Getting closer; but still not perfect!

In a previous post I mentioned that my upper rate was lifted to 175, and then recently to 200 by the DR.. Oddly enough I am still dropping to 70 / 80 as soon as my heart rate monitor gets to 150-160 - I am not getting anywhere near 200..(don't want to...)

At the 150 rate I am feeling great! It is the level where I am not out of breath, but feel like I am exercising - then bang! Hitting the wall... but, not as bad as before. Now, I can jog through it if I choose to as it is not nearly as uncomfortable as it was before (did they change something else?)

I am making ANOTHER appt, but wondering if anyone here knows what other setting/settings I should be looking at. I don't need over 200, but there has to be something else that is knocking me back into the 2:1 or whatever it is now..

Thanks!

4 Comments

Suggesstion

by ElectricFrank - 2012-12-27 01:12:14

Are you sure it is the Upper Tracking Limit they are stting higher?

The other and more serious situation is that your heart, not the pacer, is going into 2:1 block at the 150-160 rate. This can happen if it doesn't recover fast enough after each beat to support the higher rate. The pacer sends it a pacing pulse but it doesn't respond on every other beat.

What you need is to be evaluated on the treadmill with an ecg that shows ventricular pacing. If it is your heart that is the limiting factor it is very risky to keep pushing. Even with my pacemaker causing it I made it a practice to never push into 2:1 block. Just keep in mind that pushing above the limit amounts to requiring more blood flow than your heart is able to deliver.

Hope I made sense out of it.

frank

More settings changed and explanations..

by USMC-Pacer - 2012-12-27 06:12:30

At rest my av delay is normal @ 200.. when I exercise and go over 90 to 100 I start having drops and my av delay gets worse on up through my higher heart rates - the higher my HR, the worse my delay gets as high as 460 I think she said... resulting in something like a 2:1 block, or drops as she called them.

So, she made several changes that she said I wouldn't notice. But, the one I did notice was that she turned on the "Rate Responsive" with settings to start at 90 BPM with an av delay of 160.

I just got home from a jog around the block. It was easy, but far enough that would have put me into 2:1 before these changes. With no drop in HR and I feel better....

So, I am cautiously optimistic and will report back over the weekend after some more exercise.

Thanks to all for your help!

I remembered something else...

by USMC-Pacer - 2012-12-28 10:12:21

They said that my AV delay was set at 400ms to allow my ventricles plenty of time to beat on their own.. what I don't understand; I am diagnosed with "exercised induced AV Block High Grade," so I am not sure what made the (nurses) think my ventricles were going to beat normally while I am exercising. Anyway, I must say, since they turned on the "Rate Responsive" I haven't experienced any drops, and my heart rate monitor is working properly (obviously the HRM wasn't the issue here)>>>

I think the Rate Responsive setting nailed it...

by USMC-Pacer - 2012-12-29 11:12:48

I purposely got my HR up pretty high today to "test" it out. I got up to 176 and felt great with no symptoms of 2:1 blocks. When I slowed down, my HR quickly came down as it should. I am not going to make a habit of going that high, but had to give it a test... so far, so good!

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