A-Ha!

So this is only my second topic after having a Pacer put in due to Bradycardia at the end of December. For 3+ weeks now I've been having very strange Tachycardia issues accompanied by a fluttering feeling when walking. Sitting still, 60 BPM where the low limit is set. Exercising like dumbbell curls or squats, 75-80 BPM. Treadmill walk or simple walk from my front door to the car, 110-120 BPM? Why? After a week I had the tech check the settings and he said everything was fine, and "tweaked" a couple of settings. No change! A week later I saw the PA, and she said it seemed odd but everything looked normal, the tech came back in a "tweaked" again. No change! On Tuesday I convinced the Cardiologist of another stress test (Coming up Monday) as it's just NOT normal. This wasn't easy as I had one in November that showed nothing except 13 minutes to reach target rate and a quick 2 minute return to get back down to under 60. 

So, my A-ha moment today!... I'm riding into town with my son who drives a performance car (My wife and I drive a smooth riding SUV). We have a semi-rough 1/2 mile road leading from the house to the main road. By the time we got to the main road, my heart rate was at 118 and fluttering??? A light bulb went off and I told him to turn around and drive back up the hill. Same result back and forth. We got on the main road and back at 60 BPM within 20 seconds. I called my wife with excitement... I'm smarter than the Heart Center Staff!!! Simple vibration from a stiff suspended car or the vibration of me walking or running is tricking the Pacer and the unknown fluttering is the Pacer causing it! I got home, kissed the wife, got on me knees to greet the dog, started slapping on my thighs to call him to me and, TACHYCARDIA! The vibration of slapping my knees did the same thing. Problem solved... Or is it?

Now, they've been adjusting the settings for an unknown. With my new insight, will they be able to adjust it correctly to get rid of this? I never had this issue before the Pacer (Some random tachy moments that I was told was the heart adjusting to the leads, and an A-Fib event 6 weeks ago leading to an ER shock that no one knows why)... I never had THIS issue until 24 days ago.

My thought... Cancel the stress test and use the time to have them fix it right!?! And I hope they have a setting to go to because I don't want to live like this thinking every walk, drive or activity will result in that tachy, fluttering feeling, and may ask to take the damn thing back out.

5 Comments

sensitivity setting??

by zawodniak2 - 2017-03-26 14:44:59

Still seems to me that there is a sensitivity setting that needs to be addressed??

                                    Good luck,

                                    Rodger

stress test

by Tracey_E - 2017-03-27 09:18:00

I'd still do the stress test. They can tell on the test if it's you or the pacer getting your rate up. It's a much more efficient way of tweaking the settings than trial and error.

I'm sorry if I missed it, why did you get the pacer?

It sounds like you are using rate response, which senses movement and raises your rate for you. It has various sensitivity settings, so if it gets your rate up needlessly, they can turn it down or possibly off. That's another reason to do the stress test, they can turn rr off and see if you can still get your rate up on your own. Sometimes there is no perfect setting so we have to compromise. I choose to have my rate response very sensitive. My rate will jump up going to answer the door, yes, but at the gym it's awesome. I'd rather get a little short of breath answering the door than struggle at the gym. That works for me. 

Before you consider removing it, ask how often you are using it. Even a very small percentage is a lot of beats. They will be more likely to turn it down or temporarily turn it off than to remove it, see how you do then consider removing. 

Results

by CrockerNut - 2017-03-28 20:19:03

So, I did the stress test and it didn't do it (tachycardia). They have a pre-set program that starts you out at about 1.5 MPH on a 10% incline. 1. I don't walk on an incline. 2. I never walk at 1.5 MPH, It's actually difficult to attempt to walk that slow. After three minutes it speeds up to 2.5 which is close to my pace, but by that time my HR was already to about 80. 3 minutes later it goes up to 3.5 and about 15-20% incline and my HR just keeps gradually going up. After 3 more minutes the pace increases to 5 MPH and so on. Anyway, my HR kept gradually increasing and the Pacer never kicked in. I think it was due to me walking on the ball of my feet on the incline (softer compressions) and starting so slow. When I experience it walking, it's because I start from a stop and am instantly at 2.5-3 MPH and walking heel to toe which gives more of a jarring effect on the body. So, I told her what I thought and I will have to deal with the Heart staff when they call me. But I know I'm right, as it did it when I left there and all day today as well. Frustrating, but I'm not letting up on it!

Rate response

by Selwyn - 2017-03-29 06:56:40

Hi,

I see you have a Biotronik PM ( ? model).  Some of these devices have a rather unique rate response mechanism and do not rely on an accelerometer.

(http://www.pacemakerplus.com/biotronik-closed-loop-stimulation-how-does-it-work/)

You certainly need to have a discussion about what you want with regard to your life style & exercise. There are different levels of onset and offset for rate response. 

Personally, it takes me a little while to get my heart rate to increase with exercise, though on the plus side, recently, I was tossed around in the back of a van for hours on end ( in Tanzania), being constantly shaken. Monitoring my pulse rate whilst being shaken showed no change from rest ( lucky me!). Something to think about before agreeing to a safari? Something also to think about before agreeing to a sensitive setting?

You can always try quickly tapping the pacemaker case and see how soon you get an increase in heart rate. You may need to discuss whether you have a CLS of rate response for your PM as this works in a more physiological way.

Selwyn

 

Selwyn

by CrockerNut - 2017-03-29 21:09:55

Thanks Selwyn,

My Pacer is the Biotronic Eluna 8 DR-T ProMRI model. And I completely agree that it's the rate response setting. I ran into one of my Device Check Techs today and told her everything. She agreed that is likely the issue as well (After I tapped my Pacer as you suggested). She said after the Cardiologist calls with Stress Test results to come in and try, try again. I had thought about the tapping, but being so new to the device wasn't sure if it's a good idea. It's still working so I guess I didn't break it...

You know you're wired when...

You can finally prove that you have a heart.

Member Quotes

We are ALIVE! How wonderful is modern medicine.