Which pacer ?

I have had my Medtronics pacer for about 5 months now for bradycardia. I am also on sotalol for afib and that keeps me in nsr. I am an avid bicyclists, mostly mountain bike. When I ride I wear a heart rate monitor. I had the pacer programmed while on the treadmill and my doctor says it is set right. My problem is when I'm climbing and pushing my self hard some times my heart rate is 110bpm when I think it should be much higher based on my level of activity. Other times when I am just cruising my rate will be at around 140 closer to my max rate. It seems that my pacer just isn't responding correctly.

My question is...would a Boston Scientific pacer work better for me? I was told that the Medtronics responds from motion from your body. The Boston Scientific works from body motion and from your lung activity and that it is better for athletes.

Any comments on this would be greatly appreciated.

6 Comments

probably not

by Tracey_E - 2013-03-30 04:03:41

While there are some minor differences in pm's, for the most part any of them will work for everyone. Imo, it would not be worth it to have a surgery to get a new one for a few bells and whistles, and odds are the insurance would not cover it until the battery goes on the one you have. So, think ahead to possibly making a change for the next one but for now, keep what you have.

Keep in mind you are on a medication that affects your heart rate, so don't go by what the charts say you should be doing or even the monitor (they are often inaccurate for us). Two questions, what caused the brady? Brady is just a slow hr, more of a symptom than a diagnosis. Is the source of the brady sinus dysfunction or av block? And how do you feel when you are pushing hard? If you feel good, then don't worry about the number.

I can get up to 150+ from walking up the stairs but stay around 120 when pushing really hard at the gym. I feel ok both times. My pulse is all over the place! As long as I can work out hard and feel good, I don't even bother counting anymore. I'm on atenolol, which works differently than sotolol but it's purpose is still to prevent the racing.

When I took it at bedtime, my heart would race at the gym, atria would get going faster than my upper limit (180) and stop my workout. Then I tried taking it in the morning, that didn't work either! My hr wouldn't go over 110 and my arms and legs were like lead. Now, I cut it in half, take half of it an hour before my workout and the rest when I'm done. It took us almost a year to find a medicine I could tolerate, a dosage and a combination of when to take it that worked for me. And that was after spending months getting the settings right, which included sending my files to St Judes to make me a case study after my rep was stumped. The engineers that developed my pm are the ones who suggested my current settings. I have a very patient and inventive cardiologist and rep! My point is now I feel great and can do whatever I want, but it did not happen easily or quickly.

Another note, when they say it's set right, that may mean it's set right, it may mean they've done everything they know how to do and are stumped.

The gym

by LeeT - 2013-04-01 01:04:29

I too have worked out for years received my PM Jan 18th (AVblock) and as yet have not returned to the gym. My caution is not typical of past health issues. I don't take any meds for the heart. Can you please let me know if you lift weights and how far you push yourself. I actually feel better now then when I working out with some dizzy spells and shortness of breath. Thank you for your advice. Lee

Lee

by Tracey_E - 2013-04-01 10:04:19

I lift weights! I push as hard as I can :o) My official instructions are don't do anything stupid and stop if I don't feel well. I don't hold back at all, do Crossfit 5 mornings a week.

Be careful cleaning the bar if the bar sits on your pm/wires or is close enough to the collar bone that the clavicle can pinch the wires, but most have the pm lower than that so it's not an issue. Other than that, as long as your dr says it's ok then go for it. There are some drs who will caution us to not lift over head, to not lift heavy, no pull ups, etc, but unless there are other health issues involved or your pm is in a place that is risky, then decide what is right for you. I've never seen evidence that holding back makes the leads last longer, so I don't worry about it. My personal opinion is I'd rather take a little risk and live life to the fullest than sit on the sidelines for fear something might go wrong. So far, nothing has gone wrong and I've been paced since 1994.

TraceyE

by Jackcoul - 2013-04-05 02:04:12

I have tried twice before to respond back to your comments to me and for some reason they did not go through. So I will try once more.

I don't really know what the cause of my brady is, the EP just said I needed one because of my slow heart rate and low blood pressure. As I mentioned I still get dizzy but not as dizzy as before. I never passed out but came close several times.

Another thing that concerns me with the pacer is my heart rate changed quite a bit after I got the pacer. Before my low rate was in the low 50's to low 40's and my max was around 130. Now the pacer is set at low of 60 and high of 150. I thought the pacer would only kick in if the rate went below 60 but apparently it also kicks in to increase the rate under heavy activity.

I feel OK when I'm pushing hard but I get much shorter of breath and don't have the same energy level that I did before when I was in nsr without the pacer.

I'm scheduled for another catheter ablation next month to cure my A flutter (I have had several). I am hoping that once I get the aflutter stopped and get off the blood thinners and the sotalol that I can have the pacer set so it only works for the low rate and nothing for the high rate. That way my heart will be functioning normally with no assistance from the pacer at the high end and I will be able to function as I did before. I don't know if that makes sense... but thats what I'm hoping.
Jack

tafi

by Tafi - 2013-04-05 04:04:24

I asked about hrm's and pm when I went for a checkup and was told that readings may not be correct as the pm and the hrm do not like each other ( the person doing the check up told me this his words ). You can buy a hrm that takes readings at the wrist.

Low Heart Rate With PM

by hjfarr - 2013-04-16 12:04:54

I had my Boston Scientific implanted in Jan '11. I had one of my follow up visits in mid April '12. On May 19th I competed in and won my age group and qualified for IM Kona at Ironman Texas. Ironman Kona was on 10/13/12. Two weeks after I returned from Hawaii I had a follow up visit. Per the technician my maximum heart rate for the 7 month period per the PM's stored data was 106bpm even though it is set for 150 at the top. If my Boston Sci PM is typical, you won't get that great of a bump in HR..

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