Athletic Performance and pacemaker

Hey guys....recently had a pacemaker installed Dec 12. I have been a lifelong competative athlete in collegiate track and cross country and now a 50 year old Cat 3 road cyclist. I was diagnosed with LBBB when I was 32 yrs old. This was Initially rate dependent (LBBB occurred at 120 bpm), but slowly converted over the next two years to full time. I definitely had a decrease in performance but adjusted to this lower performance over several years. The condition stayed the same until about two years ago when I began having more fatigue and myriad of other symptoms. Had a loop recorder implanted (don't mess with the holter monitor stuff) and looked at data for 6 mos. Type 2 and 3 Wenkebach blocks were indicated, at times reducing my HR to the upper 20's at night. Evidently, I was one of the statistically rarer cases whose LBBB slowly leads to full heart block. I had a Medtronic ADAPTA implanted. I chose this device due to its being able to pace up to over 180 bpm, if necessary, and I had it installed with the thicker MRI leads, even though the device itself is not MRI compatible, in anticipation of growing MRI compatible generators that can pace higher in the future. Initially they had the motion sensing turned on, and when I walked I had my HR go to 140 + in less than 25 meters of walking! I had them turn off everything except the low side obviously which keeps me at a consistent 60 bpm. I am ~8 wks post op and have recently increased my exercise intensity, bringing my HR to 182 without problem. My HR response to exercise load appears to be the same. The cycling season is nearly upon us and I will provide updates as necessary. Word to the wise.....don't push the recovery issue---something that was difficult for me due to my competative nature and not wanting to lose conditioning. Follow the instructions about lifting/raising arm and jarring movement until the lead scars over. I am very pleased with the performance so far, but the jury is still out regarding full up competition. I am grateful for the technology that has resulted in my feeling better during the day and the elimination of a whole host of symptoms that made life difficult previously.

4 Comments

You have a good handle on your condition

by ElectricFrank - 2013-02-16 01:02:57

I'm always happy to see someone who really understands what is happening with their heart and pacer. It makes it so much more likely that you will get what you need in the way of adjustments.

best,

frank

Hi Titus

by IAN MC - 2013-02-16 05:02:51

It is great to read a post from someone who is not letting a PM rule their lives. When you reach that moment when you genuinely believe that you are performing as well in competitive cycling as you were pre-PM please send another post. I'm sure people do reach that stage but we never hear from them.

......... I hope those extra thick leads don't add too much weight and slow you down a bit !!

I am sponsoring a friend who has had a heart transplant and is running in this year's London Marathon. It is amazing what determination and positive thinking can achieve.

Best of luck

Ian


Interested in other competitive cyclists

by Sherriluvstobike - 2013-02-19 10:02:35

I have enjoyed reading the comments above. I had my PM inserted 4 months ago, and I am trying to learn as much as I can about what is happening with the device and my body during exercise (so please forgive my simplicity in describing my case) My PM was placed under an emergency situation, so I never had a chance to research what kind of device I should have. The cardiologist did know I was an athlete so hopefully a suitable one was chosen.( I have a St Jude duo lead) I was in sinus arrest (with 8 second lapses), and was also told it was a heart block. I have been back several times to be tweaked, but I still don't feel like things are where they should be. The RR is on, and set rather aggressively, and initially I felt that was necessary for cycling since there is no arm action with cycling. I didn't feel like my heart rate was increasing as it should with exertion, especially when climbing hills. I seem to max out at about 140 bpm, which was the case before PM insertion. There are times now (as there were before PM insertion) where I may try to exert and there is "nothing there".......my legs are dead and I just can't go. My PM is only set to not go below 60 bpm. At one of my interrogations, I was told that my SA node does work on its own with exercise. This is all so confusing! I appreciate any input or thoughts and suggestions on what kind of questions I need to bring up to get this device set correctly. I live in a rural area and I really don't think the clinic has many (if any) endurance athletes so they probably don't really know what to do with me.

Getting dialed in

by titus - 2013-02-21 06:02:40

Sherriluvstobike, I found it very helpful to contact my pacemaker technical representative (not your cardiologist) to ask the appropriate questions. My Medtronic technician knew a great deal more about my device than my doc did and answered some very technical questions I had for him. You can also find the technical manuals on line many times and you will be amazed at how programmable these pacemakers are. I think it also depends on your condition as well. Each of us likely has something different. For me it was LBBB, and for others SSS etc. As I mentioned above, I had them turn everything off because the only reason I needed the pacemaker was to prevent the HR going too low although I anticipate that I will need full pacing as my conduction system slowly fails in the future. Ask if your device has a higher setting than 140 and whether your are being paced all the time or when your are just blocking. They can change the upper and lower limits of these. If your SA node is working and responding to exercise, you should be able to get your HR higher providing your PM is set higher than 140.

You know you're wired when...

Your old device becomes a paper weight for your desk.

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