Does a Rate Response PM "learn" the user?

I have just finished my first 3 weeks with a Boston Scientific PM. Things are progressing well -- I have less dizziness, more energy, and strength than b4 implantation. This morning I got up and felt really good -- something I haven't felt for some time.

Over the 3 weeks, I've noticed what seems to be a progression in my heart rate and ability to exercise more -- for instance, at first it seemed that I had a hard time getting my HR fast enough to feel good walking up stairs or on a treadmill. My HR seems now to respond much better than it did at first. Does a rate response PM "learn" what you need or is it that my body is simply responding better to the PM - or?

For those of you interested in checking your heart rate while walking or exercising -- from a person who has tried various ways, the easiest, best and most accurate way is to purchase a finger pulse oximeter -- they work great (amazon.com has good ones for $30 to $40.)

PKite

7 Comments

adjustment

by Tracey_E - 2012-10-08 10:10:51

I'm not up on the latest rate response technology, but I'm pretty sure they don't change anything, settings have to be changed by a technician. Our hearts do get used to pacing over the first few weeks, and we heal as our bodies readjust to having a normal heart rate.

How PM Works

by SMITTY - 2012-10-08 11:10:21

Hello PK,


A PM is nothing but some solid state electrical circuits, a capacitor (one or more) used to store the electrical energy used to provide the electrical impulse required to make your heart chamber(s) contract as needed and a timer to be sure everything happens on schedule. In other words a PM is an inanimate object that cannot do anything except follow instructions it receives from its sensors. The settings programmed into the PM by your dr. determine what it will do for your heart.

Your PM does not adjust to your body nor will your body make changes to accommodate your PM any more than a digital alarm clock will adjust to a person getting up at the same time each day.

Smitty

Wrong

by golden_snitch - 2012-10-09 03:10:05

Sorry, guys, but you are wrong! As you said it depends on the settings that are programmed, but at least my pacemaker's rate response has a "learning" setting. It "watches" how much I'm exercising and running around in daily life, and from the data it gets, it determines how much rate response I need. In fact, I started running three weeks ago three times per week for 30-45 minutes, and in the beginning I used to end up at the max. upper rate pretty often, but that has changed over time. I'm now running at around 140bpm, and not 165bpm.The learning setting is the one programmed when this pacer model is implanted, so unless the cardio changes it to "automatic" or "fixed", it will adjust to your lifestyle.
Best
Inga

Boston Scientific vs Medtronic

by ebfox - 2012-10-09 09:10:16

I think Inga must have a Boston Scientific because my Medtronic does not have a learning setting- the technician has to put you on a treadmill and adjust the RR. My EP commented that the Boston Scientifics were better for "chronic exercisers" and perhaps this is an example of why.

I was going to comment that PK is also probably adjusting to the PM as well. That is a good thing to see, when you kind of forget that you even have the PM.

EB

Sorin

by golden_snitch - 2012-10-09 09:10:34

I have a Sorin Reply pacemaker with a dual-sensor rate response. However, ever since I was switched to epicardial leads, the minute ventilation sensor is no longer working. Nevertheless, the "learning" mode still works :)
Inga

PM Is An Inanimate Object

by SMITTY - 2012-10-09 10:10:45

Hi Snitch,

You may be a PM expert, especially when your PM knowledge is compared to mine, but I'll challenge you for being the most hard headed PM club member.

I still say a PM, even one with a RR that adjusts itself based what the body is doing, is incapable of thinking for itself. Your PM is just one that has a RR capable of adjusting its output based on what it sees your heart doing. Just like the one that lets the PM low set point settings determine the frequency the PM will send electrical impulses to make the heart beat.

So I still say a PM is an inanimate object incapable of thinking and is dependent on the settings programmed into the device.

Smitty

Learning/thinking

by golden_snitch - 2012-10-09 12:10:05

Smitty,

I grew up with three older brothers, I have to be hard headed ;)

Of course, a pacer is not thinking for itself, but the original question was: Does a rate response PM "learn" what you need? And I say, yes, mine does. And if it adjusts the rate response to my level of activity, without the doctor having to interfere and program settings, then I'd say, it adjust to my body's needs. It does so on the basis of the data it gets, that's true, but we all learn on the basis of information we get, experiences we have etc., don't we?

So, yes, a pacemaker is as you say an "inanimate object incapable of thinking", but the question was about learning. Sorry for being hard headed again. I see what you mean, it's just that I understood Tracey's and your comment so that you think a pacer cannot learn.

Best
Inga

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