Sports Cardiologists

Hitting the wall

by AgentX86 - 2021-03-10 00:24:38

First, you need an EP, not a cardiologist.  If you have structural heart disease, you'll probably need both.  Cardiologists are plumbers.  EPs are electricians.  There are some cross-over. EPs are cardiologists with two more years of residency in electrophysiology and some cardiologists are "interventional cardiologists".  Particularly with your issues, you need an EP to optimize your PM.

Back to your problem...  It's hard to know exactly what's going on but my suspicion is that your maximum tracking heart rate is set lower than needed for your level of exertion.  It could easily be that this is intentional to keep you safe (read: alive).  There may be an issue with RVR that flutter could make very dangerous.  OR, perhaps your previous doctor was being very onservative and there is some room for increasing your tracking rate.  That's why you need an EP.  Care has to be taken here.  Just jumping into the deep end could be disasterous.

II believe what's happening is that when your heart rate exceeds some number, your ventricular lead stops tracking the atrium.  This may make your A/V response go from 1:1 conduction to 2:1, which means that your ventricles are now beating only half as fast as they were a minute ago.  Guess what happens to your performance...  Now, stop your exercise and the heart rate goes down, fairly quickly.  Your pacemaker then swiches  back to 1:1 and you're good to go, until you hit the top number again.  Rinse, repeat.  Raising this top number may solve everything.  You need an EP to make sure this is safe for you.

specialists

by Tracey_E - 2021-03-10 07:46:16

As agent said, you want an ep, not a cardiologist. EP's are cardiologists with advanced specialized training in the electrical system of the heart. They are also likely to program the pacer themselves rather than have specially trained staff do it for them.  There are a few out there that specialize in sports medicine. If you can't find that, the next best thing is an ep that is very active, that has a lot of other active patients. You need that expertise in pacemakers. This is what I went with and, yes, it makes a big difference in their attitude toward getting us back to feeling 100%. And having a number of active, paced patients means they have the experience you need. Good luck.

Thank you

by runpacer - 2021-04-04 15:58:26

I think I will share these responses with my cardio... I also need to return to my doc because I can feel my heart flutter more often (I am off meds for about two months now)... but each episode is just seconds in length. Lastly, I did something slightly different close to the end of my 7 mile run this morning. During the last half mile I allowed my breathing to relax. I breathed to the rhythm of my footsteps. Something old and primitive about it.... it was also meditative.