Settings for Exercise

I've had a pacemaker for a couple of years, and until recently I was able to jog at a reasonable pace (for a 60-year-old) for maybe up to 8kms. I would wear a heart monitor and the pulse would hit around 148 - 155 and I felt good. The hospital re-set my pacemaker and suddenly when I jogged the pulse would only go up to around 125-130 and consequently I ran out of energy, and could only manage 2-3 kms maximum. If I ran slower the pulse got slower, so whatever speed I ran at the pacemaker was too slow. I went back to the hospital and they re-set me to the old settings, but the same thing still happens. I've just come off the phone to the hospital and they don't have any more suggestions, so I've found this web-sire and am asking for any suggestions. I've run all my life, and am reluctant to give it up now.

3 Comments

Guessing...

by golden_snitch - 2013-07-17 01:07:41

Hi Jamie!

Well, it's really a bit odd that now with the settings back to the original ones, you still can't get your heart rate up as you used to before. Your rate response - the feature that adjusts your heart rate according to your level of activity - is switched on, the DDDR mode indicates that (the "R" at the end is for the rate response). So, I'm sure you understand that this is important for you because this feature is responsible for your heart rate when you exercise. There are some special rate response settings apart from just having the rate response switched on or off. I can only make a guess what they might have changed that now leads to you not being able to bring your heart rate up when you run: they changed either the "exertion rate profile" or the "activity threshold". Those two settings define:

1. how much time you spend being paced near the upper sensor rate (range 1-5, nominally programmed at 3), and

2. to what kind of activity the pacemaker responds (range is low - medium/low - medium/high - high).

Either they changed the exertion rate profile to a lower number, so that you spend less time near the upper programmed rate. I guess that would also make it more difficult for you to get your heart rate up to that upper programmed rate. Second guess is that they changed the activity threshold to "high", so that the pacemaker now responds only to vigorous exertion and maybe running is not sensed as vigorous exertion.

Next time you go in, ask them for a printout of all of your settings, so that you can have a look at the rate response parameters. And maybe also ask them to put you on a treadmill, so that you can show them that your heart rate doesn't increase enough for running.

Hope this helps a bit.

Best wishes
Inga

More information needed

by golden_snitch - 2013-07-17 02:07:17

Hi!

I think in order to be able to make some suggestions, we need more info:
1. Why did you get the pacemaker (heart block, sinus bradycardia etc.)?
2. What model do you have (single vs. dual-chamber; Medtronic, Biotronik, St. Jude, Boston Scientific)?
3. Is the rate response switched on (AAIR, DDDR, VVIR mode)?
4. Why were your settings changed? I mean, you were doing well before, so I don't understand why they changed settings.

I'll be glad to help, but with the information you've provided now, I don't know enough to make any suggestions.

Best wishes
Inga

More Information Supplied

by Jamie - 2013-07-17 07:07:05

Thanks for your interest, I'm pretty inexperienced with a lot of this.

1. Several reasons for the pacemaker: AF, slow heart rate, irregular heart rate, electrical blockage. I'm afraid I don't know the correct terminology.
2. The device I have is Medtronic, Device is IPG DDDR and the Model is ADDRLI.
3. I don't actually know what this means. I can ask the hospital. I live in Singapore and there isn;t always a lot of information forthcoming.
4. At my regular check-up I rported all was good, but they decided to change things a little. There was much discussion in Mandarin, so I'm afraid I wasn't party to much of it. I did ask if the upper limit could be raised to 170 bpm as I felt I needed to be able to take it a bit higher on longer runs.

After this first change the problem arose, so I went back in and they made everything much more aggressive. So when I stod up to walk the pulse would leap up to 115-120. But it still wasn't going hight enough when I ran. So I went back and asked to be returned to the old settings, and that's where we appear to be now.

Thanks again.
Jamie

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