Heart Rate Does Not Respond To Exercise

Sleep

by AgentX86 - 2019-03-09 01:12:11

You'll never get a pacemaker to do as well as a healthy sinus node but since we'll never have one of those again, we're stuck hounding our pacemaker techs to get them to set our PMs up to our liking.  I wal quite a bit but mostly either on flat ground (indoors) or on a tradmill.  Stairs and long shallow slopes get me winded fairly easily.  The PM just doesn't respond well enough.  It could be  a lot worse.

As far as minimum rate and sleeping goes...  I started out at 80BPM and didn't like it a bit.  My EP said it had to be there for the first three months, then he could start setting it back.  After the three months I complained about not being able to sleep with it set to 80, so the tech set the PM to 70bpm day and 50bpm night.  The 70 didn't work out so well (PVCs) so they increased it back to 80 (still 50 at night - it's a pretty wide difference but feels a lot better, except if I have to climb any stairs.

PMs for Athletes

by KonaLawrence - 2019-03-09 01:38:00

Aloha Davecarol,
I paddle outrigger canoe (6 man crew) year around and race competitively during the summer months. I've had a Medtronics PM over a year and had may problems initially with it supporting my exercise.  The standard routine is a PM checkup at 30 days, 90 days, then annually.  I requested and got adjustment, after adjustment, after adjustment.  Eight appointments in the 1st nine months.  Biotronik is suppossed to be a better PM for athletes.  If your PM settings are the problem, you can get them changed.  Just keep asking & getting adjustment appointments.
My advice is to spend a lot of time with "Dr. Google" to learn about the options with your PM.  Then when (not if) you go in for an adjustment, you can talk their language and request specific changes.
In my case, I tried Rate Response Off and ON (better).  I had my lower and upper rates changed multiple times, finally 55 and 145.  I had changes to my Rate Response, Sensitivity Level, Response threshold, Rate Response Optimization and many other settings.  There are lots and lots of settings.  I think PMs are designed for more-or-less sedentary folks so athletes have to get special adjustments.  
Good Luck, Lawrence

Dave

by IAN MC - 2019-03-09 14:34:46

I am cønfused. In your bio you state that you have a Medtronic PM yet in the text above you say you have a Biotronik.

Assuming that you don't have one of each, what make do you have ???

Seriously, the two makes are fundamentally  different in the way they increase heart-rate in response to exercise which is the subject of your question.

Ian 

Ian

by DaveCarol - 2019-03-09 16:00:29

Thank you for pointing out the discrepancy between my bio and my text. I have corrected my bio to show that I have a Biotronik PM installed.

I would be interested to know how this type of PM responds to exercise, and if feasible (and appropriate) how to modify that response to the types of exercise in which I indulge.

Dave

Dave

by IAN MC - 2019-03-10 08:21:14

Biotronik pacemakers claim to be better than Medtronics if you are "chronotropically incompetent" and are unable to raise your HR adequately when you exercise.

Medtronics sensors respond only to movement / vibration to get your HR up . One drawback of this is that they misinterpret vibration not connected with exercise such as a bumpy car ride and they may send up your HR when you don't really need it.

Biotroniks rate response depends on measured " impedance" which loosely can be described as how difficult it is for an electrical signal to be sent/received by the pacemaker.

When you exercise your heart should go faster but even if it doesn't it may contract even more forcibly to compensate for the lower heart rate. Your Biotronik PM ( if you have Rate Response switched on ) detects the subtle change in circuit impedance caused by the increased contraction and decides that you have started to exercise; the result  is that it will increase your heart-rate.

Biotronik terminology is to call this  C.L.S. ( closed loop simulation ) and it certainly sounds as though you need the CLS sensor turning on.

One claimed advantage of the C.L.S. sensor is that it will also increase your HR in moments of stress/ anxiety for example if you are suddenly attacked by a zombie on a dark street ! In other words it is more physiological in its response than are other makes of pacemaker.

But at the end of the day it doesn't really matter how your RR function works. All that matters is :-

Do you have a Dr / technician doing the adjustments who REALLY understands Biotronik pacemakers and how to adjust them to give you back your optimum exercise performance ?  Do you ?

Best of luck

Ian

IAN

by DaveCarol - 2019-03-13 17:35:50

Ian:

Thank you for your very prompt and very constructive comments, thanks to which I felt confident enough to go see the Pacemaker Clinic, located in my local hospital, to discuss several of the points you mention.

The technician I met certainly gave me the impression that she was very familiar with both the operating features, and the feasibility of the adjustment thereof, for the Biotronic Edora 8 DR-T PM installed in my left shoulder some 4 months ago.

I explained to her the problems I had encountered in relation firstly getting to and staying asleep, and secondly to the slow response of the PM during exercise. As far as sleep was concerned, she felt that that there was little she could do beyond dropping the basic rate a little.With regard to the slow response rate during exercise, using the "Rate response" function,she reset a range of available rates and responses, including a "Max. activity rate" (120 bpm), an "Upper response rate 130 bpm), and a "Mode switching rate" and "Intervention rate" (160bpm).

All this, together with a bunch of other associated data, which the technician had used in re-calibrating my PM, she provided to provided to me on a printout.

I was impressed! I'll see how it all works during my next serious bout of exercise tomorrow.

David

Pace

My lower limit is 45

by PacedNRunning - 2019-04-13 08:41:16

My lower limit is 45 but I’m not symptomatic so I’m not being treated for my low heart rate yet. Mine does not have a night mode. My max is 185. Like someone else said. Google about these things and how it controls our hearts. I’ve had many adjustments and we are now finally narrowing down my AV delay. Seems that has helped me the most with breathing and stamina with exercise. It’s just a matter of finding the right number 

My lower limit is 45

by DaveCarol - 2019-04-24 12:23:43

Thank you for your helpful comments!

One question: You mention "AV delay adjustment"; I can find no mention of this I the printout of my pacemaker parameters. Could you explain what this refers to?

David