11 month checkup

Okay, so it hasn't been a year but I am due in next week to get myself checked out. I have been working out a lot lately, going above my theoretical max as I push my bike up big hills getting ready for the Triple Bypass but the one think I keep feeling is days were the best way to describe it is I am skipping beats or feeling like my pulse is out of sync. I had a day recently where I felt sluggish and sure enough I would check my pulse and I was just above 60 when it should have been in the high 70's. I was diaged with SSS bradycardia and because my heart was taking naps of 10 seconds or more that was causing incidents of syncope they put the pacer in. Anyway, was wondering what I should ask my tech to check out when they look at my history? The things that bug me the most is these missing beats days I have where I just feel out of sync. I can hop on my bike and work the crap out of my HR and feel fine but then just walking around I feel like shit. Anyone have any specific questions I should be asking my tech?

4 Comments

Don't know too much about a lot of this

by heartu - 2010-04-19 04:04:52

Almost 8 weeks post pm for 3rd degree heart block and am continually learning about what I need to ask the doctor at my next check up. But one thing I do know is that my upper limit needs to be raised for me since I cannot get my HR above 130. The few times I got my HR to that 130 ( 85% THR for me is in the 140s - I am 53) I noticed that I started to skip beats also. I have since backed off since afterwards I have felt lousy and try not to go above 125 (need to get a heart rate monitor for exercising).

Spealking of which, just wondering, are you wearing a heart rate monitor while you are training? If so, what are you noticing (do you see you HR go above your theoretical max? because I thought that you cannot push your HR above that setting .

I assume when you go for your checkup the tech should be able to tell you how often you hit your upper limit and should make adjustments to your pm. Do you know what your other settings are? Is rate response on?
(There were a few very nice intelligent people who filled us newcomers in on what that is for).

Sorry could not be of more help, but one question I would certainly ask is if they could raise the upper limit of your pacemaker to its max since I am sure you are working out to at least 85% of your TRH, if not greater.

Hope you get answers and that your checkup is good. Let us know what they do to your settings, because I would love to know.

Training info /

by COBradyBunch - 2010-04-19 05:04:55

At 51 my Theo max is 169 and my limits are 135 for 80% (light work out), 144 for 85% (medium workout) and 152 for 90% (hard workout). Thing is my Max is well above 169 since I hit a sustained HR of 177 the weekend before last on a killer climb. The Max I have managed to hit post pacemaker is 181 which was on a mt. bike climb last fall. I do use a Polar for all my workouts and did long before I had issues that made me need a pacer. BTW, on stress tests I come in much lower for a max HR mostly because of bad knees tend to give out before my lungs and heart do and they always want to give me my stress tests on a treadmill and not a bike where my knees are better at the punishment.

That said I have my max basically turned off (I think they set it higher than I will ever reach) and if I remember my rate response is off. This was taken care of even before I was cleared to workout since they told me my max was set for 130 and I told them I blow through that on a regular basis and because of the climbing I do on bikes at altitude an upper limit just isn't practical or needed for my condition.

My issue is low end and maybe finding out what is going on when I get stuck low. Fatigue, that funky feeling I talked about and the feeling like I just start missing beats (palpitations?) while sitting around doing nothing. Also there are the occasional can't get my heart rate up issues while doing just regular things like walking where my HR seems to want to stay lower than it should. My RHR (taken right after I wake up, before I do anything) is right around 56 and my pacer isn't set to kick in until 50 since I want the battery to last as long as possible. At 50 I have never had a syncope episode. Have not run into any issues while exercising other than some pain around the device when using my arms a lot.

Anyway, some things I am going to have they check out is if I am going into periods of afib which is not uncommon with SSS/Brady. Other than that I will have them check all my settings again and also how often I am being pacer dependent (my 90 day check came back at less than 1%) to see if my SSS/Brady is becoming more of an issue. Any other ideas fellow pacers?

just a suggestion

by Taisha - 2010-04-21 04:04:28

Only 9 weeks into this so no expert but I was feeling not so good, breathless going up hills and seemed no response from heart rate. Got an early appointment and asked if the rate response turned on they said no and it should have been. They put it on and I felt way better, bouncy really and got a bit exhausted at first. My problem is AV block, sinus node ok so by rights I shouldnt need rate response but it certainly felt heaps better with it on. They are going to put the upper rate to 150 next week which will be better too. I've read posts from people getting the RR turned off because it didnt suit them. I thought about battery saving but much better to have less years feeling better than more years feeling rotten. Your biking sounds amazing, hope you get it sorted.

Pacer Tech said

by COBradyBunch - 2010-04-23 12:04:50

Pacer Tech said all looks good. my settings are RR off and 50 at the low end. Her feeling is that my issues ith skipped beat feelings and palpitations might be related to some bouts of aFib but even that she said are not something to worry about since I am in it much less than 1% of the time and the longest lasted 8 minutes while almost all the rest are less than 30 seconds. She also said that whatever my trigger is for my syncope episodes might be what is going on when I have my 'episodes' and since they have not been able to ID that it is possible there is something there that causes me to go brady, but not so brady that my pacer has to kick in often. BTW, I am <1% in time being paced also. So good news all around I guess.

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