Am I topping out?

Pm was placecd on 1/10/2023. Today is the first day i have really pushed it ..

I played a racquet sport (pickleball) for 2 hours or so.

I would get winded at times (never did pre-op) and noticed my heart rate was maxing at around 100.... looking  at my garmin i was max 120. 

Can the pacemaker limit my max?  Is there an adjustment?

Seems like as I move and create blood/oxygen demand im not getting enough?

The device is a Medtronic Cobalt 



by Good Dog - 2024-02-05 21:25:45

This is not something I have much experience with, but it seems pretty intuitive to me. Your pacemaker cannot restrict you, but it can help you. The PM can help you if it is necessary and if it is set accordingly. If your heart is maxing-out at 100 or 120 and your rate response is not turned-on then you could be limited. So your rate response would need to be turned-on and adjusted appropriately. However, if your rate response is on, but you are still maxing-out at 100-120 bpm, then the rate response may need to be adjusted. I would suggest that you take your pulse manually in your carotid and just not to trust the Garmin. Are you confident that your pulse rate was accurate? I think the easiest and most accurate is to take it for 15 seconds at your peak and multiply by 4.  

That is just my take, so lets see what others may think.




by Pacer2019 - 2024-02-05 22:54:27

I didnt do a manuel pulse. I do know the Garmin isnt "medical grade" but I do check its acuracy but more than an exact number I follow the pattern.

It does make sense assuming HFR is somewhat accurate that if i am a bit winded I need more blood pumped.

Here's to hoping it's a simple adjustment and can be corrected !!


by USMC-Pacer - 2024-02-06 01:34:35

With heart block, your heart will only beat so fast. For me with a normal atrial beat, the cardiologist put me on a treadmill and told me to walk, then jog.. got my HR up to 150.. but only my atrium was at 150. My ventricals wouldn't go over 90 = exercise induced heart block. I had my device installed and the max heartrate was set at 125 which is common with new devices and patients. When I started pushing it again and hit the 125, I would go into a 2:1 block (Wenckebach Phenomenon) causing weakness in the legs, stomach pain, SOB, etc.. They raised the MTR (max tracking rate) and problem was fixed! There's more to it, but for me, rate response wasn't needed. I just needed the device to follow my natural HB higher. I could be wrong but I think rate response is more for folks that have sick sinus syndrome. My HB goes beat for beat with my atrium. But, as stated above if it goes higher than what the device will allow, it will drop you to a 2:1... meaning if you excede your MTR of say 130, it will drop you to 65.. which feels awesome when you are exercising.. <--sarcasm! 

This is why you need your EP to do some testing and make a determination

by Good Dog - 2024-02-06 08:03:11

While USMC-PACER may be correct, it is difficult to know for sure without a treadmill or other testing and/or more expertise. When I was younger and playing competitive basketball my HR would exceed my tracking rate all the time without any issues. There were times when I know I was well above my tracking rate of 145 bpm (165+ bpm) and I felt fine. I did that on almost a daily basis back then. As I've aged a lot has changed. However, my point is simply that you need to see the Doc to best determine what is happening so that you can get it corrected. Additionally, you need to be sure that you are getting an accurate heart rate at your peak. I can't explain exactly why, but heart rate trackers/monitors are just not very accurate in people with PM's. 

Here is what I copied from the Garmin site:

Garmin’s heart rate monitor straps (HRMs) are not designed for use with pacemakers or ICDs, nor have they been tested with these devices.  Garmin cannot guarantee the accuracy of the heart rate data from our HRMs if you have a pacemaker or ICD.  The HRM data is not intended to be used for medical purposes

If you keep at it, I am confident you'll get the answer you need!




by Pacer2019 - 2024-02-06 13:14:38

I am goimg to a followup Friday ...has been a month with this new device and those are all good things to discuss.

I remember in 2019 when I had my other device they made an the time I was playmg racquetball and found myself coing up short.

I am wondering if they insta a new device using the default out of the box settings then adjust from there after a bit


As far as the Garmin goes I do not have a chest strap device - its the Forerunner which is a watch...  Over 6the several years I have used it for running and just to spot check I find it accurate enogh to get an idea of a pattern.  Pretty simple to take a manuel pulse then check the watch and see how accurate it is... I always compare it to checks at the dctors office.

I will report back after Fridays appt and I am sure there will be more questions!

Thanks again

I agree

by Good Dog - 2024-02-06 13:29:33

I read a study many years ago that indicated a lot of doctors used the out-of-the-box settings. In any case, you know enough now to ask the right questions. When they interrogate your PM they should be able to look back and see where your rate has been. That might be helpful. Not sure if they give you the interrogation report, but they should so you can get familiar. If they don't, you should ask for it. There is much you may not understand, but it is a learn as you go situation. You are on the right track........

I wish you the best!


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