Issues when running.

Hi Guys,

I got a Medtronic Scansure MRI dual chmaber .pacemaker implanted last April 2014. I'm 38. I was told I have 3rd degree heart block.
I'm due back this Friday to meet the pacemaker technician. The issue I'm having happens during running. Once I go below 9 min miles I get out of breath very fast. the only way I can recover is to stop and wait maybe 2 or 3 min. Then I can run again.I have ran up to 16 miles slowly with no problems as long as I run slow!! But if I try and do a quick 3 miler I can't do it. It starts with a weird "feeling" in my Stomach. Then I can feel my breath struggle. Then I feel my legs weaken and a very light dizziness in the head.

It used to be worse as in I couldn't run faster then 10min miles without the problems I mention above. Then the tech reduced the sensitivity of the rate response and I felt better when running.

This time last year I could run 15 miles at 7 min/mile pace easy. My Cardiologist says there should be no reason that I can't run the same or even improve, but the pacemaker techs always resist.

It's very frustrating and really gets me down.

I don't have these symptons when cycling. My cycle is usually an 8mile commute to work and 8 mile back.

My Pm is set to 170 max and 60 min bpm.

I'm hoping someone could tell what to mention to the Tech!!???! Or someone who had similar history/events

Thanks
Barry.

19 Comments

Issues when running.

by baza1976 - 2015-02-03 05:02:09

Thanks for the reply Ian,

For my visit on Friday they have given me the option of tweaking it and letting me run down the road for a bit and re-tweaking if required or going on the thread mill.!!??!?? I have chosen the run down the road. I can change if i let them know in advance.

I'd really hate to think this is as good as it gets :(

Hi Barry

by IAN MC - 2015-02-03 05:02:48

As a lifelong runner myself I know how you feel. A few thoughts :-

- You must have problems in addition to your heart block.
Normally with heart block, your heart rate increases as it should with exercise so you don't need Rate Response.

- You possibly have a lazy sinus node which usually means that you do need RR. Sick sinus nodes can be intermittent and progressive which complicates things

- I have the same PM as you and it's rate response feature is only triggered by movement in the upper body.This is not particularly physiological and certainly
isn't as good as the real thing for people who do real exercise. One possible scenario for you regrettably is that this may be as good as it gets but keep on getting it tweaked :who knows !

- Have you persuaded them to wire you up while running on a treadmill ? That may give them some clues

- Ask them if a PM with two sensors for RR may be better for you

- It is a mystery that you can cycle OK, normally that is tough with a Medtronic PM if you need RR

Interestingly there was something in the newspaper this morning about a study of over a thousand runners in Denmark. It seems that running fast is bad for you ! Running consistently at faster than 7 mph makes you nine times more likely to die from a heart condition than slower runners !!

we can't win. Best of luck

Ian




Further thoughts

by IAN MC - 2015-02-03 07:02:01

Running down the road is OK but it wil only give them readings for 2 moments in time I.e. when you set off and when you get back unless they record your heart while you run

I would go for the treadmill every time; or better still both ! I don't know how willing your guys will be to devote enough time to do it though because it is fairly time and labour -intensive

I had 3 treadmill tests done on the good old NHS until they got the settings right but it really stretched my powers of persuasion to the limit

Also have you tried a heart monitor when you run. I bought one and in my case I identified that my HR was levelling off at 90 bpm; I showed them the data and it helped them work out an algorhythm for the optimum PM settings. But we are all different with differing electrical problems

cheers

Ian

PS

by IAN MC - 2015-02-03 07:02:30

When I said that this may be as good as it gets I meant with your Medtronic pacemaker. Next time I'm going to have a PM with minute ventilation, this means that it also has a sensor where breathing triggers off rate response as well as upper body movement

Ian

Issues when running.

by baza1976 - 2015-02-03 08:02:40

No, I'm not on any meds.

This shortness of breath comes on so fast. No matter how slow I run I can't get it back. I need to stop or walk to recover.

I can run slow all day, but if I try and pick it up just a fraction to say, sub 9min, I know I'l be in trouble within a few min.

I don't have a HRM. I'm sure when i was getting the pacemaker a tech told me they would not really work. I asked another tech and they said it would. Conflicting advise.

I might ring them up and ask them for the treadmill test. Would I have to get breathless on that for them to see whats happening? it's just when doing stress tests before I got the pacemaker the treadmill didn't go that fast.

I was hoping someone on here would have had the same experience and give me a happy ending

Do you take any meds?

by donr - 2015-02-03 08:02:40

I had a similar problem yesterday on a machine at a cardiac rehab session.

Went 30 min & could not get my HR above 105 w/o working like mad. Kept falling below 100. The nurses that run the show were quite pleased w/ my HR, saying that it indicated that I was in pretty decent shape for an old fart. They based their comment on the fact that when I started out weeks ago I could not go any longer than about 7 minutes on the same machine at the same resistance level.

I contended that there had to be something wrong because my HR, respiration rate (RR) & O2 saturation were not matching up. HR = 95, RR = about 30+, O2 Sat = 97. I was breathing much faster than what would correlate w/ the slow HR. I'd guess that my HR should have been in the 115 range, based on my RR. I was not struggling for air, but the three did not seem to correlate.

A former member of my Cardio's staff, an RN cardiac nurse, was working there & I asked her about it. She agreed & asked - "What meds are you taking?" Acebutolol (a Beta Blocker). She responded immediately: "That's it, it keeps your HR down, just like it is supposed to."

Hmmmm. I never though of that - all the while KNOWING I was on Acebutolol for just that reason - to keep my HR down to help correct an arrhythmia.

Oh, well...

Donr

heart rate

by Tracey_E - 2015-02-03 09:02:42

Do the treadmill rather than the road if you can. If I had to guess, I'd say your heart rate gets over 170 when you push harder. With block, your atria beats normally but you need the pm to keep the ventricles in sync, but it will only pace you to 170. That means if you push hard and get up to 200, your heart will by out of sync.

Write down the dates/times that you've had problems. They can tell on the reports if you were maxing out at the time.

As for a HRM, they work for some of us, not others. I've never been able to get one to work but there are some who have had better luck than me.

Issues when running.

by baza1976 - 2015-02-03 11:02:05

Thanks for the input guys.

I do get the sense that the Techs are think I should be grateful for been able to run in the first place, and I am grateful.

I'll give them a buzz and see if they will change for the treadmill.

Treadmills

by IAN MC - 2015-02-03 11:02:17

Maybe Irish ones are slower than ours. I have always found that they will go fast enough to almost throw you off when you turn up the speed.

One problem is that the techs are accustomed to treating cardiac cripples and are scared stiff of finishing you off so they need persuading to turn it up. I have spent much time on hospital treadmills with me yelling at them " Faster , faster. faster "

Let us know how you get on


HR monitor

by WillieG - 2015-02-03 11:02:45

Hi! The Polar FT 7 with a chest strap works great for me! I use it mostly while cycling as I am not a runner, except for short bursts in racquetball.

Good luck and hope you become speedy!!!

Running fast and hills

by cee - 2015-02-04 10:02:27

I have exactly the same symptoms you are describing even down to a weird feeling in my stomach.
I had a pacemaker implanted in June 2014 for a 2 to 1 AV Heart Block. They have been twiddling with it ever since. I find if I pick up my pace or run up a small hill (and I am not fast by any means), that I have a big block. My heart rate has now started rise to a very high rate (it's been to 229) stay there for ages and then drop suddenly to 85 to 90. Seems to take forever for the pacing to kick in. Very hard to run through. My throat is tight after a bad run and my hands get puffy.
I think my PM is set at 180 max.
This doesn't happen every run but I certainly feel it when it happens. If I have a good run my heart rate will barely touch 180 BPM.
I feel like I am not getting any fitter even though I run an hour a day. I'd be very interested to hear what the specialist does to combat this.

IAN MC.......................

by Tattoo Man - 2015-02-05 04:02:40


.........For not the first time I find myself shaking my head, reading your wonderful accounts..

We are all here courtesy of the best that modern medicine and science can offer....

...and still we ask for more....

...as a runner,. I run...and give thanks to all who make PMs ..just to make me able to get out and stretch my legs...regardless of previous performance.

TM

My wife thinks I've gone mad

by IAN MC - 2015-02-05 05:02:47

as I've just been running around the living room , first with a stiff upper body and then with a high knee lift !

It seems to me that the high knee lift takes more effort and more effort means your heart rate goes up more quickly which in turn means that you blow up more quickly.

But interestingly, as you do have rate response switched on this may be a factor . It feels to me that the high knee lift creates more motion in the pacemaker area which in turn would get your HR up more quickly. A heart monitor would probably confirm this ( incidentally I bought a Polar FT2 , complete with chest strap and it seems to work OK but chest straps have got the nasty habit of occasionally losing contact with the impulses which they are detecting )

Anyway, I'm enjoying this so I will do another 10 circuits around the sofas , armchairs and dining table. My wife is shaking her head !

Cheers

Ian

Issues when running.

by baza1976 - 2015-02-05 05:02:55

So I have contacted the Pacemaker Tech. Looks liek they ae going to fit a Holter heart monitor and let run down the road. I think that will be a good start.

What i didn't say above was, when running, if I try to keep my upper body straight (stiff) and not have such a high knee lift, I can got a little faster for longer before I blow up. Would that make sense to anybody?

Runner with BiVentricular pacer/ICD

by chazzf - 2015-02-05 06:02:19

Barry,

Stats: 60 years old, 3rd pacer, Cardiac sarcoidosis, intermediate marathoner (20+, 3:07 best, 4:27 most recently)

Had same issue as you....you may need more adjustments BUT I too find I can go faster/harder on a bike than running...they're just different activities. I would have the sarcoidosis discussion with them...you MIGHT have it.

Donr,

Yep, I know what you mean...those beta blockers are designed to keep your heart rate down and that's just the way it is......

Cee,

My top end on my pacer is 150 (due to ICD, then don't want it shocking me unless absolutely necessary). If your indicated heart rate is 229 but your pacer is set to 180, no wonder you're having problems...your rate is NOT supposed to exceed 180 (unless I'm missing something).

Good luck to all

I got the idea from cycling.

by baza1976 - 2015-02-05 07:02:06

You paint agood Picture Ian,

I got the idea of keeping the lower knee lift and striaght upper body from cycling. When I cycle I don't notice a whole lot wrong. that got me thinking that the "bouncing" when running was skaing the pacemaker. Again I don't kow if that makes sense, but it does work. I try to keep the arms still also. There is still movement in the upper body, but not as much

positive result..... so far !!

by baza1976 - 2015-02-06 05:02:46

So I met the pacemaker tech and medtronic rep earlier today. They both said that my pacemaker was set to pace 1:1 till 150 bpm. .. Once I went over 150 bpm it switched 2:1 !! ... They changed it to 1:1 for 200 bpm ... Sent me out the door for a run and told me to push it hard. .. Have to say it was my best run for nearly 1 year :) so I'll see how it goes over the next few days .... But a positive result ... so far !!

what does 1:1 and 2:1 mean?

by lisabfit - 2015-02-21 02:02:40

Can you explain that Barry? What does 1:1 and 2:1 mean - how does that affect your heart rate?
I'm having some wierd stuff happen during exercise as well - and I have the same PM as you! I'm only 9 days post-implant and have done 2 short cardio workouts on my eliptical- Right when my HR gets in the mid-high 140's - it will suddenly drop like 30 beats - and it's very difficult to get it back up...I haven't been able to - actually - 20 minutes is the most I've done. I know my upper limit is set at 180bpm and my lower is 50bpm. I'm using a Polar FT2 monitor to track my HR.
I'm glad they seemed to fix it for you - that is encouraging!
Thank you!

lisabfit

by baza1976 - 2015-02-21 04:02:44

The way it was explained to me was - the bottom chamber of my heart would match the beating of the upper chamber. When the upper chamber went above 150 bpm the bottom chamber would drop to 75bpm. Now it will be 1:1 up to 170. Since my last post I have had few occasions where I still get breathless. So I guess there is still some tweaking. But i do feel I'm 90% there.

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Since I got my pacemaker, I don't pass out anymore! That's a blessing in itself.