fast heart rate

My pm is set from 50 to 130. I do not have a rate response, it is something else which I don't really understand.
I have gone back after 3 weeks to exercising, by climbing 188 steep steps as fast as I can. I felt almost as if I was in A Fib as my heart started pounding. At the top of steps I took my pulse for 15 seconds and it was 44, which means it was about 170+ for a minute. It slowly decreased on resting. My question is how can it go that fast when pm is set to a max of 130? Any suggestions would be welcome. Thanks.
Alma Annie.

8 Comments

Climbing stairs

by golden_snitch - 2014-07-01 03:07:19

Hi Annie!

I'm sorry, but I don't understand this sentence:

"At the top of steps I took my pulse for 15 seconds and it was 44, which means it was about 170+ for a minute."

Do you go into 2:1 block at a certain rate, if so then why the 44? It should have been 85bpm.

Also, a heart rate of 170bpm when you have just climbed 188 stairs as fast as you could is, in my opinion, pretty normal. Maybe an atrial rhythm kicked in, and made the rate speed up? If you don't have a heart block, the upper rate of 130 can easily be exceeded by any intrinsic rhythm.

I read somewhere that you said you were paced 100% in the atria, but in that case you most definitely have the rate response switched on. Otherwise, you'd only be paced in the atria when you are at rest and the rate goes down. But even if the rate response switched on and limited to 130bpm, it can still happen that an atrial rhythm (atrial tachycardia) kicks in and makes the heart beat faster.

Best wishes

Inga

heartrate

by Alma Annie - 2014-07-01 04:07:20

Now I am not sure I understand you about a block. (I am still a bit dumb on these things!) The EP told me I don't have a rate response on my pm. Don't know any more than that. My heart rate went up to 170 a minute, but I only took it for 15 secs, like we used to in the "olden days" of nursing, then you multiply it by 4. I always take it when I have done exercise like that just to see how fit I am getting. I am not concerned as I felt ok, although it did feel like the A Fib I used to get. Yes I am 100% paced in atrium, as EP totally destroyed sinus node to get rid of persistent A Fib. Thanks anyway
Alma Annie.

I don't seem to know much

by Alma Annie - 2014-07-01 08:07:09

Thanks for your comments. Yes my pulse was 44x4 All I know is that my cardio/EP is friends with a son of mine who also works in cardio. EP has always phoned son to tell him what he is going to do, then tells him what he has done. THEN son tells me. It was so frustrating that I had an argument with EP about him not telling me things. Son said the EP had 'totalled' sinus node. I Was 95% paced before and now 100%. Since I already had the pm after 1st ablation he could really work on the 2nd. So I really don't know any more. I am not concerned, I just wondered how HR could go so high, and yes it did feel like A Fib, but I am ok.
Thanks again
Alma Annie.

Inga

by Tracey_E - 2014-07-01 10:07:48

I think she meant she counted for 15 seconds, so her pulse was actually 44 x 4

Annie, it won't PACE you that high, but your heart can go as high as it wants on its own. As Inga said, that sounds pretty normal to me for having run up stairs.

Thanks, Tracey!

by golden_snitch - 2014-07-01 12:07:07

Okay, now I get it :-) Probably didn't understand this at first due to a long soccer night, Germany started playing at 10 p.m. last night.

Destroying the sinus node to get rid of Afib does not make any sense at all. The sinus node has nothing to do with Afib. It's located in the right atrium, while Afib usually originates not from any node, but from the pulmonary veins in the left atrium. Did your cardio do an AV-node ablation? That would be an approach towards Afib, though it doesn't stop the atria from fibrillating, only prevents that the ventricles follow the erratic rhythm in the atria. An AV-node ablation for Afib would lead to 100% ventricular pacing, and no atrial pacing.

Anyways, as Tracey and I said, although the pacer might not pace you up to 170bpm, an atrial rhythm might have kicked in and apparently it was able to do 170bpm. Could very well have been a sinus rhythm. I had four ablation procedures on my sinus node, but it always bounced back a bit. You can never completely destroy a sinus node as it is not a clearly defined node, but rather an area with pacemaker cells; it's very hard to ablate each and every of these cells.

Inga

Thanks

by Alma Annie - 2014-07-02 08:07:57

Thanks for your input. I don't know how to get a copy. I had an office download last May, then I have a remote every 3 months. I don't have to see Cardio/EP now for 15 months, unless I have problems. He is the most uninformative Doctor I know, but on the other hand brilliant at his job. Would the clinic have a copy in my notes?
Alma Annie

I'd get a copy

by KAG - 2014-07-02 12:07:50

....of your PM interrogation report. It will help you understand what your PM is doing. You can ask questions here.

It will list the mode your PM is set to and confirm whether or not rate response is On or Off. Depending on that there are different settings that can be adjusted.

Other key settings are your lower and upper rates. If you have AV block then 130 seems to low.

That would be a start.

Yes

by KAG - 2014-07-03 12:07:18

where ever you go to get your PM checked (interrogated) would have copies of all your reports. I've heard of people getting summary pages. The first time my clinic gave me that. It didn't have much on it, so I went back and asked for the entire report. It has all the settings and modes for your PM. They (by law) have to give you a copy if you ask for it.

Maybe the office could send them to you?
Kathy

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