Adjusting to new pacemaker.

Got my pacemaker 6 months ago, and am recovering from hip replacement 3 months ago, so I'm just now able to ramp up my exercise and am adjusting to how the pacemaker works.  
 

I've noticed that when I walk, even if not particularly fast, my HR jumps up much higher than other forms of exercise. Did 10 minutes of HIIT on my exercise bike yesterday, and my HR barely got over 140. I can routinely walks outside and the HR can get up to 155 and the pacemaker will throttle back, even if I, not breathing heavy or don't feel like the walking is very intense exercise.  
 

So I think the PM senses movement and ramps up the HR to what it thinks I need, and since I am actually moving more than on a stationary bike or when doing strength training, it goes up higher. 
 

Is this something I have to learn to live with, or is it a programming issue that can be adjusted?
 

Feedback would be appreciated. 

2 Comments

Sounds as though some adjustment is required

by crustyg - 2023-09-17 18:02:09

I think I'm right in saying that all modern PMs have an accelerometer in them, but some have more than one (IIRC the leadless ones have three so that their data can be adjusted to align with the body regardless of their actual orientation in the heart through a calibration process).

My particular PM has a single accel, and it's positioned in the PM so that it responds to forward/backword movement, not up + down or sideways.

If you device also has a single accelerometer, positioned in a similar manner then it won't sense much when on a road bike so there won't be much feed into the PM's Rate Response => less increase in HR than walking.

Your EP-team can make the necessary adjustments when you tell them what you need.  From other contributors' comments here, your device may not be ideal for road cycling.

Best wishes.

High heart rate when walking

by Repero - 2023-09-18 19:05:04

I don't know if our heart conditions are the same, I have total heart block, but my sinus node is working OK. My pacemaker (Biotronik) therefore only has to sense the arrival of a pulse at the right atrium and pass it on, with a suitable delay, to pace my right ventricle. My body still knows when it needs a heart beat.

In the few weeks after implantation, and before my first review, I noticed that when I went out for an exercise walk, my heart rate would suddenly jump from about 100 bpm to 120, and stay there. There was no smoothly progressive increase in heart rate as my exercise level increased.

At my first review I did some exercise tests. It became apparent that the rate response algorithms (accelerometer or closed-loop-simulation) were suddenly kicking in when they had no need to.

With my condition I do not need the PM to predict my required heart rate, my body is still doing that fine. Once the rate response functions were switched off, everything returned to normal and has stayed that way.

Maybe your condition needs rate-response, but if it doesn't, switching them off worked for me.

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