Rate response question

Hi all, I have a St jude pacer for sss and Bradicardia plus it is supposed to help a bit with a fib. I have been a pacer for about 2 years. The last 6 months I have been on 25 mg Beterblocker as the a fib seemed to be getting worse, this has helped a lot but now I find it difficult to get my hr going. When I walk up stairs I feel terrible when I get to the top, and have to wait for my heart to speed up before I can continue, My pacer is set at 60 bpm, but even with running up 40 flights in 15 minutes for exercise, I can,t get it to go faster than 80. I used to get 110 before the beter blocker. Should I have my rate response switched on ?. Will this help.? Do I ask for a maximum setting, say 150?. Will my own natural pacer still work when my hr speeds up? Thanks in advance for any input.
Hope everyone is doing well, Regards, Ian.

5 Comments

Hi Peter

by IanMcC - 2008-06-04 03:06:45

I have a St Jude Medical 5366
Lead model 5076 usage ral
Lead model 5092 usage rvl

I don't know what the usage ral and rvl mean.

Regards, Ian.

What pacemaker?

by peter - 2008-06-04 03:06:57

Ian what type and model of pacemaker do you have? Also what leads do you have and what are they doing?
Sorry I cant comment until I know the answers. Cheers Peter

ral = rightatrial? and rvl right ventricle?

by axg9504 - 2008-06-04 04:06:46

I am on a slightly higher dose (85mg) a day and I don't detect any pronounced impact, although there are sometimes when i feel leaden after climbing a few stairs, but sustained fast walking or running (to the limit that I can stand it) does not show the same heavy feeling. Your rate of 60 must be the lower rate (?) Some docs won't change the upper rate, mine is at 140 I tried to argue for more, but he didn't agree. I deferred and told myself I'll present my case after I've gained some fitness. I would concentrate on how you feel rather than worrying about what the rate is. The BB does slow rates down and yes your natural pacemaker can kick in. I see mine kick in once in a while when I'm running - it goes to 150 which is higher than my pacer max so therefore it's the natural.

Rate response

by IanMcC - 2008-06-04 09:06:33

Thanks for the comment axg9504, do you have your rate response switched on?.
That leaden feeling is the thing I'm worried about and would like to change. I go up and down stairs a lot on a ship where I work and it feels terrible, once I walm up and my hb starts to increase then I'm fine and I can run up the stairs with no problem. its that initial increase that is hard to get going. I was hoping that the rate response would fix this.
Regards, Ian.

Fine Tuning

by richan - 2008-06-05 07:06:50

Hi Ian,
I have a Guidant 1280 - 2 leads. As I understand it, there are a whole bunch of "tuning" things that your PM tech an/or cardiologist can do that can influence your rate response. During the first 1.5 years I went in several times for fine tuning.
That might be something that could be done to help. You may have some limits as to what can be done with your PM.
Hope things go well for you.

Richan

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