fatigue

I've had my Medtronic PM for about 2 1/2 rears now to correct bradycardia.
For the past 2 years I've experienced fatigue with exertion that I never had before the PM. Especially when doing house repairs, gardening and constant bending and climbing. None of these can be considered aerobic or strenuous. Before the PM, I walked 3 miles in 40 minutes easily, and now get out of breath.
RR On
ADLR 3
EXR 3
ACTT M/L
ACT ACC 30sec.
ACT DEC Exercise

16 Comments

copy that!

by cb - 2013-06-25 03:06:44

I also have gotten winded at things that did not used to occur, such as walking upstairs. When I asked the cardiologist he said "you're overweight". Well I was overweight last year too and this did not happen. Like you I have a PM for bradycardia. And it is a weird kind of "out of breath"...more effort to exhale. So I am on track to losing the 20 lbs and then see what the smart doc will say next. Best I can figure is that when something goes up with the heart, things are not the same ever after. Guess you have had the stress test and the "plumbing" is clear?

Typical MD Reply

by billsharp9 - 2013-06-25 03:06:58

You responded to my post....forgot to give my name. My name is Bill.
I'm 75 yrs old, 190 lbs. 6ft tall. Non smoker. Before the PM I was 72 yrs old, 190lbs, 6ft tall Non smoker.
Take NO meds. BP before PM was 110/60.
I'm guessing my PM needs adjusting and I need to understand what the numbers mean so that I can discuss the issue with my MD.
Thanks for the reply

I have the same problem!!!!!

by maryj - 2013-06-26 05:06:59

It's only been a little over a month for me but I'm 32yo 5'2 133lbs. I was active before this. Mom of two, full time nursing student, domestic goddess and then sick sinus syndrome causing bradycardia and syncope hit me. I got a pacemaker in emergency surgery HR 20's-30's and stopping. HR is up but I feel worse than before. The automaticity had to be turned off because is was arcing from the bottom lead to the pacemaker. I am still so fatigued on exertion of any type. I have been to be adjusted four times now and I am not getting any get up and go, can't keep on weight, chest pain and dizziness but the doctors say there is nothing wrong with my heart now with the pacemaker. It is so frustrating.

settings

by Tracey_E - 2013-06-26 07:06:06

Rate response is on and you are having trouble on exertion, first thing I'd do is ask about the RR settings. They can set it to be more sensitive and go up more quickly.

Do you know what caused the bradycardia? That's just a generic name for a slow heart rate, different things cause it and they have different fixes. If it's caused by av block, for instance, having RR on could be the problem because it competes with your natural hr, just turn it off.

cb, things can most definitely be the same as before! Or in my case much better. Not all conditions can be completely fixed, but if your only issue is electrical and slow beats, there's no reason not to expect to be 100% again. It takes time and patience as well as a cooperative and knowledgeable dr and rep, but it can happen. Don't settle for less until you've exhausted all the options.

settings

by billsharp9 - 2013-06-26 08:06:41

Thanks Tracey. I do have an AV block. I was skipping beats and my heart would stop for a few seconds while asleep. This was the reason for the PM. While awake I had NO symptoms and was able to walk 4 miles in an hour. I have no other cardiac issues.
I have a meeting with the Medtronic tech next month and I'm hoping to get both my Doc and the tech together at that meeting.
I'll keep you posted. Thanks again.

settings

by Tracey_E - 2013-06-26 11:06:04

Talk to them about rate response! It is for atrial pacing, it senses movement and raises your rate for you. If all you have is av block, then you just need ventricular pacing. Sometimes they leave rr on thinking you won't need it but it's there if you do, but many of us with av block find it gets in the way.

If your heart was pausing, then you do need some atrial pacing but not necessarily rate response.

Sometimes it's helpful to get on a treadmill in the office and let them watch what happens on exertion rather than trial and error with the settings.

stress test

by billsharp9 - 2013-06-27 02:06:01

Tracey
I did have a nuclear treadmill test about 3-4 months after the implant. It was effortless and they stopped me at HR 120. I may be wrong, but 120 was the top limit of my PM setting. I could have gone much farther. Also some other maybe unrelated info on my situation that my or not be connected. The day after my implant, my BP was 160+. The day before and for years before my BP was always 110/60. I got no explanation. I may be controlling it by will only. Mind over matter!
A doppler of my heart reveals no valve problems and I recently had an abdomial doppler revealing no danger of an anurysim. I take a baby aspirin daily. That's it.
Thanks to all for your help. Hopefully I will be able to help you people soon.

120

by Tracey_E - 2013-06-28 09:06:17

120 is a pretty low upper limit if you are otherwise healthy and active. That's typically where they start us but they can turn it up. Mine is at 175.

Stay on them! You have a problem with an easy fix so there's no reason you shouldn't be 100%, there's no reason to put up with feeling worse than before.

upper limit

by billsharp9 - 2013-06-28 10:06:36

Just to be sure: where does the upper limit value appear on the printout?
I want to be sure.

treadmill

by Tracey_E - 2013-06-29 09:06:34

A nuclear test will show different things than just running on a treadmill. Take the chemicals and high tech out of the equation and just watch what your heart does when you exert.

not sure

by Tracey_E - 2013-06-29 09:06:49

It depends on the print out. It will be called upper tracking limit or something like that.

more info

by billsharp9 - 2013-06-29 11:06:28

lower rate 60ppm
upper tracking rate 120ppm
Treadmill results:
Max heart rate achieved 145 bpm (this represents 98% of predicted max HR.) ????
Resting BP rate 130/80
Peak BP was 164/82
No high risk scintigraphic findings.
If UTL is 120ppm, how did I get to 145 bpm. or am I confusing ppm and bpm?
ppm=pulses per min and bpm=beats per min?
As I stated in an earlier post, I felt that I could have gone much farther on the treadmill.

Upper rate

by billsharp9 - 2013-07-01 08:07:02

145 was as far as I got on the treadmill before they stopped me. I must be getting fatigued or out of breath at a higher rate than 145.

upper rate

by Tracey_E - 2013-07-01 08:07:39

If you pace to 120 (UTR) but got up to 145, then you did it on your own, it was not paced. Some people are like that, they need the pm at lower rates but once they get exercising their heart snaps into gear and beats like it should. That's a good thing

maybe not

by Tracey_E - 2013-07-01 10:07:19

145 was 98% of the predicted max, which means that's how high they wanted you to get while they were watching. That number is from a formula. That doesn't mean you can't or shouldn't go higher, it just means that's as high as they wanted to watch for the test. If you didn't feel well at that rate, then you probably shouldn't go higher.

If you are intermittently in block, you may run into problems working out with your upper limit at 120. If you are at 145+ on your own then go into block, you'll be depending on the pacing so your atria will be going along at 145 or whatever and the ventricles will suddenly be pacing at 120. That will wipe you out in seconds (been there, done that). If you routinely get higher than your upper limit on your own, I'd ask to have the upper limit raised just in case that happens.

Got it!

by billsharp9 - 2013-07-01 12:07:30

I think you've hit the nail on the head. We'll find out in a couple of weeks when I meet with the Doc and the Tech.
Thanks.

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