Max Heart Rate

I saw there has been some recent discussion on maxing out heart rates and I wanted to touch base on my recent PM interrogation. I am diagnosed with 2nd (3rd or complete) heart block (depending on which records I look at, neurocardiogenic syncope, POTS, a blood clotting disorder, and I'm being treated for lupus. I am in my mid-thirties and am very active (25-45 miles a week). My lower limit is set at 70 and my higher limit is set at 140. I have the rate drop response turned on.

Late last year I went to Mayo Clinic due to a lot of fainting spells and many ambulance rides and they told me I should keep my heart rate under 160 when exercising. But given that it sometimes goes into the 160s when showering or standing for a few minutes, that doesn't strike me as particularly realistic.

However, on my last PM interrogation, I had more than 60 high heart rate episodes. In some cases, the highest atrial rate was 212 and the highest ventricular rate was 256. Should I be concerned over the disparity between atrial and ventricular rates?

Even though the high rates were in the 200s, the averages of the episodes were typically around 186-187 lasting for about 25 minutes (mostly during exercise). Does anyone have any thoughts about the benefit or potential dangers of regularly exercising at higher than the max heart rate?

Would there be any benefit to increasing the higher heart rate of the PM?

Thanks in advance!

Jenny

1 Comments

rates

by Tracey_E - 2012-09-10 04:09:08

Several thoughts...
When you are in block, the ventricle will only pace up to the upper limit. So if your atria is doing 200 but you are pacing ventricle at 140, you will feel awful and it's hard on your body. When you are exercising, stop and wait for it to come down if your rate goes above 140.

If your pulse (ventricular rate) is over 140, you are doing it on your own. V-tach can be dangerous. If exercise is causing it, talk to your dr before continuing exercise.

The way I understand it, increasing the upper limit will only help you if 1) you are in block at the time and 2) your atrial rate isn't going above it. So it will help you when you are in block and beating up to wherever they set the higher upper limit.

I had a similar problem, but CHB is the only thing I have, no pots or ncs to complicate things. My atrial rate would get up over 200 sometimes. They turned my upper limit up to 180, as high as it goes. That helped because it gave a bigger cushion. It didn't totally fix the problem, I still had to stop my workouts if I got too high ( over 175-180). Eventually I started beta blockers so now no more going over 180, actually I rarely get over 150 now. We're all different and there's no one right answer. It took me a good year to get the right balance of settings and med dosage.

Good luck getting back on track!

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