Rate Response Turned Off Today

My EP had Rate Response turned off today.  Pacer implanted Nov of 2017.  Right side implant due to mastectomy.  Initially my heart rate spiked whenever I used my right arm.  I could do weights with left arm and no increase.  Right side would spike.  EP tweaked it and it improved some.  Could use arm, but repetitive motion caused it to spike.

Today he suggested turning the rate Response off, so we did.  I’m set at 70 bpm and it showed 68% atrial pacing and 8% V.

I’m finding I’m staying at 70 resting, sitting, and standing.  I have POTS, and Sick Sinus.  I’m on Multaq, which has lowered afib rates when I pop into it.

My question - should I be concerned that my heart rate is staying at 70 even with mild activity.  I’ve been bedbound for years and since pacer can do low level exercises and a small amount of walking.

Anyone have input?

I expected him to lower rate response, not turn it off.

I’ve a Boston Scientific L331 pacer with two leads. Have to admit this is new territory for me, with all the lingo and such.


4 Comments

rate response

by Tracey_E - 2018-05-23 11:13:13

How do you feel when it stays at 70 on activity? If rr was giving you problems, it was worth trying without it. If you feel good, then 70 is good. If it's not enough, then you'll have to play with rr some more. Sometimes there is no perfect setting. Mine is set fairly sensitive. I put up with easily getting sob walking across the room in order to have it be super responsive at the gym. 

The right rate response for you

by Gotrhythm - 2018-05-23 14:45:14

I expect that having a pacemaker is new territory for anyone, even people who are expert in the subject. There's a lot to learn for all of us.

When it comes to pacemaker settings, it's all about how you feel and if you can do what you want to do. The only right settings are the ones right for you.

But when it come to RR there are more choices than off or on. Hopefully, you will get stronger now that you can be more active. You might wish to try and see if there is some degree of your heartrate jumping up that you can tolerate in order to do things like walking up steps more easily.

Since my latest adjustment, my heartrate jumps from 70 to almost 90 if I do no more than reach for a tissue. It was a little disconcerting at first, but overall, I feel better. I love not needing for others to wait for me on the stairs.

Sick Sinus

by Grateful Heart - 2018-05-23 15:30:32

If you have Sick Sinus you need the RR turned on.  Your heart, just like a non-paced heart needs to rise with exertion, even mild activity.  I realize the doctor is trying to accomodate your right side by turning it off but that doesn't appear to be answer.  Keeping your HR at a steady rate when trying to move would put stress on the heart and not feel good.  He can try a less sensitive setting for the RR feature instead of turning it off completely.

Like Tracey, my HR jumps to 120 just walking down the hall but the setting is great for the gym so I don't complain about it.

Talk to your doc.

Grateful Heart

Rate Response Turned Off

by Psychdrdeni - 2018-05-23 19:21:07

Thanks for the input all.  I know my doc tweaked RR once. My heart rate was still spiking to 110-120s after he tweaked it, just moving my arm across my body.  His nurse told me he had turned it down a lot that first time.  I’m finding today that I’m exhausted.  My heart rate does go up a bit when walking, but not much over 80 - but I don’t walk much.

My resting heart rate has been 60 for as long as I can remember, with dips into the 50s when sleeping until the sick sinus hit. 70 feels odd for me.  I feel all my heart beats. 

One issue with the higher heart rates is that it triggers afib for me.  Sounds like I’m going to have to talk with him more about this.  I see him June 19 for a follow up, but I might call to see if I can get in sooner.  

I was given very little info after pacer was implanted as to number of leads, the rate response thing, etc.  

I’m grateful to have found this group! 

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