Sub muscle / rate responsive vs set

answers :)

by Tracey_E - 2017-03-14 18:03:21

1. I would for sure go with subpec! At the very least, have them put it lower and deeper than the usual placement which is just under the collarbone. Which works best depends on your build. It takes a little longer to heal but I didn't think it was bad at all, nothing Tylenol didn't fix after the first couple of days. Once it heals it will be out of our way and we can get on with our lives without worrying about bumping it. 

2. What is your diagnosis? Not everyone needs rate response so it may be a moot point. If you will use rate response, have a chat with your doctor about the best options. Many of them just use motion so if you ride a bike or are skating, it may not pick it up and raise your rate enough. Some use breathing also and there's also something called CLS (closed loop stimulation). There are pro's and con's to both. Biggest thing is to make sure your doctor is familiar with it, the device is only as good as the programming so you want one your doctor knows inside and out. If you look up past posts from Inga (golden_snitch), she is a runner and has had all three and does a terrific explanation. I have'nt seen her around much lately but if you do a search for CLS then look for her posts, there should be a bunch. 

Good luck!  

Sub muscle...

by Jackw - 2017-03-14 18:48:28

It would be helpful to have a little description of your diagnosis so that people who have a similiar condition can respond. There are so many conditions that call for a PM but have very different needs.

Condition

by Nstar27 - 2017-03-14 19:39:38

Sure

bradycardia with av node disease

rhr is around 40 bpm sometimes lower when asleep 

Subcutaneous ICD

by Rolfr11 - 2017-03-14 23:50:49

I broke the leads on my ICD after 7 years of rock climbing. The passage way between the collar bone is very narrow and repeated overhead exercise ( climbing) broke the lead.

I was approved for a subcutaneous ICD with a wire less attachment to the heart , The ICD  sits under my left arm pit , the lead circles the heart under the skin, (subcutaneous) not under the muscle, sends a charge to the heart without being attached.The follow up day surgery to implant the new icd and remove the old leads almost killed me, collapsed atrium ad emergencey open chest surgery, three weeks recovery.

If you do alot of overhead exercise cinsider the Subcutaneous ICD.

For perspective,I am a 65 year old 43 year experienced fit climber.

Condition

by Jackw - 2017-03-15 10:45:40

I have a similiar condition- sinus node disorder and chronotropic incompetence (rate does not rise sufficiently with exercise). Resting rate in the 40's dipping into the 30s at night. Peak rate with exercise did not go over 110 meaning I ran out of gas when jogging or skiing too vigorously. Should mention I'm 71 now. Doc recommended a Biotronik PM with CLS turned on. You can check the pluses and minuses for various types of rate response (CLS, accelerometer, breathing rate, etc) on this forum. Implanted two years ago. Took a few visits to tweek parameters but now have much more exercise tolerance. Peak rate goes to 150, the current upper limit, close to my theoretical peak of 220-71=149. May ask him to move it up a bit to 160 next visit since I regularly max out when exercising hard. Bottom line: Very pleased how it works for me.

On placement, I have the usual placement on the upper left side. I don't find it bothers me o lift or raise my arms above my head with a load but I'm not a rock climber!

more

by Tracey_E - 2017-03-15 11:41:17

Only ICD is available subcutaneous. Pacing is not there yet.

Having the pacer either under muscle or lower/deeper than the usual placement usually prevents the problems rolfr11 had. There are never guarantees, but that's the exception, not the rule.

Bradycardia is any heart rate under 60, it's more a symptom than a diagnosis. Do you mean av block? If yes, then your sinus node theoretically works normally, you just need pacing to complete the broken circuit and make the ventricles beat when the atria does. This is one of the conditions that rate response is most likely irrelevant. Rate response is to help when the sinus node slacks off, which is it sounds like is not your problem./ 

Impact awareness

by bridgermichael - 2017-03-16 19:48:48

ice hockey ? I was told not to have contact sports after my pacemaker fitting - I have stopped football as a result but do play golf ( had to restrict swing but with lessons actually hit ball straighter and farther ) and I can play cricket but have a chest protect pad for upper chest - I would have thought ice hockey would have impact implications and if you smash your unit it will need to be replaced straight away and need surgery to take it out. 

impact

by Tracey_E - 2017-03-17 10:39:18

with hockey, players are well padded so a direct hit to the device is unlikely. The devices are titanium and will not get smashed. There used to be a video on Heartbeat INternational's website of a boy who got shot in the chest. The pacemaker stopped the bullet, saved his life, and kept on pacing. We are much more fragile than the boxes! I fell once, my dog hit the back of my knee at a full run and I reached my hand out to keep from going face first into the corner of the steel door. I ended up with a fist-shaped bruise over the pacer. It hurt like crazy but the pacer was fine. 

The weak point is the leads, not the box. It is possible to damage leads. Possible, but not likely. Of all the years I've been an active member here and the thousands of members we have, I've heard of maybe 3-4 people who broke them from activity.