Minute Ventilation (MV) feature defeated by arm movement

I have had the Boston Scientific Accolade for a year now. After at least 20 pacer sessions working remotely with the Minnesota based tech support along with my local techs they have concluded that the movement of my arms during rowing workouts is confusing the MV logarithms responsible for detecting air volume in the lungs and elevating heart rate appropriate to the effort. One Boston Scientific theory is that arm movement is causing the pacer body to move in my chest, not so much the leads, but I wonder, and that in turn causes the PM to sky rocket my pulse to its max setting of 155bpm when it should be in the 80's, confusing the pacer body movement with increased breathing. This all takes place within 60 seconds of arm movement. I can also simply sit in a chair and move my arms like a birds wings and get the same result, so it has nothing to do with respiration. Perhaps I should just stop trying to fly.

 This is a maddening defect as it has prevented me from training or competing in the only sport I can do on the world age group stage. I have been told by Boston Scientific they have run into the problem with other athletes also, but very few it seems.

By taping the pacer body to my skin with good ole Duck tape or KT tape solidly enough I get a reduction in the rapid acceleration. What's very strange and aggravating in terms of setting adjustments is that it is an intermittent phenomena. After I start a workout and get through the first usual 10 mins of "pacer gone mad" it will actually lower and hold my HR at an inappropriately low level for the effort for up to 10 minutes and then inexplicably go turbo and shoot HR to max 155bpm holding it there for up to 30 minutes. This is a dizzying experience I might add.

 I risk providing too much information here in hopes that if this describes someone elses experience I would love to hear from you, rower or not. What have you learned if anything if you have had this problem, short of turning off the MV feature which in my case defeats the whole point of getting the pacemaker as my only heart condition is a heart block 1 with bradycardia. My goal was to get the upper 30% of my heart rate back after this condition developed. Perhaps I shouldn't complain, the Accolade has certainly given me back all the heart rate I can handle, just all at once! I have dubbed it the Accoloid, pacemaker on steroids. Blessings to all and to all a good night, Cardiovert out.

 

 

6 Comments

Rate response adjustment?

by Selwyn - 2018-02-01 12:28:59

Yes, thank you for a very interestng post.

As your pacemaker has a dual rate response ( either breathing or movement, or both), perhaps you can turn off part of the rate response activation.

Certainly worth asking the rep., I think.

Selwyn

Rate Response

by IAN MC - 2018-02-01 13:02:03

I was about to make the same point as Selwyn.

i don't have a dual-sensor pacemaker myself but find that  I, ( and my chronotropic incompetence ), can cope really well with the  gym rowing machine . This is with the help of the sole motion sensor in the Medtronic PM

I have often wondered if the two sensors in the Boston PM compete with each other when you have lots of movement in the PM upper-arm area combined with increased breathing

I guess there must be an optimum combination of sensor settings which will solve your problem . If not , as Selwyn says, I wonder if you may be better off with just one sensor switched on.

Best of luck

Ian

MV HIGHJACKING

by Cardiovert - 2018-02-01 18:25:52

Thanks to all of you who responded. I will definitely follow up with your suggestions.  A lot of setting combinations have been tried but turning off one of the sensors has not been one of them, so thanks very much for that. My current cardiologist won't restitch the PM pocket to restrict its movement for fear of infection, but I will find one that will and see if that helps also.

In case you have not heard there is a nationwide advisory concerning the Boston Scientific Accolade and another MV equipped pacemaker made by them. It is a technical sensing issue unrelated to my troubles. I will post about shortly under the heading, Boston Scientific Advisory. For pacemaker dependent patients, but a very very low percentage, it can be a serious problem to the point where some doctors are just simply turning off MV to avoid the issues. The technology in these devices is truly amazing but like some of the developments in artificial intelligence, creating algorithms that even the Geniuses creating them admit they don't  fully understand can definitely be "Trouble in River City" with a capital T especially if it's running your heart!

Snap

by RubbleCompleX - 2019-06-19 19:03:42

Hi Cardiovert, 

Thanks for posting this. I have recently had a pacer fitted (my first), and I am experiencing just exaclty the same effects that you have described. I also have a Boston Scientific model with MV, chosen deliberately as it can do a good job at rate pacing for cyclists. It is doing a good job for cycling, just super sensitive when rowing, and occasionally in everyday life when (I assume) I am making similar arm movements. 

I am going through a review of settings with my cardiologist, so can I ask please: did you get any progress over the past year, did you end up having to switch MV rate pacing off, reduce the sensitivity or did you get the PM restitched? 

cheers, John 

Arm movement triggers MV sensing and drives up heart rate.

by SimonP - 2022-03-02 15:45:26

I also have an Accolade pacemaker from Boston Scientific.  It was implanted in August 2021 and 65 years old.  I really enjoy endurance sports such as running, bicycling and swimming.  I'm also having significant problem with arm movements alone driving up my heart rate to max levels (set at 150 bpm). 

After about 30 seconds of very easy rowing (arms only on Concept 2), my HR increases to 150.  When I stop, it will drop back to baseline (70's) within about 30 seconds.  This is a repeatable event.  I have talked to a few Boston Scientific techincal representative and they did not know what is going on or how this could occur.  My medical team is also baffled.

I'm also able to drive up my heart rate by simulating a rowing motion with or without resistance bands.  However, this only occurs about 50% of the time while I'm able to rapidly drive up my HR with rowing on my concept 2 on a consistent basis.

I have found that if I walk with my hands in my pocket or on my head, my heart rate does not spike like it does on occasion.

I would like to know who at Boston Scientific you were able to work with to pinpoint the problem.  Since the time of you initial post, have you been able to fix the problem or has it gotten worse?

Regards.

Accolade MV misinterprets shoulder movements as breaths

by AbNormative - 2024-09-21 18:43:36

Same problem. The short version:

Got my Accolade Aug 2022. Wanted it for the MV pacing for bicycling. Had MV enabled and accelerometer disabled. And it did work well for cycling.

However, routine daily movements of my left shoulder, such as getting dressed, were enough to trigger the MV pacing. I could trigger it deliberately by doing a rowing motion. This was all with accelerometer pacing disabled. It appears that each individual cycle of shoulder movement was misinterpreted as a breath.

The top local Boston Scientific guru in Rochester NY said he had never heard of this happening before.

Eventually, in Jan 2023, I had them turn off the MV pacing.

-Mark

 

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