Fool your pacemaker's accelerometer?


I'm wondering if anyone has devised a gizmo that taps on their accelerometer-based pacemaker to make it increase their heart rate?

My Medtronic pacemaker uses an accelerometer to do adaptive rate response. It worked well for running. But my knee has deteriorated so now I mainly bicycle. Unfortunately, when I cycle there's not enough motion for my pacemaker to sense it and increase my heart rate.

I assume that the pacemaker cannot be set sensitive enough for cycling (at least, not without being so sensitive that it also raises my heart rate when I eat breakfast or brush my teeth). But if that assumption is wrong, please tell me.

I'm 56 and have chronotropic incompetence -- my unassisted heart rate doesn't go high enough when I exercise. (I also have bradycardia -- resting rate is too slow -- and a 2-1 AV Node block that kicks in above 115 bpm, but the pacemaker takes care of those independently of the accelerometer.)

It should be safe to (artificially) max out my pacemaker (140 bpm) for strenuous bicycling because my EP said it was OK to max it out while running, which started happening when I got in better running shape.

So has anyone devised a contraption to tap on their pacemaker?

Mark

14 Comments

Easy

by ElectricFrank - 2012-05-09 02:05:50

Just grasp your pacemaker between a thumb and finger and "twiddle" it. Works great.

How about gluing an extra weight on the flywheel of the exercise bike to throw it out of balance. That should give vibration proportional to speed.

There are all sorts of small battery operated vibrators that could be used. Find one with a speed control.

I'd work on one except that my Rate Response is OFF. It was on though for the first few weeks and lead to some interesting effects. Sitting in one of the jets of my hot tub would send my HR soaring. Running an electric Jack Hammer in my front yard really drove my HR wild. Also bouncing along a road in my 4 wheel drive.

Take a look int my photo gallery for a photo of my "Adjustment Knob" installed over my pacer.

have fun,

frank

Accelerometer

by golden_snitch - 2012-05-09 02:05:56

Hi!

Yes, cycling is a problem for accelerometer based rate response. Ever since my pacemaker needed to be switched to accelerometer only - I have two sensors but the minute ventilation sensor has turned out not to work with epicardial pacer leads -, I have problems cycling, too. And I will never understand why cardios have patients with such a rate response turned on do a bicycle ergometry, but in Germany you hardly ever get to go on the treadmill, they always do this bicycle ergometry.

When you need to have your current pacer replaced somehow, ask for a model with a minute ventilation sensor + accelerometer. They are way better than accelerometer only, and they do react properly when you cycle. I have always had both sensors until I had to get epicardial leads. So, I know how it is with both sensors and I now also know how it is with accelerometer only - beg for a dual sensor pacer, the difference is huge!

Best wishes
Inga

ugh!

by Angelie - 2012-05-09 12:05:04

I've had non stop problems with my rate response. Usually a few gentle taps on my chest will get my heart rate going for a few minutes. I do this occasionally throughout whatever I'm doing where the sensor is not sensing properly (like stairs and hiking up hills)

If my heart rate needs to be higher for my activity, I can always tell because I get short of breath and my heart pounds. It's like it pounds really hard instead of pumping faster. Once I get the accelerometer to kick in this usually fixes my symptoms.

Also a recumbant bike which moves your arms would also fix this problem, I would think.

Good luck and happy exercising,
angelie

TITLE ..your question

by IAN MC - 2012-05-10 04:05:09

Hi Rick ... no questions are stupid !

Exercise would be more dangerous if it didn't increase your heart rate .It is all about oxygen from the lungs being circulated around your body.

When you exercise you need more oxygenated blood in every organ in the body for them to operate efficiently
.
If the heart-rate didn't go up when you exercise, organs would be starved of oxygen and this could lead to all sorts of problems; death being one of them

Depending on what heart condition you have , you may be using drugs to lower your heart rate because a permanently high HR makes you tired ( just as permanently exercising would ! ) ... it is all about persuading the heart to beat at the right rate all of the time.

Hope this answer makes sense.

Ian

Funny thing about

by fishfighter - 2012-05-10 06:05:27

My rate response. After getting my implant, I didn't know about the rate response setting. Every time I had to go on a long trip, the bad roads here in Louisiana would throw me for a flip. Not all roads, just ones that had real bad bumps over a few miles. What it was doing was making me breath real hard and racing my heart rate faster and faster to the point I though my chest was going to explode. I though and knew something wasn't right. Anyway, after about 5 trips, I broke down and ask/told the doctor about this. Well, that is when I found out about the rate response setting.. I just wished they would of told me about this before hand. LOL I did learn that when I have to travel that section of the road to go above 77 MPH. Anything slower, I go into breathing labor. Oh, this is part of the interstate system with a 70 MPH limit. Sofar, no tickets. LOL

Confused

by TITLE - 2012-05-10 10:05:46

I need to be educated. If I'm hearing all of this correctly when we exercise our pacers "pick up the pace" and increase our heart rate, right? Aren't we, as heart patients supposed to slow our heart rate? I take COREG to do that.
Sorry for the ignorance, which is lack of knowledge. I get confused. I know I'm supposed to excercise and do when my body allows me to. I do this to burn calories and try and lose weight. But isn't exercise dangerous when it increases the heart rate? Why slow the heart rate down with meds then go against the grain and excercise to increase it? I apologize for sounding a bit stupid.
You can also respond in private.
Thanks everyone,
TITLE (Rick)

Sounds like a stimulation device is the answer

by ElectricFrank - 2012-05-10 12:05:18

Mark has it right when he mentioned a contraption to tap the pacer. It sure wouldn't be hard to make. Maybe build it into one of the protective straps like some use for seat belts.

Wouldn't that be interesting on the interrogation report.

Would the result be called Tapocardia? LOL

frank

Try Mt. Biking...

by COBradyBunch - 2012-05-13 09:05:11

Should work like a charm

tonym

by tonym - 2012-05-15 12:05:16

It took me a long time to get my Medtronic adjusted for my sculling this is a smooth action with no vertical movement to operate the the rate response it did the opposite and reduced the rate.

Medtronic did make adjustments to trick the rate response after testing on ergo in my local hospital and now I can scull and use the rowing ergo and my rate is good for long workouts. 30-40min

But on the bike I still have to tap the unit to get the rate on hills.

use a 2 sensor device

by cardiacphysiologist - 2012-05-21 06:05:47

there are several devices on the market that dont use the standard motion sensor, 2 in perticular, the Biotronik uses the heart contractionability, the boston uses a ventilation sensor.

motion sensors will only get about 60% of the normal person responce

The way to think about it is if you think about a normal heart responce to walk to the shop and then walk back carring shopping, which would need a higher heart rate.... the one on the way back because you are doing more work, but the motion sensor pacemaker wont notice the different and pace the same both ways.

Motion sensor

by davidbike - 2013-11-18 06:11:57

I just left a similar message about cycling and the motion sensor. I guess I will try tapping on the device, but it doesn't sound like a great solution. I wish my doctor had given me the option of getting a pacemaker with a minute ventilation sensor.

This is very discouraging.

Poor Counsel From Physicians Pre-Implant

by Marc - 2013-12-10 04:12:40

1) Pre-implant: A basic procedure should be to ensure the individual receiving a pacemaker is vetted carefully in terms of life style -- e.g., exercise -- and match this with a recommendation on the type of device being recommended. I would go so far as to say there should be a formal questionnaire that is then used to identify manufacturers and model based on the patient profile.

1b) I just had a second implant at a big name Mid-West hospital (clinic) and the pre-op review on this was completely inadequate. All the time, the medical professional kept stating that the organization was product agnostic.

2) I have recently learned about tapping the pacemaker to get the heart rate up but since there is no direct feedback on the actual rate achieved, I am forced to wear another device for monitoring.

3) This leads me to another issue, information feedback in real time: there should be a way to get continual and real-time user feedback from the current pacemakers. To my knowledge, this is not possible.

4) Increasing cost of healthcare: This is hardly cost effective nor is it helpful in terms of self-monitoring.

Are there any manufacturers that have recognized this?

Dual Sensor Devises

by Provost - 2014-02-18 08:02:30

I have a dual sensor device (minute ventilator and accelerometer)) but it still has been hard to calibrate such that it doesn't over respond to running and still responds to cycling and swimming.

Because the minute ventilator sensor responds much slower than the accelerometer, when biking I can find myself in the middle of a climb before my heart rate responds to my level of effort.

We are still trying to balance the two receptors.

Updates

by Hobietom - 2021-12-27 14:09:32

Have there been any updates on this?  I did find a device that might be adapted to activate the PM.  It is called RESPA (https://www.zansors.com/respa).  Not perfect but it might be possible to modify it for this purpose.

 

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