cycling with VVI setting

Hi,
I've been trawling the internet looking for an answer to my question and I came across this forum.

I've had a DDDR pacemaker for over 10 years, with absolutely no complications. My heart ran as close to normal as it can (considering).

For various reasons (well one), I have developed a heart flutter and pm has gone into vvi, which means I'm dependent on movement for my heart rate to increase. This means when I cycle my heart rate doesn't go up. It makes cycling harder, which is fine, I figure once my heart flutter is dealt with I'll be uber fit (indulge me on this one!), but my question is, do I still burn the same calories??

I love cycling, its really convenient for it to be my main form of exercise (work and back etc), but I will replace it with something else if, well if I'm not really getting benefits from it!

If anyone can answer this I'd really appreciate it!

7 Comments

getting your HR up

by ldebaugh - 2012-09-17 05:09:36

I had a St. Jude Accent DDDR put in in February, off label as a VVIR and am having the same problems. I want an upgrade to a CRT-P to help. I wish I could offer you some help.

I'm in permanent a-flutter or that's what I'm told. When it was put in it was "permanent afib". So obviously nothing is permanent. The issue as I see it, when in afib/flutter and having a VV and dependent on movement to make my HR increase, it goes up then as I continue to exercise it goes right back down and I am very sob.

Have they said that you can have an ablation to get rid of the aflutter?
M'Liz

ablation

by emsbell - 2012-09-17 06:09:55

Hi, thanks for replying :)

Yes there has been talk of an ablation, but I have a slightly complicated history and have had heart surgery twice in the last year and a half because of endocarditis. Sigh. And now I have an epicardial pm in my abdomen.

So my cardiologist is 'thinking' about it. I'm supposed to have a cardioversion next month, but I don't hold much hope, its already been postponed once, because my inr is too low. But I'm really resistant too warfarin. Every time I get over 2.0 m body seems to adjust and I have to up my dose (I'm on 12.5 mg!!) So I'm pretty much going Insist on the ablation.

I too wish I had CRT pm, n fact pretty pee'd off they didn't give me one when they had me opened up! But I don't think that would help with this. I would like a rate responsive pm that senses my breathing, not just my movement... in fact if this flutter is permanent then I will ask about it!

Sorry rambling, but I've actually not really spoken to many people with similar experiences!

Dual Sensor in your future?

by ldebaugh - 2012-09-17 10:09:29

I think you are on the right track and what you want is a dual sensor with both the accelerometer (motion detector) and minute ventilation sensor (breathing sensor).

You seem confident that you can convince the doc that this is what you need. Keep me/us informed because I'm sure there are many out there like you and me that would dearly like an upgrade because things are just not working well as they are now.

Good luck!
M'Liz

Rate response

by golden_snitch - 2012-09-18 03:09:51

Hi!

When you complain about that your heart rate does not increase enough with exercise or that it drops again too soon, then the rate response sensor is the problem. In that case upgrade to a CRT would not be of any help at all. All pacemakers with accelerometer (motion sensor) only have that problem with cycling as they need to sense upper body movement which you usually do not have that much when riding your bike. So, what you need to get is a dual-sensor rate response as M'Liz has suggested.

What can also contribute to SOB when exercising is that when you are in VVIR mode, the atriums and ventricles are no longer synchronized; you lose the "atrial kick". Especially in patients who already have a slightly reduced EF this loss of atrial kick can lead to an even more reduced EF which then can cause all kinds of symptoms of heart failure, incl. SOB. But again, a CRT would not help with this problem.

So, if you ask for an upgrade, ask for a better rate response not a CRT.

Best wishes
Inga

Calories and exercise

by Selwyn - 2012-09-18 08:09:30

Clearly exercise of any sort uses calories. The intensity and the longevity govern how many calories are used. I have always thought that if you do not break sweat you are not really exercising to burn off calories, i.e. your body temperature should rise with the chemical changes producing energy. This is a personal view.

The type of exercise you take is an individual's choice. Personally, I have never gone to a gym. Having cleaned my all my windows today and the conservatory roof, I was quite happy not to have my usual swim! The important thing is to be active- this may help stop blood clots forming in the upper chambers of the heart, the more so if you have atrial fibrillation and flutter.

So, the short answer is if you are doing the same cycling as before ( intensity x longevity), you are using the same calories. You can always swap intensity for extra longevity, perhaps? Sprinting tends to be for the youngsters!

Constant heart rate

by ElectricFrank - 2012-09-18 12:09:50

It depends on what that constant HR is. When you exercise at a level higher than your HR will support the result is inadequate blood flow to organs, muscles, and brain. I wouldn't push it very far past the limit especially since you are having heart rhythm problems. The lower perfusion of your heart could trigger something.

frank

Sweating as marker

by ElectricFrank - 2012-09-19 12:09:26

This is so variable from person to person that it isn't ver useful unless of course you know your own body.

I tend to sweat very quickly which is an advantage here in the desert. I usually hike with my shirt off and have a great cooling system (as long as I drink plenty of water). Even when it is in the 90's my chest is cold.

frank

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In fact after the final "tweaks" of my pacemaker programming at the one year check up it is working so well that I forget I have it.