Bad adjustment

Hey Everyone,

I had my follow up appointment with my EP to have my pacemaker interrogated, make sure the leads are still in place, have remaining bandages removed, and see that the incision is healing. Everything was looking good and still in place. I was told that the PM was turning on for the area they are most concerned with 2.8% of the time. My heart block was only occurring when engaging in cardio based physical activity and since getting the PM I have not been allowed to exercise till everything heals. 

I let them know that I was able to feel the PM turning on when it did, experienced some shoulder pain from it, and my heart felt like it would be racing longer than it needed to be. After examining all the data they decided to increase the amount of time allowed for pauses before the PM kicks in. It went from 180 milliseconds to 220 milliseconds. Now I do not feel the PM turn on but I am feeling weak and short of breath after climbing up the stairs to my apartment (every time). I usually have to sit for about 2 to 3 minutes afterwards, before I feel like I can walk again.

I am guessing I need to have them shorten the time frame again? Any similar experiences or advice? 

Thanks everyone. 

On another note, had all my wisdom teeth removed a few days ago. After being awake to get my PM implanted I wasn't even phased by them keeping me fully awake and not sedated for the surgical removal of my teeth. 

4 Comments

Shortness of breath on exercise after PM insertion

by Selwyn - 2016-12-18 08:37:43

Of course climbing stairs is exercise. You are allowed to exercise after PM insertion, just don't damage the wound site. Personally, I was bike riding ( as I was stopped from driving my car for a week) within 48 hours. The upper body is not bouncing around with normal bicycle riding.

If you have had your initial check up it is very unlikely you have a missed medical problem or a new medical problem ( such as pneumothorax). The most likely thing is that your rate response needs to be activated ( the part of the PM programme that increases the heart rate with exercise. The are fast, medium, and slow, responses , with onset and offset).  Also, sometimes the base resting rate may need to be a little higher if you take sudden exercise.

I have found stairs a particular problem, as the rate response is motion is a motion sensitive mechanism, and climbing stairs is all legs.  Start off slowly and wait for your pacemaker to catch up with the rate ( should your rate response be switched on!) . I have been treking in Nepal without problems, and when going up, eg. church towers, I now don't run, but take my time.

You need to talk to your EP department again!

Selwyn

A possible explanation

by Terry - 2016-12-18 17:41:20

The research on pacing more than 20% of the time may not be problematic as long as your ventricular lead does not bypass the native, natural cardiac conduction system (Google that). You can check that out on the Papers Page of His-pacing.org. All the best to you and yours, Terry

A tip about stairs

by Bionic Beat - 2016-12-18 22:13:46

As Selwyn states, stairs are 'all legs'.  With my first pacemaker I found stairs quite difficult and at my post op visit was told to swing my arms a bit before setting off up the stairs.  It made a tremendous difference, it gets the pacemaker 'warmed up' so that you are not short of breath.

 

best wishes. 

 

Bionic  Beat

Thank you

by Ncrespo3 - 2017-01-02 13:13:55

Thank you everyone for your comments. They were informative and have been helpful in figuring things out. 

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