Can the doctor adjust my pacemaker for this?

With regular activities and work, etc, I feel great with more energy etc. My pulse range was 40-60 and now it is 60-80. 

My issue is that if I quickly pick up my pace walking in a hurry, or climb steps, or lift something with my other side arm like a suitcase and carry it that I get winded to the point that others notice and comment. 

Sometimes it seems if I get anxiety that it impacts my breathing too a little. 

After being winded, it goes back to normal if I just go back to normal activities. 

Just don't know how they could adjust so the winded episodes can be reduced. If I exercise with a regular walk it is fine and no issues. It just seems to happen with the changes in activities listed above...

Thoughts? Any others experience this? 

my pacemaker was implanted 11/28th so I am new to this space. 

Thanks in advance


A common problem - Treatment depends on the cause

by Gemita - 2024-01-02 03:45:59

Welcome, Rebelmania,

It depends what is causing this, but yes an adjustment of a setting like say Medtronic Rate Response could well help with this problem.  

You do not tell us in your Bio why you have a pacemaker ?Sick Sinus Syndrome, Heart Block or something else, like for example heart failure?

Many of us have difficulties on exercise initiation, particularly when climbing stairs or when needing to suddenly increase our exercise capacity.  

I find when my arrhythmias are active, this problem is even more pronounced, so I would start by going back to your cardiac team for some checks to find out if a setting can be adjusted to help or whether the problem is caused by something else which might need treating?

Anxiety?  Yes that can cause my heart to beat faster and to increase my need for more energy, so there may be a few things going on.  Hope your doctors can help


by piglet22 - 2024-01-02 09:22:00

What exactly do you mean by winded?

Firstly, your symptoms are not unusual, but as Gemita says, the cause needs to be looked at.

It could be that there is some other arrythmia going on that the device is revealing. Ectopic beats is one example. Pacemakers aren't good at correcting these.

One thing you could do is check your pulse and oxygen levels while you are out to get an idea of your normal and what goes on when you get symptoms.

Now and again, and I suffer with new exercise exhaustion, I will check my oxygen saturation and radial pulse.

A pulse oximeter (ChoiceMed for example, about £35) is a good investment. A word of warning though. If there is an underlying arrythmia, the pulse reading can be false and a timed count at your wrist is more reliable. Sometimes you can detect missing or weak pulses.

One thing I have noticed is that despite being on a rate responsive setting (Medtronic Ensura), my heartrate never goes much over 80 to 90 BPM, despite some hefty hill climbing.

Certainly, for years, I cycled and walked a lot with the pacemaker and never had problems. Now it dominates things.

It is being looked into, but, excuse the pun, I'm not holding my breath. Here in the UK, the health service is grinding to a halt with another hospital doctor strike of six days due at probably the worst time of the year. This is on top of huge waiting lists.

Can the doctor adjust my pacemaker for this?

by Highplaces - 2024-01-02 10:18:32

Hi Rebelmania

I too have found that I initially get slightly winded and struggle when I start a climb (hill or long flight of steps) but have through trial and error discovered that if I give in and pause for just a moment or two and then go on a again, on the second attempt there's often no problem (occasionally it takes two pauses!).  I haven't a clue why or what's happening but I have a check up next week and this is one of the questions I will be asking so if I find out anything useful I'll post again. I have heart block so don't have rate response on but at the last check up they did increase the upper sensory rate which I think is a different thing.  It was done because I had gone over the 130bpm previously set and the pm changed "mode" on me half way up a mountain dropping my heart rate like a brick from 130bpm to 65bpm - a truly horrible experience, like someone had hit me in the solar plexus and turned my legs to concrete.  I'm also going to ask then to change the upper sensory rate to something even higher as I am constantly checking my pulse when climbing or exercising hard in case it gets too close to the new 150bpm limit and initiates another mode change.  Ridiculously anxious about asking for any changes- such a wuss!

Breathless on initiating exercise

by Selwyn - 2024-01-02 11:16:18

Hi there, you will see that in the last week or two I have posted about the same sort of problem present for as many years as I have been paced. ( Pleease do a  search re. Exercise and perhaps me). 

I have discussed at length with those in the know about how to adjust for this. 

Your rate response should be on the fastest setting ( I had  mine increased a few days ago from 12 to 16)  the fastest reaction time.  Sometimes lifting the resting pulse ( the lower limit threshold) may help. This needs discussion with your electrophysiologist.  Sometimes having less blanking ( ie. the time when no pacing is possible in the cardiac timing cycle) is a help, though this needs great care to avoid other arrhythmias.

The bottom line of my investigations is that not a lot can be done to help.  My pacemaker has a minute volume rater response - this is too slow to help and results in the accelerometer response being lessened). 

Like others, I have found that for instance in swimming, after 2 lenths, I gasp, after 4 lengths I gasp for less, and then I am OK for the rest of the 66 lenght of fairly quick front crawl. Stairs remain a problem ( gasp), as does lifting ( my grandchildren are not getting lighter!)

Anxiety releases chemicals into your blood that will increase your heart rate and make the heart more prone to arrhythmias. If this is a problem, get some help for your anxiety . This is a direct muscle effect independent from pacing .

If anyone finds out anything else useful do please let us know as I have indicated in my posts the other week about this. I expect even knowing that we are stuck with this problem is useful. It is reassuring that we are all affected by the same problem. It may be that we have to accept a bit of the rough with the smooth, though  as I said to my pacemaker people a few days ago, if you don't try you will never know.



Follow up to Gemita

by Rebelmania - 2024-01-02 16:02:33

My cardiologist said before my procedure that my heart is strong and their are no blockages per a heart catherization. 

Genetically I have had a pulse in the mid to upper 40's my entire life. He now says for a person my age going forward we simply needed to increase my pulse so no longer term damage. 

I am in Afib. Post pacemaker I was put n amiodarone but they took me off of it after several weeks due to the side effects. Waiting for the medicine to get out of my system before trying something else. 

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