Pacemaker and Settings

rate response

by Tracey_E - 2016-11-07 16:18:33

That's really odd! Rate response on SJM pacers goes by motion, so as long as it senses you are moving, it should keep your rate up. I don't know the name, but it also has a feature to prevent sudden drops, rate drop response I believe it's called? The rate can come down gradually after exercise but it prevents it from dropping off too suddenly. I have it turned on because sometimes my rate will suddenly tank during exercise. 

Is 120-130 enough? My old one was set to 170, my newest SJM is 190. I don't always get that high, but it's nice to have the extra cushion there if I need it. 

I would see if another tech can take a look at it, figure out what's up, because what it's doing isn't right. If all else fails, ask to get on a treadmill while on the pacer computer so they can watch in real time what happens. That's can save a lot of trial and error, which is what fine tuninng the settings comes down to. No two of us are alike so it's not one size fits all. 

Rate Response - Thanks!!

by TLRun - 2016-11-07 16:45:41

Hi Tracey!!!  Thanks for the input, you have helped a bunch.  I have suspected there was an issue with the Pacemaker with the settings, you have really confirmed that something is not set correctly.  Yes, I do run at a pretty low heart rate around 120.  It starts around that point for just for a few minutes and then it drops off to 80 bpm.....can you imagine???    Its like a ball and chain at that point......I just cant run.  I am pretty miserable.  I go to one of these big medical centers in large cities(Sacramento, CA) and you can about imagine the reception I get about all this.  They seem just content that I have a Pacemaker and not much beyond that.  I am pushing the issue with my Doctors office.  I have little faith in the technician that I am using.  Thanks for your input!!!  Tom

SJM

by Tracey_E - 2016-11-07 17:19:03

If your rate is dropping to 80 consistently, you might want to take a break until they figure it out. That's super hard on the body. 

I'm on my 5th SJM and have found their reps to be excellent. If the one you're seeing isn't getting it, push to see someone else. I had them all stumped once about 7 or 8 years ago. I have 3 or 4 things going on. They'd adjust for one thing and something else would become an issue, fix that and the first thing stopped working. When the local reps and my doctors couldn't find a balance, they sent my records to St Judes and made me a case study. The engineers had a powwow and sent back recommended settings. Blew my mind the lengths they went to to get me to the point I could work out! It helped that the head rep and my doctor are both runners, so they get it. Sometimes the doctor you have isn't a good fit and doesn't see being active as a priority so they write us off. Which I will never understand because you'd think it would be common sense for us to be as active as possible. Our hearts are already compromised, best thing we can do for ourselves is be fit. 

Had similar problem

by PaulFromSydney - 2016-11-11 01:26:33

Hi TLRun

I had a similar problem where on starting a run the HR would jump to130 then 5 minutes later in would drop. It felt like everything went to lead. I had the doctor hook me up to a running machine (after 2 visits and adjustments) and fortunately the problem replicated. A clash of settings was the cause (I admit I had them adjust settings a number of times previously to allow the HR to get up to 160 not the just 130). Eventually it had something to do with how long the PM waited for my heart to kick in with its own ryhthm clashing with the next heart beat (the heart is beating faster at 160). The PM was reset to reduce this interval and also the sensitivity of how quickly the heart gets to higher rates was increased. The result is the PM stays high for the period of exercise and up around the 130-160 mark depending on how hard exercising. The one downside (which I have not gone back to get addressed because something else is likely to stuff up) is that my HR will pace high 130+ on little movement (e.g. going to the toilet at night) and when stressed. Not ideal and quite disconcerning but the ability to exercise is more important to me.

Good luck

Paul 

Re: Had Similar Problem

by TLRun - 2016-11-11 12:17:27

HI Paul:  I just saw the St. Jude's rep yesterday.  He was really knowledgeable and basically described what you stated (You did a much better job than me).  Anyways, he made the adjustments and I am running much better ( I am running now !!).   My running is a shell of what it used to be but I am back.   Anyways, he increased my rate response and among other things.  Like you my HR soars with very little movement.  It is annoying but he even wanted to be more aggressive. For years even before my PM, my heart rate really never went up that much when running but I did ok.  So, seeing my HR so high now is taking some mental adjusting.  ( 7 years with a PM, my second one ).   One thing he told me was that was also really interesting was about the Fitbit.  While I was sitting there, the PM diagnostic machine (Called Merlin) was reading about 50 BPM.  My Fitbit was stating around 63 BPM.  The Merlin is highly accurate.  Also, what made sense I stated that when I started out I could walk fairly fast and then when I tried to run at that pace after about one minute, my HR would decrease significantly according to the FitBit.  When I started to run at that pace, I would put my arm that has my FitBit on the treadmill so very little movement.  He explained that FitBits works on motion so I was not getting a true accurate reading.  It made sense since I would take my pulse manually and it would be higher than the FitBit was registering at that point.  I like my FitBit but take them for what there worth.  They try to be everything in one package.  I think wearing a chest monitor like the Polar is the only accurate way to get your HR besides getting all wired up at doctors office and doing a treadmill test.  Anyways, thanks for the input as we had similar experiences.

get A treadmill

by Cardiactech - 2016-11-21 15:59:17

It sounds like the max rate is set too low, as an average your max rate should be around 220-age, if it suddenly drops to 80 it sounds like it goes into 2:1 block, meaning the top chamber is beating 2 beats for every one in the bottom due to the pacemaker not seeing the other one. 

I am putting patients on treadmill in the uk to check and having grea results so it is the best way to see what is going on as you are constantly monitoring the heart rate, this will also see what your rate is going up to and when your symptoms start, 

it is common that the device is set like this as it may still be set to normal settings out of the box.

happy to offer any help if you need, I am a device specialist in the U.K. With 14 years device experience.

Re: Get A Treadmill

by TLRun - 2016-11-22 16:55:07

Hi Cardiatech:   Thanks for the info.  I am not the most technical person when it comes to this but I thought the Max Heart Rate is suppose 220 - Age = MHR.  So, mine would be 220 - 58 = 162.  I have the MHR on my Pacemaker set at 140.  I have read many postings here where the MHR is much higher.  Anyways, I dont think I getting to 140 even with the settings I have it at now with my Rate Response increased.  This is the highest I ever had Rate Response set which is 9 on a St. Judes pacemaker.  For some reason, I keep having issues.  I am still not where I was before all this started but I am running now.....very slowly.  What you described is what I think happens with me.  Sometimes I get on the Treadmill and really have no issues but again not where I was before this issue started.  I am not hitting my MHR and feel completlely max out  Then somedays, I cant even start running as I am a complete mess.  Its easier to walk fast then even to try a light jog at that speed.  I know I could get the Rate Response increased but already it seems like my heart rate soars with little movement.  Other times it barely budges.  I am getting such mix signal of messages, I am completely confused at this point.  I know this doesnt make much sense but the last year is first time I had all these issues with my current pacemaker.  I am not trying to run races but just run at respectable pace I was before all this started.

Re: Get A Treadmill

by TLRun - 2016-11-22 16:55:07

Hi Cardiatech:   Thanks for the info.  I am not the most technical person when it comes to this but I thought the Max Heart Rate is suppose 220 - Age = MHR.  So, mine would be 220 - 58 = 162.  I have the MHR on my Pacemaker set at 140.  I have read many postings here where the MHR is much higher like you described.  Anyways, I dont think I am getting to 140 even with the settings I have it at now with my Rate Response increased.  I dont use the FitBit anymore since its so inaccurate. This is the highest I ever had Rate Response set which is 9 on a St. Judes pacemaker.  For some reason, I keep having issues.  I am still not where I was before all this started but I am running now.....very slowly.  What you described is what I think happens with me.  Sometimes I get on the Treadmill and really have no issues but again not where I was before this issue started.  Other times I am running and my body just starts to shut down and I am going so slow.   I am not hitting my MHR and feel completlely max out  Then somedays, I cant even start running as I am a complete mess.  Its easier to walk fast then even to try a light jog at that speed.  I know I could get the Rate Response increased but already it seems like my heart rate soars with little movement.  Other times it barely budges.  I am getting such mix signal of messages, I am completely confused at this point.  I know this doesnt make much sense as many issues are going on but the last year is first time I had all these issues with my current pacemaker.  I am not trying to run races but just run at a respectable pace and feel comfortable while running like I was before all this started.