One year

Hi,

My first year has gone and I'm going for the first big check up. I make lots of outdoor sports and I don't have any problem as long as I keep my HR lower than 180. If I'm trying to go faster than 180 I miss beats. Then I need to stop for a while, otherwise my rate goes down to 100. I don’t know exactly the reason for that (?). Do you have any idea?

Although 180 is quite high, I would like to have no upper limit (my PM is a consequence of a complete AV block after an ablation, so no reason to worry about higher rates), but I don’t know if there is an upper limitation due to the PM (I have a Medtronic Kappa 703KDR). Any idea?

Any suggestion or thing to worry about? Would you ask for any particular thing?

Thanks a lot,

7 Comments

Upper limits

by harley63 - 2009-06-08 09:06:43

E from Spain~

I have pacer for heart block as well for the past 2 1/2 years. The past 6 months I've increased my physical exercise. The Medtronic tech suggested that the upper limits be set at 200bpm. It's been at that for 2 months with no problems. I still have the extra beats that I had before the upper limit was raised. So I'd not feel that they are related to my exercise routine, as they happen when I'm sitting calming in meetings at work as well.

You probably will need to discuss your thoughts/concerns with the PM tech and MD's to get the proper settings for your body. They certainly can be raised and lowered to fit your lifestyle.

Take care.
Harley63

Questions

by J.B. - 2009-06-08 10:06:12

Howdy E,

I'll make a couple of comments. One, 180 BPM is awfully fast and has to be putting stress on your heart. Can't you slow down a little? Anyway, unless you have a pacemaker with rate response the pacemaker is not making your heart beat that fast. So talk to your doctor about this.

As for the skip beats that could be your heart saying "I'm tired, let's slow down a little." Your pacemaker will not prevent skip beats at any heart rate. I have them and my heart rate is in the 70 range. Also, your pacemaker will not prevent PVC or PAC which are sometimes mistaken as skip beats. You may want to have a discussion with your doctor about this also.

Good luck,

J.B.

same

by Kirsty - 2009-06-08 12:06:15

I also have complete heart block. I got my pacemaker about a year ago. My heart also goes quite fast and they had to raise the upper limit - but then again I am only 16 so they may have chosen different settings. If your rate exceeds the limit then the pacemaker will stop pacing it and it feels like your heart is skipping a beat.

I don' t know whether it is the same with you, but if it bothers you ask at the pacing clinic if you can raise your upper limit.

k

Simple Reason

by ElectricFrank - 2009-06-09 01:06:02

The pacemakers upper ventricular limit in your case is set to 180. This is supposed to limit the maximum HR. It does it by skipping beats. So when your HR goes down to 100 it is actually only pacing every other beat, and your real rate is 200.

Like Harley63 mentioned you might ask them to set the upper limit to 200 so long as you are young enough and your heart is otherwise in good enough shape to handle that rate.

I am 79yrs and have my upper set to 150bpm. This is well above what the upper target is for my age, but I don't push it that high. I just want the pacer out of my way. Actually, the skipped beat method of enforcing the upper limit is not physically a good thing. About the time our body needs the increased blood flow the most the pacer puts on the brake.

frank

Thanks

by E from Spain - 2009-06-09 02:06:34

Thanks for your answers,

I'll do as you suggested. I'll ask to set the limit a bit higher.

For two years I was training hard to climb one big mountain in the Himalayas. So I know that my heart is able (or was two years ago) to make constant effort beating between 210-220 bpm for more than 45 minutes. Anyway, my doc was not happy and he told me that having more than 210 at my age was not good (I’m turning 37 next August).

After the PM implant he told me that it was a good moment to avoid those high rates “teaching” my heart to beat a bit slower for the same kind of exercise. I guess that’s the reason for the upper limit at 180 (?).

Probably is time to talk with him again and “negotiate the upper limit”.

Only one more question, do you know the limitation of the PM?

Once more, thanks a lot and take care,
quique

Good idea

by E from Spain - 2009-06-11 06:06:14

Thanks once more,

My cardiologist agreed with you and I have an appointment in two weeks. I'll let you know the result of the test.

quique

Upper limit

by ElectricFrank - 2009-06-11 12:06:12

I don't know what the maximum setting is. It might be possible to turn off the upper limit. The only real reason for it is if you have some kind of a problem that causes your HR to go high without exercise.

One way to deal with the cardiologist might be to ask for a treadmill test. That way they could watch your heart while you pushed it to an upper level to see if is still capable. One of the things that happens as we age is that the heart conduction system takes longer to recover between beats. If the time between beats is shorter than that it can cause problems. Also, leave some head room to compensate for the lower oxygen pressure at high altitudes.

Have fun,

frank

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