Rate Response

3 months into my St Jude dual lead PM.  Bradycardia with total heart block. I had some problems that seemed to be too sensitive RR.  The tech changed my settings to less sensitive today.  He said if that didn’;t work better for me he would just turn it off.  My question is what difference will I notice if the RR is turned completely off...big deal or no big deal?  Input appreciated!


Do you need Rate Response or not ?

by IAN MC - 2020-08-25 14:37:48

Apparently around 50 % of PM recipients need Rate Response , around 50% don't . The longer you have a PM, the more likely you are to need it.

  As you have heart block as opposed to Sick Sinus Syndrome , you are slightly less likely to need it.

It WOULD be a big deal if you need it ,but have it switched off. The slightest bit of exercise could make you quite breathless . If you're not into exercise, you may never miss it !

Rate Response settings are usually a touch of trial-and-error . Why not try having it turned off ....... you would soon know if you have made the wrong decision !


I Love My Rate Response

by Swangirl - 2020-08-25 14:51:53

I have a dual lead St. Jude for heart block.  I didn't start out with a full heart block but it went that way quickly.  I have benefitted greatly from rate response and my cardiologist and PM rep careful adjustments.  I am 78 but hike, play pickleball, and circuit training at the gym.  With me on the treatmill walking up hill as fast as I could the cardiologist  and St. Jude rep made adjustments.  Because I am close to 100% paced the adjustments have worked well over time.  There's usually a few second delay when I am running for the ball but I can feel the rate response kick in and keep up the pace until the play is finished.  It's similar walking or hiking up hill.  I have a few seconds of breathlessness before it picks up.  Without this feature I would not be able to do everything I do.  The RR isn't as good in the gym since I think (correct me someone if I'm wrong) that it depends on foot strikes to work.  When I am doing military presses or other more stationary moves with weights for instance it doesn't help me and I have to modify.  

Rate Response

by Sisterwash65 - 2020-08-25 14:52:50

Your post caught my attention for several reasons...I too had bradycardia and AV block and I got my PM 3 months ago...Mine is a Medtronic Azure dual chamber and the rate response is turned OFF. I’m almost afraid to say it, but I’ve had 0 problems ! Lower rate of 60, higher rate of 130. I’m thankful every day that I have it and my energy level feels normal again. 

Best of luck on getting yours resolved quickly !


rate response

by Tracey_E - 2020-08-25 21:33:48

If all you have is av block, if your sinus rate goes up and down normally on exertion, then there is no need to have rate response on. My doctor automatically leaves it off with heart block patients because sometimes it can cause more problems than it fixes if it starts kicking in unnecessarily. 

Rate response

by AgentX86 - 2020-08-25 21:41:53

As SwanGirl said, if you need it, you need it.  If not, it will get in the way. RR is needed if you are chronotropically incompetent.  That means that if your sinus (SI) node isn't functional, you need it.  If you have heart block, your SI node can be perfectly fine and there is no reason for RR.  If you have Sick Sinus Syndrome, your SI node may still be able to push your heart rate up but at rest it may fall too low.  You wouldn't need RR in this case.

I can't see your profile so I don't have enough information to go much further.

I hadn't thought of the gym.  I pretty much only use the treadmill (and not, these days).  I'd considered swimming and biking but not weight lifting.  You're right, though.  Weight lifting could be a problem for the same reason.  RR doesn't depend on heel strikes (though that's a very good measure) but more on the movement of the PM itself (torso). Heel strikes will be "felt" by the PM.



by Radioman#1a - 2020-08-26 00:20:34

Thanks for the comments...I’m really not sure if my sinus node is ok or not. I haven’t heard my Cardiologist mention it.  He just said I had complete heart block.  I’ll look into that and if I continue to feel poorly I’ll just tell them to turn the RR off and see how I feel...Thanks again!

RR off

by AgentX86 - 2020-08-26 13:14:49

Have him turn it off then climb a couple of flights of stairs. That'll tell you if your SI node is responding (chronotropically competent). Then if your resting heart rate is a above the minimum setting,  your SI node is 100% and all the pacemaker has to do is to connect the upper chambers of the heart to the lower. There is no need for RR.

You know you're wired when...

You fondly named your implanted buddy.

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