Should my lower rate be increased?

Raising the rate

by Lavender - 2023-01-13 08:42:34

I think many of us are set at a low rate of 60 so ask your cardiologist if a higher rate might be helpful! 
 

Anemia sounds like a need for iron. My father in law got an Iron Infusion ordered by his dr. Put your questions to your pcp and see if they have more ideas. 
 

It gets tiring having dr visits and chasing down all the things that wear out but it sounds like you are hanging in there! 

already taking vitamin supps

by techiej - 2023-01-13 08:45:38

I worked with my PCP on the supplement side. Also confirmed with my Uro that it wasn't kidney related. Had a couple of consults with a hematologist who ran some more extensive blood work and xrays and did not believe it to be cancer. He htought that while I was still anemic, it was now borderline and turfed me back to my PCP

fatigue

by new to pace.... - 2023-01-13 09:19:32

i have heard that lower rate is mostly set at 60.  The other thing to test is your sensitvity to foods.  Such as Gluten.  As i know that certain foods make me tired ,

new to pace

Low iron

by Lavender - 2023-01-13 09:25:08

I'm glad they checked you for cancer. The reason my father in law had the iron infusion was that he has leukemia. He also has a pacemaker. 
I was used to a very low heart rate prior to my pacemaker. After it-it feels like I am very energetic. (I actually think that anemia raises the heart rate.) You're probably aware that your diet can help with iron. From the Mayo Clinic site:
 

Foods rich in iron include:

Red meat, pork and poultry

Seafood

Beans

Dark green leafy vegetables, such as spinach

Dried fruit, such as raisins and apricots

Iron-fortified cereals, breads and pastas

Peas

You can enhance your body's absorption of iron by drinking citrus juice or eating other foods rich in vitamin C at the same time that you eat high-iron foods. Vitamin C in citrus juices, like orange juice, helps your body to better absorb dietary iron.

Vitamin C is also found in:

Broccoli

Grapefruit

Kiwi

Leafy greens

Melons

Oranges

Peppers

Strawberries

Tangerines

Tomatoes

Still, I would ask your cardiologist if your heart rate should be raised. If it's been a while since you had a stress test, they might order that. After my stress test last year, they raised my upper rate to 130. 

Yes it is definitely worth a try

by Gemita - 2023-01-13 09:35:35

TechieJ,

I see you have Bradycardia/chronotropic incompetence and have a number of other health conditions.  I have had a Nissen Fundoplication for GERD and oesophageal spasms/motility problems (Nutcracker Oesophagus) and I have to say that was when I first started noticing my heart rhythm disturbances.  However, we need to treat each condition separately and I think your question mainly relates to your Lower Rate Limit.

If you have difficulties with your daily exercises or day to day activities and find it hard to keep your own heart rate above 50 bpm, especially with Chronotropic Incompetence, then you might well find a higher Lower Rate of say 60 bpm or higher would really help with any symptoms that you might be experiencing and improve your ability to walk further.  My Lower Rate limit is set at 70 bpm and this suits me very well.

There is absolutely no harm in trying to raise your Lower Rate limit and then working with your pacemaker manufacturer or hospital technician until the right Lower Rate limit is found for you.  They might also suggest looking at your Rate Response setting or other settings, to get them finely adjusted to suit you as well.  Try this first and see, as well as following up with your other health investigations would be my recommendation.  A lot going on and I wish you well.

borderline anaemia

by Penguin - 2023-01-13 11:43:21

Hi, 

I'm so sorry to hear that you've had such a long run of ill health. It sounds pretty horrid! 

Anaemia is not pleasant and you can still be pretty exhausted at borderline levels. It can take a while to recover and if the cause isn't apparent you may need to keep on top of your iron levels.  Is your doctor still prescribing iron?  

Re: Pacing. Your overall pacing burden (e.g. the amount of pacing you receive) and arrhythmia burden (amount of arrhythmia - if any?) might be an avenue for your EP to explore when investigating exhaustion. There are various issues that higher levels of pacing might cause and which pacing for arrhythmia might cause. Your EP could help discount things like dyssynchrony.  

Re: Settings. You've got such a lot going on in the background.  Do you think that settings changes might add to the confusion? Technicians usually change settings one at a time and then assess the effect before trying something else.  That might be a really good strategy if you go down this route.  

In your shoes I think I'd want to know what is causing the anaemia first as this is the only diagnosed link to the symptom of exhaustion that you currently have.  

Minimum Rate Setting

by Good Dog - 2023-01-13 14:09:15

Hi Techiej! I have the same concern as you and I completely agree with Gemita. A higher lower limit may provide some real benefits. It is worth discussing with the Doc and maybe giving it a try.

My minimum setting has been at 50 bpm for the last 36 years. I've only become PM dependent in the last 6-7 years and so in recent years I seldom get my rate out of the 50's. It still increases with exercise, but not as readily as in the past. I also don't get as much cardio has I had in the past. It is only recently that I have realized the potentially negative implications of not getting my rate up as frequently as I had before becoming PM dependent. Like you, I walk my dogs almost everyday and put-in anywhere from 2 to 5 miles per day. I have not had any decline in my ability to do so and/or my strength, but my stamina is not what it use to be. I just turned 74 and so I always figured that much of what I am feeling is to be expected at this age. I had a recent experience with the PM Tech turning-on the rate response that boosted my rate considerably. They never could get it adjusted optimally, so it caused me a lot problems. The problems were mostly just a lot of benign  arrhythmias that became intolerable. So they turned it off. However, I did notice that when my rate was higher there were times when I not only felt better (more energy), but I also felt that it improved my cognition. My thinking seemed clearlr and sharper. That all comes under the heading of; you don't know what you don't know. My point is, the possibility of mental improvements were not something I ever even considered.

In addition to becoming PM dependent in the last 6-7 years, I also have developed PM induced cardiomyopathy during that period of time. So I now have concern with the potential for making my cardiomyopathy worse by increasing my lower rate. I can't help but think that an extra 10 bpm is actually 14,400 extra induced beats per day, and 5.2 million extra induced beats per year. Talk about being anal. Yup, that's me! I plan to talk to my Doc when I finally get to see him in about a week and a half. I have had to wait months for this appt. with my new doc.

Anyway, you are not in the same place as me, and so as I originally had indicated, you shouldn't hesitate to consider it. You may be pleasantly surprised. Talk to your Doc!

I wish you the very best!

Sincerely,

Dave

Higher resting HR

by Gotrhythm - 2023-01-13 15:04:11

I agree with those above who say try it. It's an easy adjustment. 

I had my rate changed from 65 to 70 and the difference such a small change made was amazing. Instantly my mood was better, I could think faster and clearer, driving was more comfortable. I didn't know any of that would happen. I just wanted to feel a little more energetic.

Do be aware if your heartrate has been 50 all your life, you may feel a little "speedy", wired, like too much caffeine at first. But that goes away in just a day or two.

If your muscle cells aren't getting quite enough oxygen to walk your dog any distance, then all the cells in all your organs are suffering too, and nothing is working as well as it should.

It might be that a higher HR won't help at all, but if it doesn't, no harm done. If it does, it's an easy way to feel a lot better.

If you want

by PacedNRunning - 2023-01-15 19:12:15

Not a bad idea. Our hearts change over time. Mine has increased. We started at 40 and now I'm at 55. Not because of symptoms but because my settings blend well at 55 vs 40.