Suggestions for rate response setting?

I was feeling like I couldn't "get out of first gear" when I was exercising, so the doctor reset the rate response on my Medtronic. I felt some better but asked that it be reset again and that was a mistake that made my resting RH stay at around 90-100 and I think screwed up my blood pressure too. Anyway, they reset it higher and I feel much better. However, now that I have been monitoring my blood pressure and heart rate I have noticed that something like washing the dishes will make my heart rate rise to 90-100. It will return to 60-70 when I rest quickly and I feel okay, but my question is: for my long term health wouldn't it be best to have to exert more in order to raise my HR? I would rather "have trouble getting out of first gear" and be healthy, but I am not sure what difference this makes. Thanks in advance for any advice and/or comments.

Wantok

7 Comments

Dr.T

by DR.T - 2012-02-22 01:02:01

I implant different pacemakers and there is one company which has the most physiologic response to speed up and slow down your heart. It will match your needs to the best heart rate for the individual patient. Almost always, after we turn on "CLS" from Biotronik, we don't have to make any more changes to the sensor. Patients usually love the result and they don't have to come back for re-adjustments.
Best wishes.

Another plug for Biotronik

by IAN MC - 2012-02-22 02:02:56

Hello Dr T ..it is good to have on board somebody who tells us that they implant pacemakers. I remember you sent a similar comment some time ago recommending the same company. Could you please re-assure us that you have no commercial interest in this company.

If you don't, could you please give us an independent comparison of pro's and con's for the various makes of PM

Thanks

Ian

Similar

by Peg541 - 2012-02-22 10:02:34

I am new to this and for my first interrogation they added rate response on my Sorin pacer. Every time I moved it ran my heart rate up to 92, even during sleep. They had to turn it off. I don't need it yet. My heart will go up with exercise but I do understand it would give me more energy to have the increased heart rate.
They said I was too sensitive to the rate response. Now does that mean the lead is in a bad place? The pacer is wrong or just I am too sensitive? Not sure but since I don't seem to need it I am ignoring it for a while.
I will ask next time I am interrogated

So this sounds similar to what you are going through. Maybe one of the more seasoned members here can respond and help.

Maybe try it without the rate response for a while and see? I see you did that already. It may just be too much for you too.

Good luck
Peg

Adjusting Rate response

by ElectricFrank - 2012-02-23 02:02:32

Medtronic has a software program that can adjust the rate response while you walk on a treadmill. Ask you doctor about having the Medtronic rep run the adjustment for you.

As for the CLS" from Biotronik" that Dr T mentioned, I'm not familiar with it. With all the work being done in making pacers more adaptive, I'm not surprised that there are makes and models that are best for certain needs.

In your case where you already have a Medtronic pacer it makes sense to keep it and make the necessary adjustments. When you get nearer to replacement time it makes sense to consider a pacer that matches your needs.

frank

Rate response and health

by wantok - 2012-02-23 08:02:15

Thanks for the comments, but my concern is a bit different. I feel fine now. My question is what is best for my long term heart health? (My current response rate setting does make my heart respond much more quickly than it did before my pacemaker, but I am wondering if it matters. Isn't it true that having the heart respond less or work less is better, or isn't that why they always say people with lower heart rates are healthier?)

Effects of HR

by ElectricFrank - 2012-02-24 12:02:08

I doubt anyone really knows. In a normal person without a pacemaker resting heart rate will ideally be at a level that just supplies the necessary blood volume needed. That is a function of the hearts stroke volume and HR. So theoretically a lower HR means that the persons heart has a higher stroke volume (less beats at a higher volume/beat) which would seem to be a better situation. Looking at it this way resting HR is an indicator, but not the cause of a healthy heart. So if our pacer causes the heart to beat a bit faster it would have little or no impact on the heart.

Of course if we are dealing with a failing heart that isn't able to handle the excess HR things would be different.

Just some thoughts by an engineer that looks at pumps in a different way!

frank

EP comment

by wantok - 2012-04-20 02:04:47

Frank,

I asked my EP this question and he basically said it's up to me and whatever feels best. So that would more or less confirm your comments.

Thanks all for chiming in. I find this forum enormously helpful.

Wantok

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