Rate responder

i got my PM 5 years ago at age of 46 for slow heart rate. I’m a runner and have had the rate responder adjusted three times because about 8 mos after an adjustment I begin to feel gassed out during my workouts. Last week the tech told me she adjusted the rate responder to its max setting. I am still feeling winded during slight exertions. Anyone else experienced similar condition? Also, read a posting about thumping the PM to make the accelerometer more responsive during workouts. Does this work for all PM models? thanks!


PMs for Athletes

by KonaLawrence - 2019-07-23 02:28:59

Aloha Aerdna,
I had many problems getting my PM adjusted for my athletic activities.  I have a Medtronics PM and Yes, different pacemakers deal with acceleration differently.  In order to get the changes you need you may have to study up on the details of your pacemaker so you can ask the pacemaker tech specific questions.  I went to the manufacturer's website and downloaded the manual so I could learn what I needed to know.  If you don't know what changes to try you are dependent on the tech guessing what's needed from his understanding of what you say and whatever change he thinks will help.  They don't always guess correctly.

A few months ago I wrote a couple of posts about adjustments for heavy exercise.  You might take a look and see if it helps.
Cheers, Lawrence

PM Data    https://www.pacemakerclub.com/message/35394
Rate Response Adjustments    https://www.pacemakerclub.com/message/34917


What's your maximum permitted heart rate?

by crustyg - 2019-07-23 10:04:32

If your muscles feel like jelly during a hard work out then the blood supply available to them is insufficient and you're moving into lactate production.  For normal people, interval training is usually the quickest way to increase blood vessel growth into the affected muscles (the period of time when they are anaerobic also produces local hormones which promote blood vessel growth), while the heart increases muscle mass, increases strength of each beat which, together with a high heart rate (HR) delivers more blood per minute => better high intensity muscle performance.

But if your maximum HR is limited by your box (you say it is), then the two most important PM settings for your workout are a) rate response - how quickly does the accelerometer in your PM drive the PM's heart rate algorithm, and b) the maximum HR that your PM is set to drive you to.

Doesn't *sound* as though your max HR is adequate for your needs or hasn't been adjusted.  Lots of EP docs are very nervous about permitting realistic max HR values for athletic patients.

Time to start asking the right questions.


by Tracey_E - 2019-07-23 10:42:23

First of all, get past the tech to the doctor. There is a limit to what a tech can/will do without the doctor. Second, ask for a stress test while on the pacing computer. It can tell them exactly what's going on when you feel gassed. 

Thumping the box!

by Selwyn - 2019-07-24 07:32:19

This is not a good idea. It is true that any PM with an accelerometer and rate response switched on will respond to movement ( eg. light tapping), thumping the box is not a good idea as you are between the thump and the box. 

Some PMs adjust themselves with our pattern of activity over time.  I have my rate response turned to the most sensitive setting ( fast onset) and even then find I need to warm up slowly with exercise. The upper heart rate limit  rate may need adjusting upwards if you find you are short of breath once you have warmed up and have reached a steady state.  That is down to your pacemaker technician. Try taking your pulse once you have warmed up. If you have a print out from your last PM check the upper heart rate should be on the print out. You can then see whether your PM tech is treating you as if you are in a bath-chair most of the day.

In general, sudden changes of exercise rate are a problem as there is always a lag between sensing and pacing. PM manufacturers are always trying to make their PMs as physiological to exercise as possible. I have been wondering whether my next PM should have an accelerometer and a minute volume sensor, just so that I can get over the shortness of breath on stairs, dancing, and the 75 yard 'barrier' in swimming a mile. 


Rate responders support really helpful

by Aerdna - 2019-07-28 15:10:21

Thanks to everyone for their thoughtful comments. You’ve given me some great leads to research. I appreciate the generosity of folks on this site. Thanks again!

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