brazilian jiu-jitsu

Hi, I'm was recently implanted with a dual chamber pacemaker for bradycardia -- about once every 6mos my heart rate drops really low and I pass out. I'm now paced at a steady 50bps. I'm in my 30s and enjoy vigorous exercise, in particular BJJ. (If you don't know what it is just think wrestling: clinching, someone pinning you on the ground, full strength pushing, pulling, occasional throws onto mats. No punching or kicking.)

I'm trying to evaluate whether it's worth the risk continuing BJJ with my pacemaker. There are many conflicting opinions online and even the doctors aren't consistent. Instead of asking for people's opinions on the matter I want to consider the question differently in terms of costs and benefits. I know the benefits: I stay fit and enjoy the hell out of it. What I don't know is the potential costs of the bad things that could happen. I'd like to weigh the costs against the benefits and make up my mind.

So here's my question: what are the bad things that could happen and their costs? Here's what I can think of:

1. The pacemaker itself breaks or stops working. Given that I don't require my pacer to live on a day to day basis, the cost is just that I have to have a new one implanted. This is a hassle, but one I could live with if it doesn't happen often.

2. The wires shear. I have no idea how likely this is or how bad it would be. Can you help me evaluate? Is there a mortality risk?

3. The leads come out. Again, no idea how bad this.

4. The leads poke through the heart. Again, no idea how bad this is or what the redress is.

Do you have any input on the above? Any risks that I missed?

Thank you all so much, and thank god for this web site. I've had about 100 questions about other things answered just by browsing around! A real lifesaver (so to speak).

5 Comments

costs

by Tracey_E - 2014-09-10 09:09:39

1. the pm itself is titanium. You can't hurt it. There used to be a video of a boy shot in the chest, the pm stopped the bullet and kept on pacing

2. No mortality risk, just inconvenience. More likely what they'd do is be damaged. They'd do a laser procedure to remove the old one, then put a new one in. Recovery would be similar to the first time.

3. After the first few weeks, the leads are secured in the heart by scar tissue. After the first year it takes a special laser to get them out. Nothing you do will pull them out in the heart.

4. See #3. Not going to happen. Your heart is physically protected by your rib cage.

The biggest risk is bruising. You get hit the wrong way, it hurts like he##. We are a lot more fragile than our pms.

There are a very few people here who have damaged leads from sports, two I can think of off the top of my head. There are many, many more who do what we want and have never had a problem. Some also say we shouldn't lift weights, do pull ups, push ups, etc. I choose to do all of that. I truly don't believe the risk is more than minimal but if there is risk, then it's a chance I'm willing to take to do what I love and to stay fit. Not being fit, imo, is much riskier. I'll take a teensy chance of a broken lead over a high risk of heart disease. Everything has risk, I choose to not sit on the sidelines and watch life go by. YMMV, of course.

Risk ??

by donb - 2014-09-10 10:09:23

Hi, The big question for anyone to consider is, "How tough is this body of mine"?? Housing a chunk of Titanium between your rib cage & skin is not the same for everyone. My experience of having site problems with 5 out of 6 implants has been because of my build and way too much physical abuse doing upper body activity. As a result both my left & right chest areas are no longer suitable for an implant and now have mine implanted in my lower right groin. So far this past year has been the most comfortable with my belly implant and still do heavy upper body activities.
DonB

Risks

by PeteFindlay - 2014-09-10 12:09:10

I'm firmly in the same camp as TraceyE, although I've only got 4 months experience to go by so far! I have not been advised to avoid anything, so I intend to carry on as normal. I'm not sure the medics quite realised what 'normal' is, mind you! Thus far I have found no restrictions, and less and less discomfort. Lots of Crossfit, heavy weights, pulling and pushing. Signed off for skydiving, with no issues encountered there either.

Hard, direct trauma on the PM site seems to be the main risk I have been warned about. Mine is well buried sub-pectoral, but I'm still a bit cautious about anything that could hit the upper chest. No problems yet! Apart from potentially hurting, depending on where it's implanted, the risk is injury and bleeding in the surrounding tissues, leading to infection around the PM - which is a serious problem. So if you can avoid being thwacked hard in the wrong place...

Pete

re: I know the feeling

by bionicpulse - 2014-10-24 04:10:07

talldave, what does your EP say about it?

All the input here is really encouraging but I still don't feel like I have a handle on what the risks actually are. I did find a guy who trains with a PM in florida (his is in his abdomen) who also hasn't had any problems. But I guess there's just not a lot of data about this kind of thing.

I know the feeling

by talldave - 2014-10-24 05:10:16

I have been doing krav maga since 2008, and paced since 2010 and continued Krav after a 1.5year break. By now I am an instructor and I have yet to encounter any problem with the PM. I even spar and have been hit right on the spot a handful of times. Still, never had any issues. It does help though that my pm is subpectoral below the muscle.

We also do grappling in Krav and I am considering starting BJJ as well right now. I never seriously considered the PM being a problem doing groundfighting.

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