Heart Rate While Working OUt

Hello:

I am new to the club so please excuse the question if it has already been covered. I am 63, had a dual lead pacemaker implanted in October 2016 and Aortic valve replaced in 2012.. SInce the implant I find I can not achieve peak heart levels while working out like I did prior to implant. The pacer is  set at 60 BPM and paces me roughly 50% of the time. Prior to implant I could achieve 120-130HR while doing aggresive works outs. Now I am lucky to get to 105 BPM. The other issue I seem to be having lately is the variability of the heart rate. I can be working out at 95-100 HR and the excercise equipment and a pulse oximeter will show me suddenly dropping to the 70-80 BPM range. When this happens it takes my ability to work out down alot. After that happen it takes a 1-3 minutes to return back to the higher HR. I do have PVC's but normally those did not impact me that  much. Anyone else have a similar situation.

 

Thanks Lumpy

6 Comments

Maximum heart rate

by LondonAndy - 2018-02-15 05:34:13

A couple of possibilities that might be worth investigating: pacemakers have a maximum heart rate setting too, so might be worth asking what yours is set at, and they can increase it.

Also, the way pacemakers adjust the rate at which they operate is through a "rate response" system.  There are different ways that they can work: some can be based on vibrations, so if your workout does not cause much actual movement in your body then that might not be picked up by the device.  However, they can adjust the sensitivity setting.  

I am sure others will have more direct experience and be able to help more.  Good luck!

Agee with Andy

by dclly - 2018-02-15 08:57:45

I had 4 pacemakers sine 2003.  I think Andy is spot on as I excercise several times a week at age 64 and I have had your same results.

I still recommend speaking with your physian.  

Good luck!

David

Heart Rate While Working Out

by Lumpy - 2018-02-15 11:38:23

Thank for the heads up. My doctor did ajust the upper limit to 140 BPM 4 months ago. After that it did go higher but still not to the same level, prior to the adjustment is no able to hit even 100 BPM. I wonder with a resting heart rate of 60, if that is going to be a level that is all I can expect, (95-105bpm). My aerobic work outs are on either elipticals or treadmills followed by weights, so the vibration sensitivity does make we wonder if I am shaking things up enough! Anyhow thank you for the feedback, glad to hear I am not the  only one that has had similar situations.

Lumpy

Heart rate

by Jimmy Dinfla - 2018-02-15 22:29:53

The meds you might be taking could be a factor.  I used to get my heart rate up, but meds now keep it low even as I exercise at the gym.

exercise

by Tracey_E - 2018-02-16 10:07:06

Upper limit refers to how high it will pace the ventricles when you are in block. If you are in block and your atrial rate gets to 150, the pacer will max out your pulse at 140. The heart can go higher than that on its own, the pacer will just watch. But it will only pace up to the upper limit. 

Meds can artificially keep the rate down, but the pacer should override that. 

Rate response is the feature that senses movement and gets our rate up on exertion. Elliptical or treadmill should be more than enough activity to activate it. Are you sure it's turned on?? Sounds like maybe it's not. Once it's turned on, they can adjust the sensitivity until it's getting your rate up adequately.

If you feel bad, especially if you know your O2 sat is low, STOP. That is super hard on the body and a big red flag that what you are doing is too much for your heart rate at the time. 

If your rate is suddenly dropping, ask if the feature for afib is on. There is a feature intended to help us out in afib. With afib the rate gets too high but the heart is quivering, not doing strong beats, so the pacer will sense this and put us into an artificial 2:1 block, so if you were cruising along at 140 and it decides you are in afib, it will pace at half that, 70. If you are in afib, that's great. If you are working out, it's like hitting a wall. BTDT. If you have no history of afib, they can turn it off. 

If your rate is dropping on its own, they can turn on rate drop response which watches for sudden drops and kicks in with pacing to keep the rate steady.

I have had all of the above, I'm a bit of a problem child :o) It took months and months and a very determined doctor and SJM rep to get my settings fine tuned. They eventually sent my records to SJM, the engineers who developed my pacer had a powwow and I became a case study.  No two of us are alike, so it may take some trial and error to find the mix that works for you. Some doctors are better at challenging patients than others, more willing to do research and think outside the box. But the answer is out there. Be persistant and don't give up. A treadmill is a helpful tool. Get on and exert so they can watch real time what is happening and make adjustments. 

Heart Rate While Exercising

by Lumpy - 2018-02-16 14:46:05

Again to all of you thanks for some good tips. The PM was implanted in 2016 after wearing the 24 hour monitor, and it showed heart was periodically  stopping for 3-4 seconds, which explained my dips I was feeling. HR was always slower than most and have been on Propanolol and Flecainide since the valve was replaced in 2012 and I know they will keep my HR down by design.  Only Afib I have shown in the past was while in hospital  after valve was done. I do work out a a cardio rehab gym at the same hospital. There are cardiac RN's and exercise physiologist's at the gym and they put me on the  monitor every 3 months while working out. So far no reason can be found.Will see where this leads, in the meantime I am still working out and sweating.

Thanks Everyone - Lumpy

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