Pacer Defaults & Mild Exercise

Hello all!

I had a Medtronics Revo pacer implanted on 22-APR. In a brief experiment I encountered something unfamiliar to me.

Background: Supraventricular tachycardia, sick sinus syndrome, severe bradycardia.

I got on a standard LifeCycle at the gym for a 15 minute test. Level 4, mid-cadence just to see how I'd feel since my recovery efforts are nearly of my own direction and education as unfortunate as it is. I maintained a 140-150 bpm HR until 6m 30s and then the familiar 200+ of the SVTs arrived. The SVTs showed up under the least exertion I've undergone on a LifeCycle, road bike or step mill in 11 years.

The two differences I noticed were that (a) it happened far sooner and under less exertion than in my history and (b) it felt as though he pacer was fighting me. Kind of painful, definitely uncomfortable and different. If my low and high are set at, say, 50 and 140, would the pacer even be in-play in this situation?

It seems have a turbo-lag of sorts with day-to-day things and the pulse strength is really different than pre-pacer (other than being consistent on the low-end).

Any info is welcomed. Thank you.

2 Comments

pacing

by Tracey_E - 2011-06-06 06:06:37

The pm won't pace you over your upper limit of 140, but your heart can go faster on its own. If you pace atrial and your heart goes higher on its own, you should feel fine. If you pace ventricle and your atrial rate goes over your upper limit, your hr will only be as high as your upper limit so you could have an atrial rate of 200 but a pulse of 140, that feels awful (been there, done that!).

Are you on meds to control the svt? That's how I ended up taking care of it, using meds to prevent the racing.

High rate pacing

by ElectricFrank - 2011-06-07 02:06:45

I agree with Tracey's description. As soon as you hit the pacemaker Upper LImit chaos breaks out. As you mention it is possible to exceed the upper limit if you don't have complete block. However, this can make things even more chaotic as the block kicks in and out.

One important question: how did you measure the 200+ HR? Most HR monitors including those on gym equipment aren't designed to handle the unusual ECG waveforms that occur with a pacemaker. Often they will count both the pacer pulse and the ventricle wave as beats resulting in a 2x reading. The problem is that even this isn't consistent with exercise. The expansion-contraction of the chest with deep breathing changes the conduction of the signals to the chest wall so the miscounts change.

I use my own ECG modified from the biofeedback equipment I used to manufacture to monitor my heart rhythm. I record the waveform on a computer and then go back an analyze it visually. This is how I picked up on what was happening early on with my pacer and instructed them how I wanted it adjusted.

The only other reliable ways to check is with a photo electric type blood pulse sensor or even better taking your pulse manually.

frank

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