PM lagged response

Had a Biotronik Eluna 8 DR-T implanted in 2015. I'm now 77 and have had good results. Includes work outs walking and jogging. I still ski mostly blues but some blacks. Now, in the last year or so I have noticed a lag in response of the pm. When I go out for a walk I often get short of breath for the first 10-15 minutes. When I check my watch it shows a beat rate of from 65-75. But not always. Eventually it rises to anywhere between 115 and 135. I have discussed this with the PA who is assigned to me. I have been told that the pm has been set on maximum sensitivity response rate and there is nothing more they can do. I was told to try jumping jacks before I walk/run to get the pm rate up. Not clear that this makes much difference. My real question is, has Biotronik improved the algorithms since 2015 to be more sensitive? The reason I went with Biotronik was because it seemed that its proprietary CLS technology was more likely to help an active person like me. I am due for a pm replacement in about 2 years so I am doing some research. Any comments or suggestions?


Shortness of Breath

by windway - 2023-12-16 08:11:41

I don't think your symptoms are PM related, seems something else could be going on, having had similar symptoms myself sometime ago, which were diagnosed.  I won't go into details, but I would seek advice and maybe an angiogram would be useful.


Exercise & Sports

by Jackw - 2023-12-16 10:46:36

Windway, thanks. I have had an electrocardiogram this summer and an echocardiogram this fall. The comment from my doc is both are normal for my age. I should add that I am 90%+ atrial paced and about 10% ventricle. When I go out for a jog, once I get the pm revved up, I can comfortably jog 2-3 miles at about a 11-12 minute pace. The course I run on has about 90 feet of elevation change. In general, I have been pleased with Biotronik but I am hoping to get some comment from people who have a newer model Biotronik pm to see if some of the issues have been addressed. 

Biotronic slow resp --

by CityslickerFarmhand - 2023-12-16 11:13:27

When last PM check?  Or certainly at next (usually 6-months?) could be some adjustment to "respond" more quickly.  Seems most "modern" PMs have lots of sensors and "adjust" on what they're sensing, as "exertion" so know to boost heartrate a bit -- could be some lag?  You note due replace in 2 yrs, thus current IS bit older technology (ADVANCES so FAST !) but could be PM tech, with instructon from cardiologist, could do some adjustment.

Biotronik slow response

by Jackw - 2023-12-16 11:33:11

I have a cellular transmission from the pm to my doc every quarter. Had my inperson check in August.

Biotronik slow response

by Paul3199 - 2024-01-16 02:31:25

I have similar experiences with my Biotronik Eluna HF-T (2021 installed). I'll go out cycling and frequently my heart rate just drops to sub 85 bpm. It can stay like that for up to an hour or more no matter how hard I try to push. Mid 70's, heart rate usually runs around 125 to 140 when PM is behaving. Techs have no idea why, they just talk about adjusting sensitivity settings and my age. Cardiologists aren't clear why either. Not much help I know, but you're not alone. Yes, I'm resigned to a 5+ miinute lag between setting off and heart rate rising, if it's going to rise.

Re: Biotronik slow response

by Jackw - 2024-01-16 15:29:15

Paul3199, thanks for the comment. I assume your pm is set for CLS response, not accelerometer. The inconsistency is hard to understand. I have similar experiences to yours. Sometimes I start out on a jog and my rate goes up to 130-145 pretty quickly. I can then jog several miles with no problem. Other times I find my breathing becomes rapid and I have to slow down for a while (2-5 minutes). Then usually I can pick up the pace. The one thing that seems to correlate with response or lack thereof seems to by my activity level prior to the jog. If I have been sitting or otherwise sedentary I seem to have the lag. If I have been physically active the response seems to happen more quickly. 

Biotronik slow response

by Paul3199 - 2024-01-28 02:51:46

Jackw, yes my pacemaker is set for CLS. The techs have tried the accelerometer option with no noticeable success. Strange, today I was out for a ride, stopped for 20 minutes after an hour or more of mid 80's nonsense. When I resumed riding my heart rate went straight up to 110+ with no lag. Fine for the final 15 minutes home.

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