Rate Response and bicycling

Hi all. I'm 10 mo PO with PM due to Bradycardia and chronotropic incompetence. I have rate response and minute ventilation sensors. I have trouble with sob and muscle exhaustion when bicycling. I find myself constantly yawning for O2. My heart rate doesn't want to go up on its own so I deliberately huff and puff, or pump my arm to try to raise my heart rate. I wonder if changing the settings to a more aggressive response would help. Any advice? Thanks!

2 Comments

Rate response

by golden_snitch - 2014-06-14 02:06:20

Hi Minnesota!

If you have minute ventilation + accelerometer, do you have a Boston Scientific device or a Sorin Group?

I don't think that pumping your arm will help. My minute ventilation sensor reacted to arm movement, for instance when I moved a fingertip to the sternum back and forth, that could bring my heart rate up to the max in less than a minute.

You could also get your sensor threshold/activity level/activity threshold/physical exercise (different manufacturers have different names for this) changed. Usually it offers very low, low, medium, high and very high. In a Sorin pacemaker, the higher you go, the less aggressive the rate response will react. That's also how my Biotronik device works, and I know Medtronic uses this, too.

Depending on your manufacturer, there are other rate response parameters than can be changed. The options in a Sorin pacer are a bit limited, though. It's only the threshold parameter I already mentioned, the sensor choice, and if the device should learn automatically and adjust or you want fixed settings.

In a Boston Scientific you have activity threshold, response factor (or something like that), acceleration and deceleration (how fast the rate increases/decreases), and it can also be set to learn and adjust automatically. All these parameters are for the accelerometer. For the minute ventilation sensor you have a response factor, too, which differentiates between high rates and lower rates and a switch parameter. You can mix both sensors, three more parameters for that. Sorry, I cannot go into more detail here, because I don't know the Boston Scientific rate response from my own experience. Never had this manufacturer. But I'm sure that, if you tell your cardio that you are short of breath, have weak legs, and cannot bring your heart rate up when cycling, that he'll be able to optimize RR settings for you.

Good luck!

Inga

RR settings probably need tweaking

by JerryG - 2014-06-14 07:06:28

to get the right settings for you and your activities. I had a Medtronic A3DR01 implanted September 2013 and it took a few sessions with the cardio and the Medtronic technician before my RR settings worked the way I need them to. The last session was early in March and since then I am totally happy.

I have sick sinus syndrome which makes me rather dependent on the RR of my PM as I work out daily on my treadmill. I battled to get my HR up then if it came up, it would suddenly drop off without warning. Like you, I got SOB among other things as my body was short of oxygen for the level of exertion.

Like Inga, I don't know what make of pacer you have but I am sure your PM's RR can be adjusted in various ways until the right settings are found. I persevered with travelling (550km each way) to my cardio and having my PM adjusted until it worked the way I wanted it to.

I suggest you get back to your cardio asap and ask for the PM to be adjusted and persevere until they get it right.

Jerry

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