Paddling the ICD

Paddling and tapping

by USMC-Pacer - 2024-01-17 22:12:01

I think that was in reference to the older pacers. 

I had the same type of issues as you with increased intensity. It turned out, at least for me, to be with my av delay. They explained it and I'm still confused about it. Anyway av delay would broaden during exercise and my device wasn't quick enough to deal with it for lack of a better way to put it. With my first device, they put me on a treadmill while hooked up to all the monitors and made a few tweaks to the delay.. problem solved. This new device, also a medtronic like yours CRT does it better. But, I still needed some pvarp adjustments. All is well now :)

Hopefully someone will be along that can explain what I just said better than I .. 

Exercise

by piglet22 - 2024-01-18 07:40:30

I can't speak for your model or your condition, but I can certainly relate to the change in exercise capability.

I've had a pacemaker in for nearly 19 years now and for 18 of those, carried on exactly as normal.

A keen cyclist, not the lycra variety, I could tackle long rides and steep hills.

A year on, the same hills are now a struggle to walk up. Fortunately, there are many shop windows and an excuse to stop and catch my breath.

It's not so much running out of breath but aching legs that stop me.

A quick stop restores function until the next stop.

What I do notice is that my heartrate hardly changes between level walking and steep incline walking, despite being set to rate response. The base rate of 70-BPM might increase to 80 or 85, but nothing over 100 as I might have expected.

What has changed has been the medication that now includes a high dose of betablocker to suppress the ectopics that now interfere with the pacemaker.

I don't know if my lack of capacity is down to the BB directly, or the PM behaving differently.

Just out of interest, I looked up your model and can see that it is quite a new one from Medtronic.

There was a note about a software update. Are you aware of that?

settings

by Tracey_E - 2024-01-18 08:12:10

Have you been back to your doctor to tweak the settings first? Rate response has various sensitivity settings. 

Pacemaker settings for exercise

by Selwyn - 2024-01-18 08:27:57

The rate response ( ie. the ability to change heart rate with exercise) for pacemakers has a number of settings.

I cannot speak for your pacemaker/ICD however for mine I have:

1. Activity threshold ( very low... to very high)

2. Reaction time ( short... to long)

3. Recovery time ( short ... to long)

4. Minute. Volume /response factor.

1-3 are common to most modern PMs.

You also have the option of looking at the upper rate limit, the lower rate limit, and the atrial blanking time ( this can be shortened though is not without risk of feedback).

You need to discuss these settings with your cardiologist physiologist.

In the last 3 weeks I have had my reaction time set to fast - this has made a big difference to my breathing on initiating exercise.  It has taken some years to get this improvement as I always felt that my problems were minor compared to some of the problems people are having. I had some terrible bouts of breathlessness and decided 'enough was enough'.

Settings

by Lurker (Doc DX) - 2024-01-18 12:04:49

Something you might try before going up stairs is to violently rotate your upper body for a few seconds. This is usually enough to temporarily set the rate response off so you can get up or almost up the stairs.

Used to work for me before my rate response was turned on. 
 

Doc DX

Great Comments.

by Mike123 - 2024-01-19 05:26:21

Thanks all. A few things to think about and look into.

Getting adjustments is not so easy for me as my area is short of cardiologists so I keep getting bumped from locum to locum. Currently there is not one available so no visit for me until April.

Update

by Mike123 - 2024-07-11 23:09:26

So here is an update, with some good news, that may also help others in the future. I finally was able to get assigned a full time cardiologist and had an appointment in mid June - about 1 month ago. This of course included a session with the device technicians. So I managed to convince them I needed the response rate increased to deal with struggling during stair climbs, walking inclines and Physiotherapy excercise routines. They also increase the max rate figure. Then due to so many side effects the Carrdiologist agreed a medication change was in order. So changed from Metropolol Tartate to Nebivolol.

I can report there has been a dramatic change to the better. No more problems with stairs, inclines or excercise. No more central Apnea sysptoms, no more anxiety sleep issues, thus no more fatigue issues, No more weight gain issues. Now feeling pretty much back to normal! One very happy camper here now!

So pleased to hear this Mike

by Gemita - 2024-07-11 23:31:58

It is perhaps hard to assess whether the improvements are primarily due to a medication change or to settings changes, but either way, I am very pleased for you.  

I am on Bisoprolol and weight gain has proved a problem so I may look into Nebivolol as an alternative.  

I hope you continue to do well and thank you so much for taking the time to update us.  If you want more members to see this update, you might be better posting a new message, since I see your original post was in January.