Struggling!!

Hi everyone,

it has been 5 weeks since  I had the spark plug put in as I was diagnosed with 2 degree block. Prior to the operation I was running 50/60 miles a week at 8 min mile pace. I started running again two weeks ago but am really struggling. It feels as if I have not run for years. I am only running 4 miles a day as its all I can manage.

my pace maker has been set at 60, my normal heart rate at rest is 50.

any advice please.


5 Comments

60 is like the standard setting ...

by MartyP - 2017-11-22 17:13:14

5 weeks is probably not enough time for you to fully recover from the surgery and getting used to the PM.

The other thing to consider and ask your cardiologist or electrpysiologis is why did they set the PM at 60 when your resting hear rate is 50?  50 or 55 may be a better setting.

Although I don't fully understand about the setting called "rate response" you may want to ask about that as well.

Talk to your doctors and be "patient" a little longer.

New Normal

by Hoosier Daddy - 2017-11-22 21:43:12

I agree with MartyP about your resting rate programming. 60 is typically the "out of the box" rate set as a device's resting rate, especially for patients whose symptoms are due to bradycardia, but for persons who are otherwise physically fit, and for patients on significant doses of beta blockers, whose resting heart rates are well below 60, for your device to kick in at 60 is pointless and it eats up battery life, too.

I presume your device's mode is DDDR, meaning that it adjusts the heart rate based on your level of activity. The most common specific way devices do this is with a peizoelectric sensor which feels your physical movements and raises its rate after a certain period of perceived activity, with a programmable rate of acceleration, up to a maximum rate, and then with a programmable rate of deceleration back to the resting rate.

Check your pulse after you've been resting for awhile, then go up and down a flight of stairs and recheck your pulse, then check it again after running. If you are achieving an incrementally faster pulse, your pacer is likely capturing your RV appropriately and is programmed appropriately, too.

Have your meds been changed or have your doses been increased recently? 

PS: I'm 57 and I couldn't run 4 miles a day 25 years ago, let alone now. Kudos.

 

 

 

 

Fencer

by IAN MC - 2017-11-23 08:58:23

I see from your bio that you have been an athlete at Olympic level so I can understand that a rapid drop in your running stamina will hit you pretty hard .

I can't see why a resting HR of 60 rather than 50 should affect your running performance in any way as your heart rate will be elevated anyway when you run but it would probably makes sense to have it reduced

As Marty said it is still early days and I certainly found an improvement in my running after a couple of months but you must be wondering " Is this as good as it gets ? "

The crunch deciding factor is whether you have become  " chronotropically incompetent " or not . If you have, your heart-rate won't increase the way it did before when you exercise in which case you definitely need Rate Response switching on . If it is on, then your mode setting will end with the letter  "R" e.g. DDDR as Hoosier Daddy said.

The way that Rate Response works depends on the make of pacemaker ( which one have YOU got ? ) .  Most have an accelerometer which detects upper body movement and then triggers off extra heart-beats. This is pretty primitive and relies on the vibrations from exercise triggering off a piezo -electric sensor as was said above.  Other makes have additional sensors which increase heart-rate when increased breathing is detected.

An unfortunate fact of life is that none of these sensors are as good as having a normally fuctioning heart so if you ARE chronotropically incompetent ( and you may not be ) then you may never get back to your previous high levels of athletic performance.

I strongly recommmend that you find a cardiologist / electrophysiologist who understands the needs of the athletic patient and is happy to adjust your PM settings while you run on a treadmill

Best of luck

Ian

lower rate

by TraceyE - 2017-11-24 12:50:43

If you have av block, it shouldn't much matter what your lower limit is because that's not how we pace. Rather than setting the pace, the pacer is completing the broken circuit and making sure the ventricles beat when the atria does. If your atrial rate happens to be lower than 60, it could kick in with atrial pacing. They can tell on the interrogation reports if it's doing that. That shouldnt affect your performance, tho. 

If you have av block, generally the atrial rate is normal and we don't need the pacer's rate response to artificially get our rate up for us. Sometimes they leave it on thinking it'll either not kick in or be there if we need it. That's ok for some people, for others it gets in the way and can affect a workout so we're better with it turned off. 

Another issue that can come up for athletes is the upper limit. The pacer will only pace the ventricles  up to the upper limit. Sometimes they start it as low as 120-130. If the atrial rate is higher than that, the heart is out of sync and it will kill our stamina. 

Talk to your doctor and get them to check your settings. Know that it's normal to take a few tries to get it fine tuned because no two of us are alike and they like to make changes in small increments. Athletic paced patients typically are both rare and harder to program so don't be surprised if it's a bit of trial and error. If they adjust 2-3 times and you still don't feel right when you run, ask to get on a treadmill and run while they monitor so they can see what's going on and adjust the settings accordingly. This helped me tremendously. 

Get It Lower

by Jap - 2017-11-25 05:42:08

Hi,

My pacemaker was set at 60/min for many a year. About 4 years ago I told them I used to have a resting heart rate of about 45/min. They immediatley agreed to lower it to 50/min and see how I went on. IT's still at 50/min, I'm happy, they are happy.

All I would say is like others have said get used to it first and don't push to much to begin with. I certain your abilities with return as mine have.

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