Sports pace maker

Doe's any one have a suggestion as to which pm is the best for athletes?
I have a medtronics for a little over a year now and when I'm pushing hard on my bicycle my heart rate wont go above 150 and I just hit a wall. I have talked to my Dr. and the medtronics tech and they say my pm can not be set any higher. So now I'm considering changing to a pm that is more sports orientated but don't know which might be the best. Amy info would be appreciated.
Jack Coul

6 Comments

Sorin Reply DR

by PacerRep - 2013-09-26 08:09:49

The Sorin Reply DR currently has the highest upper rate at 185bpm.

You're also going to want a device that has a dual blended sensor, Your medtronic only has 1 sensor.

Boston Scientific
Biotronik and
Sorin are the only companies with dual sensors

Medtronic and St Jude only have 1 sensor, they are not very efficient at peak exercise volumes.

I hate to be the one to tell you, I highly doubt that they are going to just change your device....when the battery goes out you can select your brand but I've only seen them change one early for a different brand maybe 5 times in my life and it was for way more serious of an issue.

Do you need the sensor?

by golden_snitch - 2013-09-27 01:09:12

Hi!

Agree with PacerRep. I have a Sorin Reply, and before I had this one implanted, I did lots of research about it. All doctors, techs etc. I asked said that this is the best sensor combination.

But what I was wondering:
If you can push your heart rate up to 150bpm when cycling, it does not sound like you need your pacemaker's rate response. Medtronic only has an accelerometer sensor, and that does hardly react to cycling because it needs upper body movement to sense that you are exercising. Just talked to a Medtronic rep two weeks ago, and he told me that, if I should go for a Medtronic pacemaker, I should be prepared that cycling won't work. So, if you can reach your upper rate limit with an accelerometer only, I'd guess that it's rather your own rhythm and not the pacemaker.

If you do have an own rhythm that's working well when exercising, you'll need a pacemaker with a high upper rate limit. Medtronic Adapta has 220bpm, and Biotronik has (not 100% sure) one with up to 200bpm.

Best
Inga

Boston Scientific

by Dasser - 2013-09-27 05:09:35

Hi , I do a lot of bike riding just over a year ago with out any warning I had my pacemaker implanted I received a Boston Scientific Ingenio model which is like a sports model I was the first person to receive one in Australia I was told. Had a few problems at the start but after a few months of tweaking getting the settings right while doing stress tests I could not be happier with my pacemaker doing all the things I did before I had it I got the pacemaker because I was going into second degree heart block.Good luck for the future keep me posted on how things go Darren.

Inga

by PacerRep - 2013-09-27 11:09:52

He may need to be tracking his atrial rate even if he gets his sinus node up to 150. He may need it to maintain synchrony...the 150 applies to this scenario as well.. He said he hit's a wall at his max sensor rate so there's a 99% chance he's implementing his pacemaker in some fashion during his workouts.

Biotronik

by gleesue - 2013-09-27 12:09:39

I do al lot of biking and other activities, tennis, golf, kayaking etc. I have the Biotronik and have had great success with it, 20 mile this morning. My doc also told me he had several marathoners on the same PM. Gie it a good look.

Jerry

Complicated

by golden_snitch - 2013-09-28 06:09:13

Hi again, Jack!

Having looked up the specifications for the Medtronic Revo, I can tell you that its upper tracking rate and upper sensor rate are both 150bpm. So, there you go. Your pacer cannot go any faster. Your heart could only go faster, if sinus and AV-node both function normally. But the older you get, the slower your sinus node usually gets, so maybe 150bpm is all it can do. If you want faster rates, you need a pacemaker with faster upper tracking and sensor rates.

I read the two other questions you have posted before, and now I'm confused: In those postings you said that your upper rate limit is set at 140bpm. Now you say that when you reach 150bpm you hit a wall. Has your upper rate limit been increased to 150bpm? Or is that your own rhythm?

Also, you mentioned that you have bradycardia and Afib, but that the Afib is controlled with Multaq. Did you have bradycardia because of Afib, or did you also have bradycardia when you were not in Afib? Just wondering, because if the bradycardia was caused by Afib, and Afib is now well controlled, it would be interesting to know, if the bradycardia is gone, too.

PacerRep, I don't understand your argument, because if it's just about tracking the atrial rate and thereby synchronising the atria and ventricles, you do not need the rate response sensor. But with Jack's history of bradycardia and NO heart block, it doesn't make sense. I would have guessed that Jack needs the RR because he has bradycardia, but an accelerometer just doesn't pace you up to 150bpm when cycling. So, apparently his sinus node is doing a good job.

I'm still not sure that you, Jack, need the rate response sensor. A normal accelerometer sensor will not pace you up to 150bpm when cycling; in some Boston Scientific pacemakers you have a blended sensor with accelerometer + minute ventilation, and then this works, but not with accelerometer only.

The upper rate limit is something that only limits your heart rate in case you have complete heart block or sinus bradycardia. In the first case, the pacemaker will pace your ventricles up to that rate and not any faster; in the latter case, your atria will be paced up to that rate and not any faster. But if your sinus node goes faster than 150bpm, and you have a healthy AV-node, there is no way that the upper rate limit will stop your heart rate from going faster than those 150bpm. If your sinus node does 180, and the well working AV-node passes those 180 on to the ventricles, it doesn't matter what the pacer is programmed at, the ventricles will beat insync with your atria.

So, my guess would be that your sinus node is working well up to 150bpm, and then that's it. The pacer cannot further increase your heart rate because it has already reached its upper rate limit and your sinus node has reached its limit, too. You'd either need your upper rate limit increased, or if that is not possible with your pacer, have a pacemaker implanted that has a max rate of 180 or more bpm.

Best
Inga


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