Why

I have a question for you people that are smarter than my doctor, which I'm sure includes at least 99.99% of you. Now I may have asked this question before, but I don't recall the answers so please indulge me while I do it again.

I got a dual lead Medtronic in 2000. I've had more problems with the thing than I can count, but a new one cropped up in Mar. '07 and will not go away. The settings on it are low 70 high 120. The problem is when I do anything really physical, like cutting the grass, which I did this morning, my heart rate drops to somewhere between 45 and 55. Like this morning, after a few minutes I was SOB to the point that I needed to sit down and then I started having angina. Not bad, but any angina gets me attention as I have been told that is the heart's signal that it is not getting enough oxygen. So I checked my heart rate and found it to be 48, with many skip beats, PVC, PAC, or whatever. They all feel the same to me. After resting for 20 to 30 minutes, my HR rate went up to 68 to 72 BPM and I felt fine again. It will stay there so long as I sit on my rump, but let me go back to doing something physical, and after a little while here we go again.

I have asked Dr. Einstein and he first has the "deer in the headlights" look and then will say "I don't know." I'm sure he does not believe me. But he refuses to come follow me around for a day or so I can prove it to him. I've worn a Holter monitor and an Event monitor and the report I get is "the results are inclusive." One time he did put an Oximeter on my finger and lead me up and down the hall as fast as he could walk for a couple of minutes. Of course nothing happened, and I tried to tell him it usually took a little more exercise than that, but I guess that didn’t register

Any of you have any ideas why my PM can’t keep up. I am open to all suggestions.

Thanks,

Smitty

8 Comments

for sure

by jessie - 2008-08-07 01:08:12

yes we do need him. i think that his help at this site has been astronomical. the sun is shining . it is hot here. my husband is going to meet some guys for dinner and i have me time. great! it could not be better. well it could but some things we just have no control over like my husband's health. take care aldeer .warrena nd smitty. jessie

Why

by SMITTY - 2008-08-07 01:08:48

Jessie and Warren, Thank you.

Jessie, With the low setting of 70 my PM it is supposed to keep my heart rate at level or above. It did that until Mar. '07 when the exercise/low heart rate problem started.

Warren, I've had 2 PM checkups since May 12, '08. Each showed an estimated remaining battery life of 2 to 2.5 years. I know that would mean a longer than average battery life, but I had the thing turned of for 2.5 years. Actually, it can't be turned off the but low set point was 30 and since my HR never went that low, the PM did nothing but monitor my heart function those 2.5 years. Even now with the low setting of 70, it paces the atrial less that 70% and ventricle less than 10% of the time, so they tell me.

Smitty

settings

by aldeer - 2008-08-07 01:08:52

Hi Smitty.... could it be that when they turned it back on, the low setting didn't register. Perhaps as Jessie said, try having them turn it to 60. That is what mine is, and maybe just the change will make it "wake up". I do know that they save the 65 setting for the warning that your battery is beginning to wear out. I can just be doing housework or getting a little stressed and mine will easily go to 100. Have those settings checked again and lots of good luck. We need your advice! aldeer

Slow heart rate with exercise

by Cycledoc - 2008-08-07 02:08:07

Obviously something is wrong. I'd ask the cardiologist to do an exercise test or a holter monitor (essentially a 24 hour EKG) to document what's going on when you exercise.

my 2 cents worth

by Pookie - 2008-08-07 10:08:32

Hi Smitty.

There is an answer, we just have to find it. First, like many people in the States, do you have access to a Medtronic Rep? It seems they know a tad more than the doctors about our devices. I'd even go as far as writing the company and tell them what is happening to you!

It's got to be the low setting, perhaps it's not set properly. Do you get the print out of the reports? If so, perhaps you could compare them to see if anything jumps out at you.

Or the next time you're at the pacemaker clinic (or wherever you go to get it checked) bring along your lawnmower, and prove to them once and for all what is happening to you....I'm sure they would appreciate the free mow!!

I'd also request that at your next check that you have a cardiologist AND the pacemaker rep there, plus the tech of course. One would think that 3 sets of eyes and 3 brains might be able to figure this one out. And leave Dr. Einstein out of the picture!!

Good luck and keep us posted.

Pookie

smitty

by jessie - 2008-08-07 12:08:17

my setting can't go below 60. i wonder if they could do that for you. jess

INTERESTING QUESTION

by pete - 2008-08-08 02:08:03

Hi Smitty. Sorry to hear you are having problems again.
Here is my contrary theory on your problem. I could be right I could be wrong. Firstly a pacemaker only "ASKS" your heart to beat . Your pacemaker cannot force your heart to beat. If your heart is tired and its muscle decides it does not want to work it wont. So what I think is happening is that you are overstressing your heart and it is telling you to take life a bit easier. You could still cut the lawn but with frequent breaks.
I also wonder what the margin of safety on the energy levels set in you pacemaker. Each pacing signal to each chamber pulsed is adjusted usually by duration of pulse . I believe the voltage level can also be adjusted on some pacemakers. They energy given is set so that it is in excess of that required to capture the heart muscle. It could be that when your heart is tired it needs more energy in each pulse . When you go for your check everything seems ok and the safety margin will look good. You are not cutting the grass in hospital. So maybe you need to ask the technicians to increase the length of each pulse. This would reduce your battery life but might cure your problem. For what its worth thats my suggestion. Cheers pete

Why

by SMITTY - 2008-08-08 04:08:16


Hey Folks,

I sincerely appreciate all the helpful comments. Some of it has been covered with the doctors, but some has not. I'll be seeing a cardiologist on Monday and will go over that which he has not considered, mentioned, or thought of and see what he has to say this time. I can be honest with you my friends, I have become very pessimistic when it comes to finding a solution with this bunch.

For you Pete, I say cut the yard, I do that, but not with a "push" mower. I ride for that. If I drug out my push mover my wife would settle it all when she shot me for even thinking of doing that. Actually, what brought on the last episode was I did some weed eating and kept at it too long. But I had reached the point where I had just a little to go and thought I can finish before putting this thing down. Next time (if there is one) I'll not try for that extra minute or two.

You are right about my having a tired heart muscle. An old one too - my words not yours. I have been told that by some good doctors, but I'm not surprised when you think about it. I just did a little math and my best estimate is that my heart has already beat at least 24.9 billion times. I got that by 60 BPM X 1440 min/day X 365 days X 79 years. Think about it, that is enough to make anything tired.

Anyway, thank all of you very much and I'll let you know what transpires now.

Smitty

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