Bi-V and heart function

Its been 6 days I had my ICD with Bi-V pacing and I went on couple of walks around my house (roughly 2.5 miles in 40 mins). There was a slight incline along the path and  my apple watch used to show  around 120 BPM once I get to the top of it.Now it shows just 100. I know its not a lot of data and I kept the same speed.It seems like with Bi-V my heart is able to accomplish more output at less BPM. Anyone experiece something similar? 

3 Comments

New pacemaker

by AgentX86 - 2021-03-25 15:28:35

We'd have to know a lot more about you to even hazard a guess.  Why do you have a PM? Are you chronotropically incompetent (SSS or other)? Pacemaker mode?

I had a PM

by seenu302 - 2021-03-25 16:58:26

My PM was due to SSS and Bradycardia.They put it ater A-flutter ablation back in 2014. It was Medtronic dual lead one. I was 100% paced on it. Last week an ICD took its place due to recent vtac episodes (asymptomatic) and just getting back to normal.Now I am Bi-V paced, hoping ATP would trick my vtac and avoid a shock or 2. 

SSS after ablaton

by AgentX86 - 2021-03-26 00:01:29

OK, that likely means that you're chronotropically incompetent (CI).  That is, your heart no longer reacts normally to oxygen demand.  Essentially, your SI node is toast.  The SI node measures the blood oxygen (actuall CO2) levels and adjusts the heart rate when the O2 goes down (CO2 goes up).

Your pacemaker can't do this so does the best it can.  Most pacemakers use an accelerometer to measure the movement of the torso as a proxy for exertion (thus oxygen demand).  This measurement is far from perfect and *will* have to be adjusted to your body, activity type, and activity level.  This featue is known as "Rate Response".  

The good news is that what you're feeling now is perfectly normal.  Your pacemaker just needs to be tuned up.  The bad news is that this isn't a one-and-done adjustment and the more athletic you are, the more tweaking is necessary for best/acceptable results.  There are probably twenty (maybe more) adjustments that affect how you feel and your ability to exercise.  Your doctor probably used out-of-the-box settings and they just need to be set for you.

You might want to get a copy of the technical manual for your PM (from the manufacturer's site) and look at all of the settings.  When you go in for interrogations, get a copy of your settings and compare to the manuals.  Comparing the two will make it easier to understand the important stuff and even be able to tell the PM technician how you want it set or at least what you want to try.

There's nothing wrong with you that a tune-up, or three, won't fix.

 

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