Exercise Limitations

Hi There..

I'm 29 years old and recently have been diagnosed with bifascicular block - right bundle branch block & left posterior hemi block. I have been recommended to have a rate response pacemaker inserted as a back up should my heart ever drop below a certain rate due to my conduction disease or a vasovagal episode. I have planned to have this installed early January 2013.

I am incredibly passionate about my fitness - I ran a marathon last year and now have a huge focus on weights training at the gym where I go 4 - 5 days per week. I also love swimming, golf, waterskiing & jetsking.

I am very concerned I won't be able to continue this activity when I have the pacemaker installed as I understand that certain exercises or movements could put me at risk of dislodging / fraying or cutting my wires?

I would love to hear from anyone who continues to do weight training or swimming without fear? Are there any weight exercises that I won't be able to do or can I do everything again as long as I ease back into it?

Appreciate and welcome any comments.






8 Comments

my best advice

by walkerd - 2012-11-12 07:11:37

is ask your docotor/cardilogist. All people are different with conditions that they have and what will affect your health. I would air to the wise side on advice given that others have done your condition may be somewhat different. consult your doctor and make sure you tell them excatly what you want to continue and how you do your workout.
best of luck
dave

you will hear....

by ohiolaura - 2012-11-12 08:11:36

You will hear many different opinions here.which is good.
I agree,ask your medical professionals and also people who do what you are doing who have a PM if thats a possibility.
I was told,as many,after PM surgery,first time(for me),not to lift more than 5 lbs with arm on side of implantation,also not to lift same arm above shoulder for 6 weeks.
After the 6 weeks,I was told no limits,above limits were done away with.
I dont do weights or stuff like swimming,but work out daily,cardio mainly.Have no issues with it,but after a couple of weeks before surgery off excersise,then after coming home,had to get back into workouts slowly.
I physical tiredness as well as emotional exhaustion to learn to deal with and overcome.But thats just me.
I think Ive read alot here that as long as your Dr says its ok, you will be allowed to do all you want,once the leads are settled in the heart,and your incision is all good.
Im sure you will get alot of info here,happy reading!
Laura

ask, but

by Tracey_E - 2012-11-12 10:11:26

Most drs limit movement for 6 weeks, no lifting, no raising the arm above shoulder level. Check with your dr first, but you should be running again within a week or two as long as you feel up to it. I was out walking the day I was released from the hospital. 8-12 weeks is more common for strenuous lifting and things like golf swings and swim strokes.

After 3 months, anything should be ok as long as you don’t risk a direct hard hit to the pm (tackle football, competitive karate). Even those things are ok if you’re careful. They make special shirts, and a direct hit isn’t going to damage the pm (it’s titanium!) but it will bruise like crazy.

We are all different and if you ask 10 drs you’ll probably get 10 answers but most of us have no limitations after we heal. There are some conservative drs out there who have their patients afraid to do much of anything. I do not have one of them! Life is too short to sit on the sidelines when I’m lucky enough to have a fix for my problems, I love having a dr who agrees and encourages me to get out and be active. My official instructions are don’t do anything stupid, if it hurts stop. So, there isn’t much I don’t do. I hike or ski most vacations. I do Crossfit 5 days a week. This morning I ran, skipped rope, stood on my head for 30 seconds at a time, kettlebell sumo deadlift highpulls, then ended with snatches and overhead squats with the barbell. I’m on my 4th pm now, got my first one at 27 for congenital av block.

Make sure your surgeon is aware you are active and discuss placement in advance. Many place the pm just under the skin, just under the collarbone. This is the easiest, the fastest to heal. Some people, esp people who are very thin, can end up with it too close to the collarbone so they have to limit some weight training for fear of pinching the leads with the collarbone. This is easy to prevent so make sure you get it lower than that. Also, you may prefer it deeper, possibly even under the pectoral. Mine is buried and I love it. Healing is a little longer but I can carry a heavy backpack on hikes comfortably, I can clean a barbell and not get close to it, seat belts don’t rub. It’s deep enough I can pretty much forget it’s there.

A question... the block names you mentioned are new to me but in general an electrical block means we don’t really need rate responsive pm’s. RR is for atrial pacing. They all come with RR so having it is no big deal but unless you actively need it, you will probably want it turned off. It’s sensitive to movement which is a good thing if your atrial rate doesn’t go up on its own. Most of us with block have a normal atrial rate and only need the pm for ventricular pacing, to help the ventricles stay in sync with the atria. If it’s on when you don’t need it, RR can compete with our hearts natural atrial rate and cause problems while working out. Ignore all of the above if you will need atrial pacing :oP

If you do bumpy things, like jet skis or the old wooden roller coasters or motorcycles, rate response will sense the vibration, think you are exercising and raise your rate for you. Not dangerous, but annoying. Another reason to turn it off if you don’t use it.

Hope this helps!

Unusual diagnosis Ther's a reason...

by donr - 2012-11-12 11:11:56

...why Tracey has not heard of this one.

I Googled it & found at this link:

http://www.uptodate.com/contents/course-and-treatment-of-chronic-bifascicular-block

that it is not a commonly used diagnosis in the US because it is somewhat redundant in terminology. Has to do w/ the way the right & left bundles split up as they travel below the AV Node.

Don

don

by Tracey_E - 2012-11-12 12:11:51

I read the link and still don't get what the difference is! But just ventricular pacing most likely to fix it, correct?

Over the years I've been told I have LBBB, plain ole av block, CCHB, type II mobitz, and Wenkenbach. I like my childhood cardiologist's explanation the best- the top and bottom of my heart don't talk to each other. :oP

Outlook

by gleesue - 2012-11-12 12:11:51

I’m passionate about fitness also. I can tell you everyday I’ve worked out, what I’ve done and for how long since 1982. I had my PM put in Aug. 2 and I was working out within a few day’s. Cardio at first since you can’t raise you arm above your head. I was jet skiing Labor Day weekend, jumping waves etc. Started back weight lifting at about six weeks. My Doc recommended using less weight and doing more reps to reduce straining. He also said if an exercise hurts stop doing it. Shoulder shrugs hurt at first and so did butterflies. Worked back slowly and those movements no longer hurt. I also golf and was down in Florida last week for several days of golf, 18 holes a day. I went back to golf also at about 6 weeks but just on 2, 9 hole leagues. I must say that 18 for several days did cause some discomfort. I don’t run much any more because of some arthritis but play tennis and do a lot a biking both stationary and outside I also use an elliptical . I have a gym in my basement. I’m back to where I was before PM. The only area where I still take it a little easy is weight lifting because I can feel the strain. But I’m happy where I am and even look for more improvement in the future.

Good luck to you.

Jerry

sooner than I thought

by hoppenjan - 2012-11-13 09:11:58

At 53, I don't take exercising to quite the extreme you do, but after only one week, my EP said I could do ANYTHING I wanted.

At the insistence of his PA, he suggested I give weightlifting and riding my Harley (850 pounds that requires some effort when parking, etc) one more week.

This was a pleasant surprise to me, since I was expecting more like 6 weeks from my research.

The only lifting exercise I was really worried about was a butterfly or pectoral exercice on a machine since it required such a reach back with my left arm to get started. Initially had someone spot me to get me going when I continued this resistance.

After about a month, I was doing same weight and reps as pre PM.

Consult with your doctor and you may want to get very specific about certain exercises or lifting you do and what your concerns are.

Continued Exercise

by hjfarr - 2012-12-15 10:12:44

Be sure to get a Doc who understands athletes. I am 70 years old and have competed in triathlons for 30 years. I was told in late 2010 that I needed a PM. I researched my options and interviewed several docs. I found one who not only worked with athletes, but had implanted PMs in several competitive swimmers. I had the implant in Jan 2011 and signed up for Ironman Texas 2012, a full 140.6mile ironman tri. I raced IMTx in May,and was fortunate enough to win my agegroup and qualify for the World Championship Ironman in Kona which I completed on Oct 13. Get the right doc and your are only limited by your attitude and desire.

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