Trying to decide which is the right pacemaker

Depends !

by IAN MC - 2017-04-27 11:56:47

There are 2 possibilities

- your husband might need "Rate Response" switching on or

- he might not  ( roughly 50 % of PM patients don't need it )

Rate Response is where you need the pacemaker to increase your heart-rate when you exercise . If your husband's heart-rate doesn't increase as it should when he is cycling up a hill then he is "chronotropically incompetent" and needs Rate Response to add extra heart-beats.. It would then be important to choose the right pacemaker.

If he doesn't need RR then any pacemaker will do.

As you seem to be aware , a PM detects when you are exercising by the use of " sensors".

The most common sensor known as an accelerometer depends on upper body movement / vibration to detect exercise.  While you are right that this would make your heart-rate increase on bumpy roads an even bigger problem is that it is really not satisfactory if you are cycling on a smooth road. His heart-rate would not increase sufficiently and he would quickly become breathless.Cycling simply doesn't generate enough upper body movement to trigger off the sensor

My advice would therefore be to avoid pacemakers which only have a motion sensor ( such as Medtronic and I think St Jude ) . Instead insist on having a dual sensor pacemaker as used in Boston Scientific  .One sensor detects motion/vibration, the other "minute ventilation" sensor detects breathing . There is yet another sensor, known as CLS which Biotronic use and claim to be the most physiological but some people seem to have problems getting the settings right.

But this may be all irrelevant if he doesn't need Rate Response anyway  ( .On the other hand chronotropic incompetence can develop over time  )

Best of luck

Ian

one more thought

by Tracey_E - 2017-04-27 14:39:40

Ditto everything Ian said! First find out if he will even need rate response, it may be a moot point. If yes, then you'll want one his doctor knows inside and out. It's a good idea to ask your questions and do your research, but ultimately they are only as good as they are programmed to be so it's usually best to go with your doctor's recommendation. If you can't get answers from his doctor, it might be a good idea to get a second opinion and find a doctor who is a better fit, one who works with more active patients.

Thank you!

by Runner_pup - 2017-04-27 14:48:28

Thanks so much Tracy & Ian. Yes, my husband does need a PM with Rate Response and he also wants on the is MRI compatible. We will continue to do our research to find the best "fit" for him.

mri compatible

by Tracey_E - 2017-04-28 08:32:33

It's a bit of a misnomer. With a compatible device, we can have an mri under controlled circumstances at some facilities. It doesn't mean we can go just anywhere and have one any time. Also, there are more and more facilities that are safely doing mri's on paced patients that do not have mri-compatible devices. I would not let mri-compatible influence your decision much.

There is at least one mri-compatible device that only goes up to 150. If he is active, that may not be enough for his needs. Most devices go to 180, two or three go to 220. We've had more than one frustrated member who got mri-compatible and found the 150 upper limit to be too low. 

other factors

by dwelch - 2017-04-28 21:51:21

The doctors should really be choosing your device not you.  But talk to them about your situation.

Also understand that the device ideally makes you  more normal, so whatever heart rate or whatever he needs to do these activities today he may not need if his heart is working better.

He is not the first nor last active person to need a pacemaker, read around the forums, lots of folks here.

The goal is not to make his life worse but to make it better.

Mt Biking

by Teletim - 2017-07-06 06:52:12

Yes rough trails will make the heart rate go up with the motion sensor type PM. I Mt Bike a little and it feels strange sometimes on long downhills. I had my max adjusted DOWN to 160 so this would not be so dramatic. That may seem a little low but since I am 60 years old if you take the simple formula 220-your age 160 max is just about right for me. Once in a while I might wish it would go a little higher but now it does not seem to be running way too high when I really don't need it. A trade off I am willing to make.

Mt. Biking

by Runner_pup - 2017-07-06 09:31:39

Thanks for all your input, it's greatly appreciated!