Curious about Fitness Levels

Hello,
I am 27 going to be 28 next Wednesday, and on Monday I am scheduled to have a ICD put it. I was born with a condition called Transposition of the Greater Vessels and had a Mustard Procedure to correct the condition. A side effect of the condition is a heart rate averaging around 40 bpm with it dipping into the 30s randomly throughout the day. During my exercise test it never got over 80. I also have a much higher chance of a lethal lower heart rythm, hence the ICD. I have always struggled with exercise and cardio workouts. I was curious if anyone else here noticed substantial increases in their exercise capabilities after having the procedure, and any advice on how to start exercising and what kind of activities I can do after recovery. Thanks in advance and I am pretty happy to find this community. Needless to say being 27 I am extremely concerned about how this device I will now have the majority of my life will affect me.

3 Comments

Ups...

by golden_snitch - 2014-05-17 01:05:43

Having read Tracey's comment, I realized that I just assumed you were suffering from sinus bradycardia. If, however, your slow heart rates are due to a heart block (like in Tracey's case), you'll probably not need the rate response sensor at all; most heart block patients don't, because their sinus node is working well, and can therefore dictate the pace. So, everything I said about the sensor choice, will probably not apply to you, if you should suffer from heart block, and not from sinus bradycardia.

Inga

Chronotopic incompetence

by golden_snitch - 2014-05-17 02:05:52

Hi!

If you hardly ever got your heart rate over 80 during an exercise test, you suffer from something called "chronotopic incompetence". It's the inability of the heart's electrical system (mostly the sinus node) to adjust your heart rate properly to your level of activity. Now, a pacemaker can certainly help with that. It has a feature called "rate response" that incorporates one or two sensors that sense motion and/or minute ventilation or cardiac contractility and adjust your heart rate accordingly. Not all manufacturers offer all sensors, most only work with a motion sensor. Boston Scientific and Sorin offer the combination of motion + minute ventilation sensor; Biotronik offers closed loop stimulation (CLS, measuring cardiac contractility). You should talk to your cardio about which is best for you. It depends a bit on what kind of exercise you'd like to be able to do. The shortcoming of a motion sensor alone, for instance, is that it needs upper body movement to sense activity. Hence, it often does not respond to activities like cycling. In my opinion, someone with chronotopic incompetence should always get a combination of motion + minute ventilation sensor or a CLS-sensor. At first I had this combination, then for a while only the motion sensor, and now I have a CLS sensor. My experience: Motion sensor alone sucks, combination works well, CLS works well, too.

So, once you got your pacemaker/ICD combo, and you have the rate response feature activated, you should be able to exercise much more and better. You'll be able to get your heart rate up over 80bpm, which will allow you to do all kinds of activities, like running, swimming, cycling etc. The settings for the rate response sensor might need some fine tuning, though, so be patient and let your cardio optimize settings until you feel fine. Don't be discouraged, if this takes some time. Also, keep in mind that a sensor is never as good as a fully functioning sinus node. So, while you'll most likely do a lot better, there might still be some limitations, and some compromises that you need to make.

But before you head into surgery, talk to your doctor about the sensor choice.

Best wishes!

Inga

exercise

by Tracey_E - 2014-05-17 12:05:32

Different condition here (congenital complete heart block) but my hr never got over 45 before I got my first pm at age 27. NIGHT and DAY!! Before I had zero stamina and wasn't able to do any sports. Now, I can do whatever I want and I feel great. I started walking the day I got out of the hospital. Actually, I got in trouble for pacing the halls while I was still in the hospital, lol. Here I was feeling this amazing surge of energy and they wanted me to stay put. I increased distance and speed over the weeks it took to heal, added ankle weights and tried the recumbent bike. After the arm restrictions are over (4-6 weeks, drs vary), you can try whatever looks fun. I took tennis lessons, bought inline skates, fell in love with hiking, learned to ski.

You will read here of people who struggle, who either don't feel better after or struggle to accept it. They are not you. There is no reason to think this will do anything but improve your life.

Ditto Inga's advice about sensors. Also discuss placement with your surgeon, ask if they can do it a little lower and deeper so it's less likely to get in your way.

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