what happens when......

I am a 7 week pacemaker recipient and while I was working out tonight at my new gym I realized my heart rate was at 136. I remembered my pacemaker is set for a minimum of 50 and a Max of 140. I know that at 50 the PM kicks in and manages my rhythm until I get above 50. What happens if my heart rate goes above 140 while working out?

5 Comments

Heart Rate & PM Set Poinhts

by SMITTY - 2011-11-15 10:11:37

I can tell how I think the PM works. As you know if hour heart rate drops below the low set point the PM will come on line and keep your heart at least at the point. While the heart rate is between the low and upper set point the PM watch and keeps the ventricle beat at the same speed as the atrial, should it try to slow down. When the heart rate exceeds the upper set point the PM becomes a monitor only. It will monitor your heart function until such time the heart rate drops below the upper set point.

So if your heart rate exceeds the upper PM set points while you are exercising, the PM just sits on the side line watching the show.

Smitty

Not the whole story

by ElectricFrank - 2011-11-15 11:11:04

Smitty's description is correct as far as the pacers function. Now the rest of the story!

First off it depends on what your heart condition is that cause you to get the pacer. A common problem is one of the electrical blocks that keeps the information from getting to the ventricles. If the block is 100% then the pacer is required to substitute for the AV nerve bundle in order for you to have a reasonable heart rate. When you reach the Upper Tracking Limit (MAX) the pacer starts skipping beats in order to keep the average rate below the limit. It's a crude way to do it, but all we have.

So depending on a lot of things when you exceed 140 you will start having increasing skipped beats and may even go into a 1/2 mode. So suddenly you may drop to 70. This is not good when your body needs the blood flow for the workout level.

My suggestion is to do like you mentioned and keep your HR down in the 136 or so level. There may be a small overshoot when you stop some kinds of exercise. For me when hiking if I stop for a break my HR will overshoot by as much as 5 bpm before starting back down.

If you are in reasonable shape and don't have any serious other heart problems I would ask to have the upper limit raised to 150 at you next checkup. That's what I have done even though I'm 81 yrs old. I don't push myself that high, but I want to set my own limit. I had a bit of a flap with the cardio, but finally got it done. Like I told him, if I'm being chased by a bear in the campground I would rather die of cardiac arrest than be eaten!

frank

It's called "winky bonk"

by Gitta - 2011-11-16 10:11:31

I've had this happen to me many times. I am a 48 year old woman with Complete Congenital Heart Block, who has had a pacemaker now for 17 years and just had my 2nd replacement. Winky Bonk is the term the medical community calls the situation when your heart rate surpasses your upper limit and goes into a 2 for 1 mode. In other words your pacemaker is not able to fire all the beats your atrium is signaling and therefore misses or skips a beat. This isn't serious. You just feel a bit crummy while it happens. Like Frank said once your heart rate comes down the winky bonk stops and you feel better. I often notice it as a kind of "thud" in my chest and a subsequent "queasy" feeling. I would discuss your exercise routine with your dr. and inquire if they can set it at a slightly higher rate. I only found out that this is possible after having been paced with a limit of 120 for 16 years! I couldn't even ride my bike up a moderate incline without it maxing out. Now it is set at 150 and I can do so much more :).

Gitta

correction.

by Gitta - 2011-11-16 10:11:48

Winky Bock, not Bonk.

Gitta

Actually Wenckebach

by ElectricFrank - 2011-11-17 12:11:59

But I like the Winky Bonk better. When it happens your eyes wink shut and your head goes BONK on the floor.

LOL

frank

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