janet's questions

Ok, I feel like an idiot. Maybe some of you can educate me further. My upper rate is 130. That's all the programmer said. This is my 2nd adustment is pm surgery 6 wks ago. It's was given for a 2nd degree block in my ventricle (right one). Question: does rate mean pulse? TraceyE, they set yours to the max of 160? Is this your pulse during a work out? Is this setting hard on your heart? Or does it just give you the capability of exerting yourself better w/o getting SOB? I'm 55yo and work hard on a farm. Still can't push myself w/o getting tired too easily. Do you think it has something to do with my upper setting at 130? And Frank, thanks for your input. I'll be getting that pre and post info too.

2 Comments

settings

by Tracey_E - 2008-09-01 07:09:43

You are not an idiot, you're just new at this! So many doctors don't take the time to explain anything. I was diagnosed in 1970 and got my first pm in 1993 so I've had a few more years than you to do research and ask questions :o) And I'm not so good at explaining things so tell me when I don't make sense!

If you have a block, your atrial rate is more or less normal. As you exercise and work hard on your farm, your atrial rate goes up with your need for more oxygen, as it would in a heart with a normal rhythm. The atria is the brain and the ventricle is the brawn- the atria senses you need more oxygen and tells the ventricle to go faster (when your hr goes up). The signal from the atria to the ventricle is blocked for us, that is when the pm steps in and makes the ventricle beat.

The upper limit is not your hr all the time, it is the fastest hr the pm will let you have. If you are set to a max of 130, the ventricular lead will only keep up with your atrial rate up to 130 bpm no matter how fast your atria is going. If you are very active, it is likely that your atrial rate is getting higher than 130 (because it is normal and not pm dependent). Your heart is trying to go faster than 130, the ventricle isn't getting the message to do it on its own (that's the block) and the pm isn't doing it because it's not programmed to. That makes you sob, you're being blocked from going higher.

It really sounds to me like you need that upper limit to be higher. Mine was not bumped up to 160 overnight, it was done in increments, and being sob and getting tired easily were the symptoms each time. I get in the 150's when I work out (they found this out by doing a stress test) that's why they set me to a max of 160, it's just a bit higher than I need. No, it's not hard on my heart, it just means I work out hard.

Don't be concerned that they've adjusted it twice and it still isn't right. Those of us who are active make the pm work a lot harder and the "normal" settings are often inadequate for us. They like to make changes a bit at a time, so it may take a few tries to get it just right for you.

Heart Rate

by BOB 1 - 2008-09-01 09:09:12


Janet,

There are two set points on our pacemakers. A low and a high. My low set point is 60 and the high is 120. This means that my pacemaker is supposed to keep my heart rate form going below 60 beats per minute. And when my heat rate exceeds 120 beats per minute, say when I'm excerising, the pacemaker quits assisting but continues to monitor my heart rate and will step in to help should it think it is needed.

The doctor selects the lower and upper set points based on what he knows about the patient and their heart. It sounds like you may need to talk to our doctor about your settings and let him explain the why and what for before making any demands on what you think you need.

Bob

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