Rate Response question

I read archived posts about bouncy roads vibration triggers an episode which is what I experience. Every time, I get into my small car and drive through certain roads that are bouncy, my heart rate would be out of sync at first, then gradually turned into an episode. Is it the rate response feature that is causing this? Do I need to have the rate response turned on? Can I just have it turned off if I have what they call Sinoatrial Node Dysfunction? I had my PM back in March this year. It has been hell for me. One other question, I don't understand why I am out of breath from just walking up the stairs or sometime from just sitting around, but I can run continously 5 miles/hr on the treadmill for 45 minutes with no problem. I think my setting is currently at 60 & 150 if I'm not mistaken and I don't know if the rate response setting is on or off. I assume that it's on. Does anyone have any answer or explanation? Thank you so much in advance and I appreciate your input.

2 Comments

RR Problems

by momtotom - 2013-07-13 02:07:04

I agree with golden_snitch. When I had my first Medtronic pacemaker implanted in 2005 (third degree heart block from an ablation to correct svt), the same thing happened to me. Every bumpy road caused me problems with my heart rate. I had the rate response turned off and the problem went away.
I had the pacemaker replaced 6 weeks ago and the same settings were put in the new pacemaker, rate response is turned off and unless there is a very compelling reason to turn it back on, it will stay off.
Hope you feel better soon,
Julie

RR problems

by golden_snitch - 2013-07-13 05:07:04

Hi Duke!

Yes, that could caused by the rate response feature. If you suffer from "chronotopic incompetence" your heart rate does not increase adequately when you're active/exercising, and so you need the rate response feature to do that job. However, if you "only" have sinus bradycardia at rest, but your SA node works well when you're active, then you could have it turned off, and see how that goes.

Most rate response sensors have a problem when you walk up the stairs, they do not sense any activity then and therefore do not increase the heart rate. So, you're probably out of breath because your heart rate is too slow. What the rate response senses pretty well, however, is running, usually also swimming, while cycling is a problem because there is hardly any upper body movement.

I just read that you have a Medtronic pacemaker. I have done some research on their rate response sensor lately, and have been told by Medtronic that nowadays their sensor doesn't react inappropriately to vibrations, and also that it does react when you walk up the stairs. Now, what you are describing contradicts what the representative told me. Interesting. But that Medtronic guy doesn't have the first hand experience; he only tells you what the pacer is supposed to do.

To find out if the rate response is switched on, you need to know what mode your pacer is in. Pacemakers can be programmed in different modes, any mode with an "R" at the end indicates that the rate response is on, for instance AAIR (that would be a typical mode for patients with sinus node problems only). If it is switched on, you should call your cardio or tell him at the next appointment about the problems you're experiencing.

Good luck!
Inga

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