Pm for an active person

At 68, I still ski, hike, run. At least I did until recently. Been diagnosed with sinus node disorder. Harry runs in the 40s dipping to 30s while asleep. The only symptom is I get out of breath when I ramp up exercise. Getting a pm in about a month. Doc has mentioned Medtronic and Biotronix as options. Does anyone have thoughts on which pm has the best rate responsive characteristics? I understand there are different approaches to adapting to higher exercise demands on the cv system. My goal is to be able to ski, hike or run for a good number of years yet.
Thoughts? Experiences?

Thanks!

3 Comments

rate response

by Tracey_E - 2015-03-06 09:03:38

If you have sinus node dysfunction, you will be depending on rate response to get your rate up for you on exertion. There are two ways of doing that. One senses motion so it's great for hiking and running, not so much for biking and skiing unless it's a bumpy run. The other senses your breathing so it seems to be more sensitive and a better choice for athletes. If Inga (golden_snitch) does not reply, go search her posts. She has had experience with both types and can explain it better than most drs.

Rate response

by golden_snitch - 2015-03-07 02:03:02

Hi!

You actually have three choices when it comes to rate response sensors:

1. accelerometer (motion sensor)
2. accelerometer + minute ventilation (physiological sensor), and
3. closed-loop stimulation (CLS, physiological sensor).

With a sick sinus node and chronotopic incompetence - sinus node does not increase your heart rate properly when exercising - you should be getting either option 2 or 3; a motion sensor alone has its limitations, for instance when you bike, because it needs upper body movement to sense activity. Now, option 2 is only available in some Boston Scientific pacemakers and some Sorin Group pacemakers. Option 3 is only available in Biotronik pacemakers. Medtronic is offering pacemakers with accelerometer only.

I have been through all three options, currently have CLS because I have epicardial pacemaker leads now and those do not go together with a minute ventilation sensor. So, I was left with accelerometer or CLS, and then chose CLS.

CLS is a nice sensor, but it's a bit tricky and it has a tendency to cause inappropriate tachycardia. It adjusts automatically every day, and if you don't move enough, it can get quite aggressive in its response (fast heart rates with minimal exertion). I was sick for a while, not allowed out of bed, and that's a situation when CLS is hard to tolerate - at least in my opinion. However, if you do exercise regularly, it's a great sensor. Plus it also reacts a little to mental stress, not only to physical exercise. That's something the other sensors don't do. Now, option 2 with the combination of motion sensor and minute ventilation sensor works really well, too. I have had that for many years. It did take a while to get the settings right for me, but once it was optimized, it was a good sensor. Downside of the minute ventilation sensor is that it sometimes causes tachycardia at rest when you move your arm a lot, for instance when you do strength training for the arms, shoulders, chest muscles.

Can't really say, better get this or that, option 2 and 3 are both good. Ask your cardio about his experiences with these sensors, especially with CLS (not so many patients out there that have it). All I can say for sure is, don't go for a Medtronic pacemaker with motion sensor only.

Best wishes!

Inga

I can relate

by gleesue - 2015-03-11 10:03:47

I can relate. I am 68, have had a PM for about 2 ½ years. Mine is a Biotronik. My EP gave me that because I am so active and he even said he has marathoners on Biotronik. My heart is a little different from yours. My main problem was Bradycardia. My heart will still speed up on its own, but takes a while to get there.

As far as being active, I snow ski, jet ski, kayak, play tennis and golf, hike, bike, lift weights and coach youth soccer. I also plan to continue this level of activity for a long time to come.

My experience with Biotronik customer service has also been great. I’ve had to be cardioverted a few times since I’ve had the PM and they have been there and been very helpful in reading my PM so the doctor new exactly what was going on with my heart before conversion. I would certainly recommend Biotronik if you want to maintain your activity level.

Good luck and let us know how things go.

Jerry

You know you're wired when...

You’re a battery-operated lover.

Member Quotes

I am not planning on letting any of this shorten my life. I am planning on living a long happy battery operated life. You never know maybe it will keep me alive longer. I sure know one thing I would have been dead before starting school without it.