Boston Scientific - INOGEN EL ICD DR D142

minute ventilation

by Tracey_E - 2018-06-07 11:42:02

That's about the only type of rate response that will work well for cycling. You can call Boston and ask, they will be able to tell you what kind yours has. Most with av block don't need rate response, tho. How high are you getting? 170 was not enough for me. My pacer could go to 170 but sometimes my sinus rate got up to 180 or 190, the pacer could only get the ventricles up to 170, anything over 165 was iffy for a hard workout . I tried to keep it under 160 so there was always a cushion. When I got a new one two years ago, they gave me one that goes to 220 so now my upper limit is 190 and no more problems. So for me, the problem wasn't rate response not getting me high enough, it was the ventricular pacing not keeping up with my natural sinus rate. They can tell you how much you pace atrial vs ventricular. If you're pacing all ventricular, then you aren't using rate response. 

Boston Scientific - INOGEN EL ICD DR D142

by Three blind mice - 2018-06-07 12:06:15

Hi

I will call Boston and ask.

Currently I can get 120 on the flat and 145 on a hill but this is difficult to maintain and after an hour/hour and a half I get very fatigued. Although some of this is down to lack of fitness I assume having had a couple of months due to having the pacemaker fitted (March and April 2018). Prior to the pacemaker i was up in the 175 range

I will also ask about why i have the Rate response turned onas as far as i am aware i do not have a sinus issue.

Thanks for your response and comments

Just want to say this is a great forum. I have learned a lot

rate response

by Tracey_E - 2018-06-07 13:38:26

Rate response kicks in when we need our sinus rate higher on exertion, tho if it's an accelerometer it won't pick up on that if we are on a bike. In theory our sinus rate is normal when we are primarily paced for av block. With av block the pacer is just playing follow the leader and making sure the ventricles keep up with the atria so your heart is setting the pace. You aren't getting near the upper limit so maxing out as I described above is not your problem. Sometimes rate response is helpful even if we don't think we have sinus problems. I have av block but sometimes my rate plummets, other times it doesn't jump up enough on exertion, so  my rate response is on and I use it a very small amount, like less than 2% of the time. But those small amounts make a difference in my workouts. 

Sometimes a treadmill is a great tool for figuring out what's going on. They can watch in real time and see what it's doing, how much our rate goes up on exertion, how we feel at the time, then they can fine tune the settings. 

We can get deconditioned fairly quickly in the time it takes to diagnose what's going on, get the pacer, and heal enough to get back to activity. 

Don't go by the numbers, the charts don't really apply to us when we are paced. Go by how you feel. If you feel strong, your rate is good enough, whether it's 120 or 170. But you don't, so you need to find out if it's conditioning or if a boost from the pacer to get your rate higher would help. 

Who needs rate response switching on ?

by IAN MC - 2018-06-07 13:50:44

Tracey in her first reply said that  " Most with AV block don't need rate response ".     Everything I have read suggests that this may not be true.

The only determining factor re rate response is whether or not you suffer from  "Chronotropic Incompetence ".    The causes of C.I. are complex and not clearly understood.  Also, there is strong evidence that the need for Rate Response increases over time for ALL pacemaker recipients whether they have AV block or Sick Sinus.

Three Blind Mice .. I look forward to hearing what your cardiologist says when you ask him WHY you need rate response.

Ian

Ian

by Tracey_E - 2018-06-07 14:22:28

My rr wasn't on originally because they thought it would compete with my natural sinus rate, and they were conserving battery by turning off what I didn't need. It was turned on later when I got on a treadmill and they saw I had occasional CI. A different ep did my last replacement and he turned it off again, so I had to ask again to have it turned back on. In theory av block and CI are two separate diagnoses but electrial problems seem to be a mixed bag in a lot of us so who knows.