Treatment

Hi,

Since I had a Boston Scientific CRT-D inserted, Oct 2015, my condition has deteriorated precipitously.  In April, I'm told, I had a heart attack - tachycardic- 197bpm?  From April to July I did rehab exercises with good BP readings and pulse rates 52 to 134 bpm. Since then I've become totally exercise intolerant with a pulse 'fixed' at 71 -72 bpm and breathless after one or two minutes down from 45 - 50 minutes continuous excercise with varying resistance and steady (pedal) revolutions of 70+.

The only non-medical reason I can offer is that I fell, heavily over a raised 'manhole' cover which 'winded' me and caused lots of pain for weeks.

 Despite my massive deterioration pacemaker clinic say everything is fine offering only to make rate-response a little more sensitive. I presume they did but HR still reads no more than 72 bpm when I attempt to exercise.

How common is my experience?

4 Comments

Doesn't sound right.

by DampDog - 2017-01-20 12:50:50

Unfortunately the reasons we have these modern day miracles implanted are myriad and complex so there is no “one-hat” fits all answer. But I agree, something doesn’t sound right.

I’m also in the UK and have a CRT-D (March 2016) If I were you I would ring the pacing clinic voicing your concerns,ask to have the device interrogated to check for any irregularities, likewise to double check if you really do top-out at circa 70bpm.

I have a Medtronic device that was provided with a CareLink remote monitor, if your Boston Scientific device has something similar, you may well be able to do it without the need for a hospital visit and simply initiate a data transmission. If you are more breathless than you were then you need to be seen by your cardiologist to get to the bottom of it. Even in the NHS you can ring the secretary of your cardiologist to explain your concerns and request a rapid/urgent appointment.

My CRT-D is set to pace me out of bradycardia @60bpm, however as my heart rate rises on exertion in rehab I see rates of 130+. Up to now breathlessness has not been an issue, other than my fitness level having fallen off significantly following the device being implanted and me being very sore post implant, so just taking things easy.

Something is amiss

by SteveE - 2017-01-22 13:04:06

Your pacemaker should not be operating at an asynchronous, stable rate of only 71-72 BPM.  It should be going up and down, in response to your body's needs.  I would contact your device clinic and demand an explanation.  Do you have the option of being seen at a different clinic?  I might opt for that, as well.

 

The only time my pacemaker runs at a constant rate is when I "outrun" it at the gym - if my heart rate goes above my preset maximum pacing rate of 160 BPM, my pacer drops to 90 BPM to slow it down.  Once things settle down, all goes back to normal.  During exercise, my heart rate normally goes from the 60's to the 140's with no issues.

You need answers

by Gotrhythm - 2017-01-22 14:16:40

Don't accept the old "your pacemaker is fine" answer. It might be fine but it might not be working so well with your heart. Or your heart might not be responding well to it.

The question is, if you have a pacemaker, why is your heart rate not going above 72 when you exercise?

Echo

by BillH - 2017-01-23 01:07:32

Ask about getting an ECHO while they adjust the timing of the CRT.

In some cases that has help alot.

 

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