Increasing Pulse Rate

I have a Medronic ADDR01 dual chamber. I have a lwer setting of 60 BPM. I have heard (another chat room) that when my model pacemaker senses a quick drop in HR of 25 beats it automatically increases the up to 80 for 2 minutes. Can anyone confirm this?
Also another problem I have is this: If I am doing a physical activity that is basically anaerobic that gets the heat rate over say 100, suddenly my pulse shoots way up and I feel like my heart is fluttering. I get an unonfortortable feeling in my chest. Not pain, just feels like the pacemaker turned on. This goes away after a couple of minutes when I stop the activity. Anyone experience this problem? I think rate responsive is on in my pacemaker.

5 Comments

Rate Drop Response

by ElectricFrank - 2011-03-03 02:03:27

The Medtronic you have has a feature called Rate Drop Response which detects sudden a drop in HR and provides supportive pacing at a higher rate. It is used for patients where the drop in rate stays within the lower limit setting, but produces light headedness. The increased pacing rate prevents the sudden drop in BP that causes the light headedness. After a programmed interval of pacing the rate is slowly lowered to either the sensed rate or the lower limit.

If you have the need for complex support like this I would try to have a programming session with the Medtronic rep. They are very knowledgeable about the interactions of this setting and the standard Rate Response. The best way to get these tweaked is on the treadmill where they can run your exercise up and down.

frank

frank

Me too

by charcurran - 2011-03-04 11:03:43

My lower setting is at 50. I rarely get lower than about 55 but occasionally have episodes of my heart pausing so I need the pacemaker. My problem is that the least bit of activity sets my pulse up over 100 and just walking bumps it to 150 where it stays. I discussed it with my doctor and he says I need medication and it definitely isn't the setting. I think I need to talk to a rep for Medtronic but I don't know how to do this.

A way to approach the problem

by ElectricFrank - 2011-03-05 10:03:04

The first thing to do is get a copy of your last interrogation report, both pre and post versions. Take a look at the mode the pacer is set to. If there is an R in it such as DDDR then rate response is on. If not as in DDD then the pacer is taking its pacing cue from the atrial beat.

If RR is off then the high HR with exercise is likely coming from some sort of sinus pacing problem and the pacer isn't involved. I guess I should qualify that because you could still have pacemaker mediated tachycardia.

However, if RR is on (DDDR mode) then the most likely problem is that it isunnecessarily turned on or set too sensitive. Turning it off isn't necessarily a magic cure, but we have had a number of folks here who have near magical result when it was.

On more way to tell is to try wiggling your pacer with a thumb and forefinger at a time when you are sitting quietly and your HR is in the low range. A fast wiggle of about 3/sec will give you a good check. If RR is on this will give you that same increase in HR you are noticing.

Try a some these suggestions and then let us know the results. You may need to put some pressure on the doc to get a Medtronic rep checkup, but it can be done.

It is always possible that there is a heart problem that might need medication to treat it, but it should be a last resort. Meds were proposed in my case and I insisted on RR OFF, lower limit of 55 and upper of 150 as a trial before I would consider them. In my case those settings solved the whole problem even though I was given dire warnings about my request.

frank

No problems here

by dtread - 2011-03-05 10:03:25

Warren, I've got an ADDR01 also and do not have the problems you describe, but my rate response is turned off. Mine was originally set with lower limit of 60 but I convinced my Cardiologist to turn it down to 55 and then later on to 50. My resting heart rate is around 55 - 60 so I didn't want it kicking in when it didn't need to. Mine records high heart rate events but does not regulate them. Overall works great and no problems at all, even when exercising. But your medical condition is likely not the same as mine so my experiences may have little relevance to your situation.

Thanks Frank

by charcurran - 2011-03-14 12:03:57

On Friday I met with the doctor and the medtronic rep. The rate response indeed was set too aggressive according to the rep. After huddling and studying the data, we decided to turn the Response Rate off and see how I do. Within an hour, I went for a 5 mile run with a heart rate monitor. I had some spiking into the 175 hr. during the first 10 minutes. It would go back down if I walked. The rest of the run, it settled into a rate of 125-130 which is about 80% effort for me. Saturday, I rode a bike, used a rowing machine and walked with normal increases for my efforts and no spikng. Then today I ran 6 miles with similar results to Friday. I started medication for a-fib too. I guess now I need to decide to live with the spikes in hr. while running or get the RR back on with a less aggressive setting. I'll wait a week or so before calling the rep back and decide. I should never have waited so long. Thanks again

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