how does it know?

I had a pm fitted about 3 weeks ago because I have a total heart block and my heart beat had dropped to 35, and I still have another 3 weeks to go before my check up.
This may sound like a silly question, but.... How does the pm know to increase the heart beat if you do any exercise or dance? Can it?

7 Comments

It's Magic

by jhull413 - 2010-11-16 03:11:05

It must be magic...no seriuosly, mine is a Medtronic Adapta model and has sensors to detect motion and respiration. I know an accelerometer senses motion and vibration but am not sure how respirations are detected. There is a sensitivity adjustment that can be made. I have had mine about three weeks and haven't had the first adjustment yet. I notice when I drive over bumpy pavement, my rate increases. The sensitivity on mine probably needs to be adjusted, but I hope they don't change it too much. I would rather have a fast rate when I don't need it than a slow rate when I do.

Rate response on

by Hot Heart - 2010-11-16 05:11:20

If your RR is off, then the pm only stops your heart from dipping to dangerous levels, if it's on it gives it a bit of a helping hand.

Thats my theory! If I'm wrong someone will come along and say so.

HH

pacing with heart block

by Tracey_E - 2010-11-16 06:11:22

Rate response is for people with atrial/sinus problems, so the above answers don't really apply to you. When we have heart block, our sinus node- our natural pacemaker- works just fine and our rate goes up and down normally.

Think of the atria as the brains of the heart, it senses oxygen levels in the blood and raises/lowers our rate accordingly. The ventricles are the brawn, they are strong enough to make the contraction we feel as our pulse. The atria tells the ventricles when to beat but that connection is messed up when we have heart block so the ventricles either always or sometimes do not get the signal so that's why we typically have a low pulse.

The pm watches for the atria to beat. If the ventricle doesn't immediately follow with a beat, the pm will generate one. All it's doing is completing the broken circuit and keeping the heart in sync so we have a natural rhythm. Before the pm it was either occasionally beating in sync with the atria, or more likely, just beating at random. The definition of complete block is the signal never or almost never gets through.

Something to keep in mind if your heart jumps up for no apparent reason, sometimes they leave rate response turned on whether we need it or not on the assumption we don't need it. If we don't need it, it's best to turn it off because sometimes it'll kick in on things like bumpy roads when we don't need it and it's annoying. Harmless, but annoying and easily fixed. You can use Smitty's test to see if yours is on.

jhull413, if your rate is going up on bumpy roads, that's almost definitely rate response kicking in. It has a variety of sensitivity settings and may take some fine tuning to get the right balance between going up when you need it and not shooting up every time you sneeze or drive over a bump. Tell them when you have your next check.

Fasinating

by Larrie - 2010-11-16 07:11:23

Oh wow, thank you so much for the infomation,I never knew it could do that. So I should, in theory, be able to do most anything, dance, run, climb etc and I don't have to worry............oooh I can't waite to tell my friends to stop insisting I stop lol

go for it!

by Tracey_E - 2010-11-16 09:11:44

As long as you feel good and your dr cleared you for activity, you should be able to do whatever you want! I have friends like that, too. I just smile and keep going. It took a long time for my parents to see that I truly feel great and can do whatever I want, I guess to them I'll always be that 5 yr old with the heart problems. I hike, ski, rollerblade, had two babies with my pm. We've had members hike over 14,000 feet, participate in triathalons. There have been pm recipients in the Olympics.

A VERY common problem that young active people run into with their pm that you should watch out for is hitting the upper limit. The pm is only going to pace us as fast as that limit is set to go and it's often set pretty low when we first get them, 120-130 is average. That means if you go for a run and your atrial rate goes to 150, the pm will only pace your ventricles up to 120 (or whatever it's set to). It's a simple thing to reprogram it. You'll know immediately if it happens, dizziness and fatigue are pretty sudden and severe. So, if that happens, don't worry that something is wrong, just ask to be checked and question that upper limit.

And if you have questions, there are a lot of us here who have been there, done that, so feel free to pick our brains. :o)

Roller coasters

by Larrie - 2010-11-17 01:11:11

I live in Blackpool Uk, home of the pleasure beach, filled with the roller coasters etc I love, what will be the situation there?

still go for it!

by Tracey_E - 2010-11-17 03:11:48

I'd give it at least 6 mos, a year is best, for the leads to settle in good, but we have members who go on roller coasters and have no problems. Me, I hate them and use the pm as an excuse LOL

The only ones to avoid are the new ones with the magnetic brakes. They really mean it when they have a sign that says no pm. The rest are fine, have fun!

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