how do i know what settings i have?

OMG! I am so scared. I haave had my PM for just over a week. First time ever and I just happen to find this website. The more I read others posts the more questions I have. I know my PM is rate responsive and dual chamber. I don't know what all this setting stuff means. All I was told was its rate responsive and it won't go above a certain amount or ever drop below 60. Does this mean that if my high is 150 then my pulse will not go above that? I want to try to get back into my workout routine and my target heart rate is around 160-170. Which I usually had no problem reaching before the PM I could get my heart rate up to between 160-180. How will this affect me. I am so confused. My drs main concern was my resting HR staying at 40 or below. Can the settings be for blood pressure also? I am asking this because I read it on some one elses post.

So far my resting HR is about 62-65 but once I get moving even just to walk through the house it can get up to 100 or so very easily. Is this good or bad? I have so many questions I hope I don't drive any one crazy.

4 Comments

? About New OM

by SMITTY - 2010-07-16 02:07:56


Hi Stacey,

First, let me say I haven't read the other comments yet so if what I say contradicts some of their information, forget what I say.

Second, get over your fear of the pacemaker. I know that is easier said than done, but believe me, that pacemaker is not going to fail and it is not going to do anything crazy to up set your heart function. All it does is monitor your heart's natural pacemaker and when it fails to keep your heart rate at the low setting on the manmade pacemaker it will come in and send the impulses necessary to make your heart beat at that rate. Or, say your heart is chugging along at 80 BPM and for what ever reason your heart's natural pacemaker fails to send an impulse to make it beat, the manmade PM will send the necessary impulses.

Let me back up here and talk a little about pacemaker settings. There at least a million possible settings combinations on our pacemakers. More than 99% percent of those settings were established at the factory and will never be changed. The settings the patient will be most familiar with are the low and high settings. There are also settings for the rate response part of your pacemaker and I will say a few words about that later.

Based on what you say about your heart rate (in the 40s) before you got the pacemaker and finding your resting heart rate at 62 to 65, I'm going to venture a guess that your low setting is 60 and the upper setting is 120 to 130. Of course your doctor can tell you what your settings are and why he chose those particular numbers for you. But in the meantime let's say you settings are low of 60 and high of 120. What that means is your pacemaker will send the necessary impulses to keep your heart rate at 60 BPM and if your heart's natural pacemaker takes it above that level the pacemaker will continue to monitor the rate and send impulses as necessary until your rate reaches the upper set point. When that upper sent point is reached the PM becomes a spectator. By that I mean it will continue to monitor your heart rate but will not send impulses until your heart rate drops below the upper set point. One other thing here. You say you found a resting heart rate of 62-65. If the low set point is indeed 60 you may wonder what is going on. Well, trust the PM to know what it is doing and the discrepancy in HR is probability due to your inability to get an accurate HR count.

For example with a low setting of 60 your heart would beat every second, but if you are counting and you count your pulse for 15 seconds and then multiply by 4, if you miss a beat or start your count right after a beat was completed and you could count 14 and that means you will get a 56 for a heart rate. Same thing goes for the electric devices that give the heart rate.. It counts heart bats for X number of seconds and computes your heart rate based on that number. It can miss a beat the same as you do. I always figure that if I get a count that is plus or minus 5% of PM settings, that is close enough.

Now a word on the rate response. When your physical activity increases the rate response knows this and will increase your heart rate to its upper set point which may or may not be the same as the upper set point on your pacemaker. It is usually higher. When the HR reaches that upper set point the rate response stops helping and also become a spectator waiting to see if HR drops below its set point and when it does if it thinks you activity warrants a higher rate then it comes back on line.

Rate response has a "wait and see setting." By that I mean it will wait for X amount of seconds before it starts to increase your heart rate. That way, say you jump over a mud puddle, that may be enough activity to start your rate response, but with its time delay feature it will not increase unless you are jumping mud puddles or running, or doing whatever for some amount of seconds. The delay on my rate response is about 20 seconds.


As for your exercise target HR of 160 to 170, check with your doctor to see if this is a safe rate for you. Your rate response can be set to that level if the Dr thinks it necessary, or it can be set lower. If the rate response is set lower that means it will not help your heart rate get that high, Neither will it interfere with your heart's natural pacemaker taking it to that level.

One last word. The important thing to remember about your pacemaker is that it is nothing but a helper for your heart's natural pacemaker. It is programmed to know when to help and when to be a spectator. Some times some of that programming has to be changed, but that is no big deal. So enjoy your pacemaker and just think of it as the little electronic device that makes you a first cousin of the Energizer Bunny.

I wish you the best,

Smitty

re how do i know what setings I have

by davmilb - 2010-07-16 03:07:27

I have had my PM for 6 months and had similar pre and post Heart Rates (I have run a number of marathons). At my most recent check the cardiologist cut the maximum rate back to 135 from 160 and slowed the "climb" rate. It now takes longer to reach my maximum of 135 (although my HR will go up to 160 on fast work) and the recovery rate is down to 110 after 2 minutes. I would still prefer my heart to find its own "cruising" pace but will discuss this with my cardiologist at my next visit. My previous 2 min Recovery was around 50 a far cry from the PM assisted rate. David, Australia

settings

by Tracey_E - 2010-07-16 08:07:05

You can find out what your settings are by asking for a copy of the report they do when they check it. If you post the numbers here, we have a few guys who can explain them to you.

Rate response means your pm is sensitive to movement and senses when you are exerting and raises your hr for you.

Dual chamber means you have an atrial and a ventricular lead. This is standard. Even if we only really need one (for you, that would be atrial), the other provides information so the pm can work better.

Upper limit is how high the pm will PACE you. Your heart can go as high as it wants on its own. When you have a problem that uses mostly atrial pacing- such as SSS- your upper limit is more or less irrelevant. Lower limit is the one that affects you, the setting that makes sure you never get below 60.

A pm cannot be set to control blood pressure. All it can do is add beats.

TracyE

by stacykay1 - 2010-07-16 12:07:19

okay...great! Thats what I thought. So maybe I read someone elses post wrong it seemed as if they were talking about blood pressure.

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