Rate Response ..another question

Hello
I had a PM fitted 10 weeks ago to treat Sick Sinus Syndrome.It appears to be working OK and kicks in at 50bpm which prevents the dizziness and fainting which I previously experienced.
......but, as a runner, I am finding that I become far more breathless after about one mile than I used to.

The Rate Response is switched off; in the words of the cardiac technician " You're a fit guy, you don't need it ! " but ( and I now realise that I don't understand this ) I was told that the upper PM setting is 130bmp. What does this mean if the RR is switched off ??

Also an observation, rather than a question , Electric Frank ( or was it Smitty ? ) have reminded us in past messages that there are hundreds of different combinations of PM settings.
It is possible that minor tweaks could make many of us feel so much better. It seems that trial-and-error is the only way to find out. I intend pestering the PM clinic time and time and time again to experiment with these settings until I find one that is perfect for me.

As to whether or not this is possible to do here in the UK , only time will tell !

Best Wishes

Ian

3 Comments

Rate Response

by SMITTY - 2011-11-06 05:11:35

Hello Ian,

I just commented on a question by Noelp (right above your question) about the upper set point on a PM. Some of that comment may apply to your question.

But to be a little more specific, the upper set point on a PM is independent of the rate response set point. Or put another way, the RR is a separate function of your PM and while it must have the other parts of the PM to do its job, the other parts of the PM do not need the RR to do their job. If you are becoming more breathless while running it is entirely possible your PM also needs tweaking.

As for the number of possible PM settings combination, I recently read an article by a Dr that said there were more than a million possible setting combinations on a PM. But fortunately only a small percentage of those possibilities are ever needed. When I read that the thought went through my mind that I should never P-Off the nurse/technician doing my checkup. In fact maybe I should even consider taking flowers or candy to them when I go in for a checkup to help keep them in a good mood. Because I know they have the ability to create a world of discomfort for me during one of the checkups. Just kidding. I don't really think one would ever purposely do anything like that.

Good luck,

Smitty



A Question

by donr - 2011-11-06 06:11:18

Ian, does your heart increase its rate when your body demands it?

If your heart naturally increases under demand, something needs tweaking.

If not, it means that you would need the RR function turned on & tweaked. One of the purposes of the RR is to cover for a malfunctioning sinus node that doesn't incrfease its rate when needed. What were the characteristics of your SSS? It's one thing for your PM to kick in if your SA node drops below 50. That doesn't tel us what happens AFTER it kicks in.

One of the aspects of having a complete SA ablation is that there is not only no way for the heart to beat on its own through its normal functioning, there is no way for the heart to increase the rate under increased demand.

Don

Thanks

by IAN MC - 2011-11-08 05:11:16

Thank you Smitty and Don for your replies.. I now have a clearer understanding ( I think). Although I've had an ablation my sinus node is still functioning in that my heart is still naturally increasing on demand ..I will find out if PM tweaking can improve the increased breathlessness on high exertion.
If I can't move in the PM room because of all the boxes of candy and flowers I will know that you have been there Smitty
Best wishes to you both Ian

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My cardiologist is brilliant and after lots of trial and error got me running. I finished this years London Marathon in 3hrs 38 minutes.