Exercise following a shock

  • by Wings
  • 2024-02-11 06:57:35
  • ICDs

Hi All

Sorry for this long message but I need to give some background before asking some questions (if you dont mind)

I had a Medtronic ICD fitted about 2 and a half months ago (dual, pacemaker and defib) following a cardiac incident while out jogging that eventually led to me being shocked in hospital to get my heart rhythm back on track.

Turned out I had Arrthymgenic cardiomyopathy that had finally reached a point of "no return" (was told most likely just an age thing being 61 as there had been no previous warnings)

All was good at my 6 week check up and was told I could ramp up my exercise and nothing was out of bounds other than golf and tennis (which was to do with the ICD instalation wires nothing else, which didnt bother me as I don't play either).

So I built my jogging back up and for the last few weeks had been happily running 10k (about 6 mile) with no issues until yesterday, without warning, I suddenly couldnt take a breath. So I stopped jogging, took some breaths but within about 20 seconds the defib went off (the sudden ability not to take a breath was the same sensation that occured when I ended up in hospital the first time).

After the "kick" I felt OK (although shaken up) and my wife came and got me in the car and took me home. After this we had such mixed messages.

The notes given by the hospital said if you have just one shock and feel ok you should notify your doctor (or pacing team) but need take no further action at that time. My wife was understandably worried and made me call 111 who arranged aa doctor call back. He recomended going into hospital to be checked out.

I didnt want to do this as I knew the pacing teams dont work weekends but still went anyway as I didnt want to go against his advise.

They ran the normal tests, ECG etc and all was fine but as expected there was nobody available to chekc the icd data and they wanted me to stay over night so that hopefully I could be checked the following morning.

They did say they had spoken to one of the cardio consultants to get his advise and part of his response was to tell them I shouldnt have been running anyway (whiuch was not what I was told at my 6 week check up)

I declined to stay overnight as I said that by chance, I was seeing the pacing team the very next Tuesday as I wanted to discuss the settings on my ICD anyway and had luckily managed to get an earlier apointment rather than wait to the next 6 month check up  (I have the normal preset of 60/130 BPM and wanted to see if they can turn on the night time mode which reading this forum I know exits so as to lower it to 50 bpm at night as well as discuss increasing the max rate to be closer to my normal max running rate of 160bpm).

They werent very happy about me going home (duty of care which I understand) but agreed to discharge me  (after signing a waiver form) and I returned home and have felt ok now for 24 hours since the ICD first going off.

The reason for this long post (apologies again) is to ask the following.

1) Should I be running in the first place (as mentioned to me in the hospital and said to have come from the cardio consultant) as this incident has occured twice now while out jogging? (I'm just a jogger not a runner and the incident happend both times at around the 6km mark well short of my usual 10k and even before I hit a slight hill on my retuurn)

2) After a defib goes off, how long must you wait before undertaking any further exercise (even if its just walking)?

3) Is ther  anything else that can be done to stop me having a cardio event that causes the need for the defib to go off (can the pacemaker settings help or is there other medicines to stop my heart going out of rythm causing the defib to fire. 

Thanks again for reading and appreciate any advice.


Exercise following a shock

by Wings - 2024-02-11 09:06:24

Thanks Angry Sparrow for your quick response. 

I agree,  getting the data from the device is the most important thing and I should get that early next week. 

Looking back at the incident,  the sensation before the shock was the same as the incident that got me the ICD in the first place so I think the shock was appropriate but hopefully the data will tell.

Your right about the information out there , lots of it is very old but it doesn't help getting different information from different the different "specialists "

Feeling ok today but not physically  100% (although my heart rate has remained normal).

Mentally it's tough. You worry it will go off again without warning and I'll really have to change my exercise regime which has always played a major part in my mental and physical wellbeing .

Still, like it or not, the ICD is part of my life and I'll have to get used to it (and for others out there,  the shock though unpleasant is not awful and lasts a second)

Exercise following a shock

by Gemita - 2024-02-11 11:16:38

Wing, I will try to answer your questions as an arrhythmia patient, one without an ICD.

Question 1 is difficult.  You need an explanation of why exactly the consultant questioned the safety of running?  As an arrhythmia sufferer I know that exertion, particularly in the presence of an active arrhythmia can quickly cause worsening symptoms, like breathlessness, chest pain as I fight to maintain a good level of activity.  Exertion can trigger a fast, irregular arrhythmia, so I have to listen to what my body is telling me sometimes.  If I do not have any difficult symptoms I may continue to push but at the first signs of trouble, I would tend to slow down or even stop my activity.  Not perhaps what you would want to hear?

I would want to know why you had another shock, whether it was for a dangerous ventricular arrhythmia like sustained VT or whether you received an inappropriate shock, perhaps for a less dangerous atrial tachy arrhythmia?  You need to speak to your doctors to ask what arrhythmia was seen and what therapy was given?

Question 2 it seems obvious but you should go by how you feel.  Clearly if you feel stable after a shock, then a gentle walk should do no harm, but this too is a question for your doctors who will know you best.  There should be a clear plan, clear instructions of what to do in the event of a shock and I sense that none is in place from your questions.

Question 3 there are many effective anti arrhythmic and rate control meds that can be given to prevent or to control an arrhythmia and again you need to speak to your doctors about this, since prevention must clearly be better than treating by shock therapy?  It may also be possible or necessary to make some adjustments to your device settings, depending on what caused your shock.

I send my best wishes to you and hope that you will get some answers and that you will be able to continue doing what you love

Exercise following a shock

by Wings - 2024-02-11 12:52:21

Thanks for your response Gemita.

I think it was a genuine attack and not an inappropriate shock (due to the breath seeming to catch in my throar both times, before and after the ICD insertion) but will no doubt find out this week.

It does look like I may have pushed myself to soon in the recovery from the first incident but like that incident there was no warning, no gradually struggling to breathe just a catching of a breath one moment  (feels like its caught in your throat) and this time, the defib going off.

I hope to get more answers this week to many of my questions from the pacing team (fingers crossed)

Exercise following a shock

by Wings - 2024-02-13 07:38:44

Hi all

Quick update. 

Saw the cardio team and it was a cardiac event and not an inappropriate shock.

Seems I went from 130bpm to over 200bpm very quickly so no real notice and no time to do anything to stop it happening. 

Waiting now to speak to the cardiologist consultant but got the feeling that my running days might be over (as running at 130bpm is nothing exceptional and well within normal limits but does seem in my case it may trigger an irregular rising heartbeat and therefore the defib)

Will update after speaking  to the cardiologist consultant. 


How to exercise safely

by Gemita - 2024-02-13 10:50:04

Thank you for the update Wings and I hope you will have a helpful discussion with your consultant as to how best to proceed?

When one door closes, another always opens but it may not necessarily mean that you have to give up running completely, especially if you can get your arrhythmias under better control which would help to “prevent” a future shock.

When you see the consultant, you could always ask about seeing a cardiac nurse/therapist who could guide you through an exercise routine and teach you how to safely pace yourself.  I recall when my husband was recovering from coronary artery surgery, he went on a programme of cardiac rehabilitation.  It was excellent and he was able to build up strength and confidence.

Keep your spirits up.  Life can still be good 

Exercise safely

by Wings - 2024-02-13 15:22:51

Thanks Gemita.

Your right, I need to find out what exercise I can safely undertake as there is a lot of conflicting information out there.

Let's see what the consultant advises.

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