing the strange HR pattern especially if Rate Response is turned on.

It would seem that they could also go a bit further with diagnostics. Do you have a measurement of ejection fraction. Also, lung function.

One other question I have: why did they use a bi-ventricular pacemaker? These are usually only prescribed for conditions like CHF.

I agree with TraceyE that a prgramming session with the Medtronics rep would be a good idea. If possible have it scheduled with a treadmill available so the rep can see the results of changes. Several people on the forum have mentioned having this done.

Keep in mind that most cardiologists aren't that knowledgeable about pacemakers. Their specialty is "plumbing". The reps or a good EP are better at dealing with the electrical issues.

frank

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