Restrictions - living with a Pacemaker

Hi.

I have a couple of quick questions.

I'm 24, and have recently received my first pacemaker for Neurocardiogenic Syncope. All's going reasonably well, with a good report after my first check-up only a few weeks ago.

I have been trying to get more active, and resume normal exercise (swimming, joined the gym, walking etc). Last weekend I went up to Mount Kosciusko (largest mountain in Australia), and after leaving the chairlift to start the walk, I had difficulties breathing and a painfully pounding chest. I ended up collapsing about 500m into the walk, needing about 20mins to stable my breathing before I could get up again. I guess this was the altitude more than anything, but just wondering if this is a normal reaction for pacemaker patients?

Also.
With one of my jobs, I’m a "pokie technician", so work with and service pokie (slot) machines. I was just wondering if these produce EMI or affect the pacing, or functioning of my pacemaker? I’ve tried searching details on the manufacturers websites, with no luck.

If there is anyone that could shed some light on either of these topics, that would be greatly appreciated.

I was also wondering if there are any particular website, publications, journals etc, that gives a detailed, concise and understandable guide to living with a pacemaker. I can find snippets of useful information in amongst very blaze editorials, although nothing that really gets into the “hows”, “whys”, and explains the “whats”. I’m after something that explains things medically, both about living with a pacemaker, and also anything that could be condition specific….there seems to be shortage of information – or am I not looking in the right places? Any other information (medically, or support-type) that goes into detail about living with the condition or the pacemaker would also be appreciated.

Thanks so much.

Lyds

8 Comments

high altitude

by thomast - 2009-04-18 02:04:59

I don't know how high you were, but if I get over 4000 ft I have problems. It is not the PM, just the condition of my heart. I now live at about 450 ft, so no problem except when I travel. Good thing I no longer live in Colorado, I lived at 5000 ft there and had a small cabin in the mountains at 8400 ft. We are going to SEattle the end of May. Have to go the long way down thru El Paso and up the coast, as cannot go over the mountains, the way we used to.

Mountains

by bowlrbob - 2009-04-18 07:04:05

I have the exact same thing you do. I have NCS with Bradycardia. About 6 or 7 months after implant I went to Virginia City in Nevada it is about 8000 ft. I live at 1300 ft. It bothered me while we were there. I got short of breath and tired easy. But just after i had the PM adjusted to help with the NCS. My EP turned me up to 70 BPM all the time. I have been back there and to the Volcanos in Hawaii. Ihave had no problems since the adjustment. So talk to your Dr. Bowlrbob

information

by Tracey_E - 2009-04-18 08:04:59

I don't know how high you were when you were hiking but if it's the highest mountain in the country I'm guessing it was pretty high! It is perfectly normal to have breathing problems at high altitude. I don't think it has anything to do with the pm, every person reacts differently to it. I live at sea level so it's a huge change when I visit my parents, who live at 7500. I chill the first day and am very careful about hydration, by the second day I'm ready to ski or hike (depending on the season!). I've never been able to acclimate to anything over 10,000 but we have members here who live and hike much higher than that.

I've never heard of slots causing problems. Do they have magnets in them? Magnets are the main issue for us. if you are around them and feel fine, odds are excellent it has no effect.

Manufacturer's websites are the best place for the technical info. Someone here recommended a book that was great for explaining about them but I can't think of the name. I will ask her, or maybe someone will jump in with the name sooner.

Read through the old posts and FAQ's here, it's one of the best resources on coping that I've ever seen. We have some very knowledgeable members here and a lot of wonderful support.

book

by Tracey_E - 2009-04-18 10:04:16

The book is "The Nuts and Bolts of Cardiac Pacing" by Tom Kenny

Altitude

by ChicagoKim - 2009-04-18 10:04:41

Hi Lyds,

I've been talking to a friend of my in-laws as he's had 6 pacemakers over the years, and I will be getting one in the next month or two.

He said that the only problem he's had over all the years is when he was up in the mountains in Peru many years ago. He said the altitude was really a problem. He had to come back down to sea level to get it straightened out. He said that his doctor had scaled back on the amount of voltage that his PM was using so he could get more time out of the battery and not have to replace the PM as soon. This wouldn't have been a problem at sea level, but was a problem when he was up high. So they readjusted the voltage on his PM and then he went back up and was fine.

Maybe you could ask your doctor and the manufacturer about it.

Kim

Altitude effects

by ElectricFrank - 2009-04-18 11:04:26

There is nothing about the pacemaker other than the adjustments that are sensitive to high altitude. Just keep in mind that there is some reason that you need the pacer which indicates that your heart isn't what it used to be. If the condition results in lower than normal cardiac output and you push it at high altitude, your brain just doesn't get enough oxygen.

A couple of years ago I rented a Jeep in Colorado and went over a 13,000' pass. At the top I hiked another several hundred feet up to a lookout. I got winded a bit quicker than down here at 2500', but so did my non pacemaker friends.

One trick is to avoid the "shortness of breath" feeling. It actually results from anxiety when we get a bit short of oxygen or long on carbon dioxide. I joke with my friends that I get "long of breath". When I start to have that SOB feeling I deliberately breath much deeper, and generally the feeling vanishes. This won't overcome an actual cardiac limitation though so respect what your body is trying to tell you. I'm coming up on 79yrs and realize I'm not going to be able to do this forever.

frank

This Might Help (a bit)

by Pookie - 2009-04-18 11:04:55

I'm pretty sure I found this on the Medtronic Website:

Now that you have a pacemaker (or soon may get one), you may be wondering why you need one and how a pacemaker works. Your artificial pacemaker is a modern marvel; it's medical science's solution to the electrical problems of a slow or irregular heartbeat. But before you can understand how your pacemaker works, you first need to know a little about your heart. Basically, your heart is a pump made of special muscle. It pumps blood to all your body's cells. This is vital, because the blood carries oxygen and nourishment to keep your cells alive and healthy.

Your heart beats (pumps blood) because special cells in your heart (the heart's natural pacemaker, called the sinus node) produce electrical impulses. These cause your heart to contract and pump blood. The impulses travel from the pacemaker cells down certain electrical paths in the muscle walls, causing a contraction. As long as the electrical impulses flow down your heart's walls at regular intervals, your heart pumps at a rhythmic pace. Sometimes, though, something happens to interfere with how the electrical impulses of your heart's natural pacemaker are made or flow down your heart. When this occurs, the natural pacemaker can't do its job as well as it needs to.

Problems that change the heart rhythm include:

A complete block of the heart's electrical pathway
A slow beat
An irregular rhythm

If you have a slow and often irregular heartbeat — or if your heartbeat is sometimes normal and sometimes too fast or too slow — blood isn't pumped around your body well. In that case your doctor may recommend an artificial pacemaker. A pacemaker will make your heart beat more regularly. That will help ensure that enough oxygen and nourishment gets to your body's cells. An artificial pacemaker system has two parts: a generator and wires (leads).

The pacemaker generator is a small battery-powered unit. It produces the electrical impulses that start your heartbeat. The generator is implanted under your skin through a small incision. The generator is connected to your heart through tiny wires that are implanted at the same time. The impulses flow through these leads to your heart and are timed to flow at regular intervals just as impulses from your heart's natural pacemaker would.

Modern pacemakers last much longer than earlier models. As with any electronic device, your artificial pacemaker will require some care. The batteries, for example, will wear down over time and the pacemaker will need to be replaced. This is a minor surgical procedure. Your healthcare provider can explain it to you. (I personally don't know if I agree with these 2 last statements!!)

Most pacemakers work only when they're needed. They're called demand pacemakers. Demand pacemakers have a sensing device that shuts them off if the heartbeat is above a certain rate. When the heart is beating slower than the pacemaker rate, the sensing device turns the pacemaker on again. In this way, a demand pacemaker works something like a thermostat. The difference is that instead of working according to temperature, it works according to your heart rate.

As the batteries wear down, your pacemaker will slow down, but it won't stop right away. Using a special analyzer, your doctor can detect the first warning that the batteries are running down. This can be done before you can detect any changes yourself. A sudden, major slowing down of your heart rate, which you may detect, probably indicates a more serious problem. If that occurs, call your doctor

Good luck in your search for answers and please share if you find anything, because like you, I like to know ALL the "whys" too.

Knowledge is Power!

Pookie

Thanks

by Lyds - 2009-04-22 06:04:47

Thanks guys....all very helpful.

Possibly i should just give the hiking a miss for the time being !!

I'll have to look into those books. I have trawled the medtronic booklets and such, but no information of much substance stood out to me.

Thanks again

Lyds

You know you're wired when...

You always have something close to your heart.

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