HR while exersizing

I am 25 days post PM.....and back at the gym...but afraid, due to ignorance, as to what my heart rate should be...I just walk on the treadmill 3.6-4 MPH and my heart rate, which I never paid attention to before, is now a focus...I am scared of getting above 130. Bought a pulse oximeter and use it a lot...
Is there anyone who can share how they got back on the workout horse?
Also, while I am using the leg press, hip abductors, and calve press...when did you go back to the weights for the chest/arms?
thanks!
cb

14 Comments

Yer Crazy!!!!

by donr - 2013-03-21 01:03:15

To reach for the brass ring so early.

You have a very serious cardiac problem if you have a complete block.

You have the rest of your life to do that. Creep up on it slowly by starting out w/ a goal of say 120 BPM. Do that for a bunch of days, then add to it slowly. Find out what you NEED.

Like Frank said - his HR topped out at over his UTR AFTER he sat down to rest. You have no idea what your heart will do if you run over the UTR & you do not really want to find out. Especially if you do not NEED the 150 capability. Go find out.

Go over the 150 & the PM stops pacing. W/ a complete block, you may be left hanging w/ the Atria beating & the Ventricles doing NOTHING or the PM working at half the desired rate to keep from pacing you into a V-Tach or V-Fib. That is not good.

In that one statement, you went from wimp to nutcase.

Sorry to sound judgmental, but that is reality.

Don

Hmmm! HR of 130...

by donr - 2013-03-21 01:03:21

...sounds like you are afraid to go to your upper tracking rate. Unfortunately, you did NOT tell us what your HR was the first time you remounted the horse!

Just be careful that you do not become obsessed w/ the Pulse-oximeter.

What you need is a great big dose of confidence! I'd write you an Rx, except that no pharmacist I know of stocks it. It is something you have to build yourself!

Lemme suggest how to do this: Get on the treadmill & check your HR w/ the P-O before you start. You should have checked it while at rest, well before going to the gym, so you have a base line. Go for two minutes at a nice slow rate that you obviously feel is NOT running you up close to the UTR. Go by feel, do NOT check the HR w/ the P-O. Check the HR at the 2 min point. Increase your speed a small amount. Go for a long enough time that you know that your HR has stabilized. Check it. Work your walking rate up to a point where the HR stabilizes at about 120. DO NOT go till you reach a HR anywhere near 130. You need a margin for error. Perform this ritual till you are comfortable walking & only making mental note of your pulse, knowing that it is below the magic 130 BPM. This ritual will give you the confidence you need, (Hopefully).

I just completed a modified cardiac rehab course & that is what the PT monitoring me did w/ me. He was deathly afraid for me to go anywhere close to my UTR - 120 BPM. The thought did not faze me. Got home & reported this to my Cardio's head nurse. Her comment was that I did not want to intentionally run my HR up beyond the UTR. To do so MIGHT cause the PM to go into a 2:1 blocking & potentially cause V-Tach leading to V-Fib. Not Good! My PT was paranoid about me even coming close to my UTR. Nurse said "Good for him!"

The other questions I cannot help you with.

Don

Upper tracking rate

by ElectricFrank - 2013-03-21 02:03:19

If you can find out what that Upper Tracking Rate is you can use it as a guide. My approach was to stay about 5 bpm below the UTR right after implant. They had my UTR set to 120 and at least for me there tends to be a small overshoot when I stop.
I was out in the desert yesterday for climb up a hill and pushed my HR to 125. When I stopped it climbed on up to 130 before starting down. It's actually no problem these days because I pushed them into setting my UTR to 150 which at 83 yrs is well above my safe rate. I just keep track of it myself. I don't want to get into that 2:1 block situation.

hope I make sense,

frank

Go for it

by gleesue - 2013-03-21 02:03:34

I'm not 100% paced and am set to 140. My doc said no problem going over as it means my heart is doing it on its own. I work out hard 5-6 days a week. As far as weights my doc just said if it hurts don't do it. He also suggested doing more reps with less weight to begin with. My cardio work outs are actually stronger than before my PM. My tennis buddies also think I'm even a little faster than before. I don't even think about having a PM anymore.

Jerry

Gee, Don...

by cb - 2013-03-21 03:03:42

I dont want to be a nut nor dead...clearly I do not understand this new reality. I wish the surgeon, who is the only medical person I have spoken to (and at that only 2x) who told me to "go back to the gym" 10 days post PM, had filled me in on what the parameters should be...thus I turn to this club. I really do appreciate your input.
This morning I just hung out about 115 BPM..it felt natural and good and I did not push it....came back and read what you wrote and was glad for that! I am balancing feeling "normal" with remembering I have a pacemaker...it is tough.

going over the UTR

by Tracey_E - 2013-03-21 04:03:03

I've done that lots of times!!! It doesn't feel too good but it's basically harmless. I have 3rd degree heart block also. If the atria goes faster than the pm can pace the ventricles, the heart is out of sync, like before we were paced but with a higher pulse. For me, this means my legs feel like lead and I get dizzy. I stop and breath deeply and slowly until my rate comes back down, then get back to my workout. It's an annoyance, not incapacitating.

If you find yourself feeling bad and your hr is right at 150, ask them to turn it up. Most of them go to 180.

If you feel good working at 115, then don't give the pm another thought!! You have plenty of cushion. We all worry and check our pulse a lot at first, it's perfectly normal. As we feel better, as we get back in shape, it gets easier and easier to trust the pm and forget it's there. One day it'll occur to you that you haven't thought about it in a few weeks and you feel like your old self.

Depends

by ma_ku - 2013-03-21 06:03:16

I was back to trail running just over 2 weeks after implantation but the answer to the question is that I think it depends on your underlying condition.

I had my pacemaker implanted in February. They set my upper rate limit to 150. However, I regularly exceed this up to my pre-implantion Bruce Protocol measured max heart rate of 184 when out running. The first time I exceeded it (as measured by heart rate watch) I was nervous and curious about what would happen, but in fact nothing did. My heart rate increased normally (according to my watch and I felt fine). I don't worry about exceeding the upper limit at all anymore when exercising.

However, I am not pacemaker dependent. I have 2nd degree heart block that affects me only at rest. My PM mode is set to AAI/DDD, rate response off.

If you are pacemaker dependent (3rd degree heart block), then the advice and the experience of exceeding the upper tracking rate would be different.

From what I have read on this forum, if you are pacemaker dependent and start to block due to exceeding the upper rate limit you would know about it pretty fast and be unable to continue the workout.

I think the key thing is how do you feel when you are exercising?

Mark

all great advice

by ohiolaura - 2013-03-21 08:03:17

As far as weights,I believe most Doc's say dont lift abouve shoulder and more than 5 lbs for 6 weeks post op.
I think all the advice given to you is right on,esp Don's.
I asked my EP the other day about my getting a heart rate monitor to use when I work out,he said not to bother.
He said theyre really not something I need,and Ive read sometimes the PM interfere and they dont work correctly.
Dr told me my targeted rate for my age and such,and I honestly dont really take my pulse while I work out,as long as Im upright,breathing and still going,Im good.
Start slow for sure,take it easy,25 days isnt that long,it took me awhile to work up to where I was before the PM.
Just try to pay attention to your body,relax,and do what youre comfortable with.
Good luck!
Laura

HR

by Tracey_E - 2013-03-21 09:03:04

I'm smiling at the other comments with logs and details. I'm kind of lazy like that. I have no idea what I did this morning much less last week or beyond. ;o)

I found that the charts with target heart rate and all that don't mean much when we're paced. HRM's are useless for many of us, too, my pm interferes and they all tell me I have no pulse but I'm pretty sure I do! Or some people find they work but are not accurate, picking up the pm spikes as well as the beats.

The right hr when I'm working out is whatever my heart is doing when I feel good. I push/exert until I can barely talk and try to stay there for the rest of the workout. If I get dizzy or arm/legs get heavy, I back off until it goes away then get back to it. I only count my pulse if I feel bad. If you feel good, don't stop and count!!! Just concentrate on your workout. If you feel bad, then count and see if you are near that upper limit, that's an indicator it needs to be raised.

After 6 weeks, ease back into the upper body exercises. Stick to just cardio/legs until then. I didn't have a plan or instructions, I just did it! Start low, add weight and reps as it got easier.

Cardiac Rehab

by donr - 2013-03-21 10:03:18

Personal opinion: A lot of cardiac rehab is to treat the head, not the body. For those who have not read my comments on this, I start by stealing a quote from one of Napoleon's Marshals back in the early 1800's. "...in battle, the mental is to the physical as three is to one..." Now, I'll admit that I probably butchered that a bit, but the principle is the same for medical & especially cardiac problems.

You have just come off a life-threatening event; you are scared to death - after all, you have just stared Death in the face & walked away from an intimate relationship w/ him/her. You can expect to be a bit stressed out & anxious. Therefore, it is MHO that a lot of the monitoring effort by the staff during a cardiac Rehab is to treat your head, to give you confidence that you CAN once again do things.

I just went through a modified cardiac rehab after 5 months of nearly total inactivity following a foot surgery that went south pretty badly. I convinced my cardio that I really needed it, based on my physical AND mental state that had me so tied up that I could only work around the house for about 15 minutes before having to take a 15 min break to get my breath back. Actually, it did not take much convincing, he knew me & saw what was happening to me physically, so wrote a letter justifying the procedure.

The PT clinic I went to did not have the full monitoring capability needed - no cardio on duty, no ECG capability, etc - so they got w/ my cardio & worked out a protocol that called for HR, O2 & BP monitoring during the exercise program. Worked like a charm. Took but two sessions to convince my head that I was far better off than I thought. IN less than a week, I went from 15 min breaks every ten minutes to working at a slow rate for about 12 hrs, w/ probably 5 breaks during that stretch. A break consisted of visiting the computer, sitting down & checking PMC!

I discovered that the BEST way to determine how well my heart was doing was to talk continuously throughout the program. If the situation arose where I could not talk, that meant I was SOB & my HR was probably high. Worked like a charm. Turned out that the highest physical stress rate came from climbing the 3 step stair case. Routinely put my HR at 118, which scared the PT guy crapless, for fear that I'd go over the magic 120 UTR.

That is where you can learn how to sense, w/o measuring, how the heart is doing.

Oh, BTW: using the little Pulse-Oxymeter is a good place to see an illustration of what I say about the HR being a series of independent events. The P-O can & often does, change the displayed HR w/ each beat - because it measures the time between beats & converts that into a rate for display. Illustrates the slight variability in timing of beats by the Sinus Node.

Don

Nutordead

by donr - 2013-03-21 10:03:25

CB: Look at this like Boeing looks at test flying a new airplane. The engineers have calculated what they think the plane can do. They've "Flown" it in a wind tunnel.

They make several dry runs down a runway, just to rotation speed then abort the takeoff. They then take off, do a 360 of the field, gear down all the while & land. Then they take off, retract the gear & start exploring the way the plane flies compared to what all the calculations & wind tunnel test say it should do. The they start exploring the outer reaches of its envelope. Finally, in the case of the 707, a true nutcase named Kelly Johnson does a loop in it - just because he THINKS it can do it & survive.

Look at your new PM in the same way. Don't do the loop till you know that the human/PM combination function just ducky below their calculated limits.

BTW: back in my callow youth, I saw a B-47 scream along the ground at near sonic velocity, pull up & perform a half loop, followed by a half roll (An Immelman, I believe it's called) - just short of the perpendicular point to the ground, it loosed a bomb, effectively tossing it a pretty good distance. Don't you suspect they crept up on that maneuver?

Don

thanks....

by cb - 2013-03-21 12:03:53

Thank you for the feedback. I have complete heart block and the UTR is set for 150....so staying under 130, after reading the above was apparently a bit sissy of me. I have a vision of the atrium beating away at a good rate but the ventricles topping out at 150...what happens then? ...will hit the treadmill this am with a 145 goal. Just to see how that feels.
I am really grateful for your input!

Effect of going over the UTR

by ElectricFrank - 2013-03-22 01:03:03

The only way the pacer can enforce the UTR is by skipping beats. So what happens as the UTR is reached is that the HR first becomes erratic, and finally enters a 2:1 block. So if the UTR is set at 120 and you push to an atrial rate of 130 you get a ventricle rate of 65. That doesn't sound too bad until you consider that it happens when your body is demand the cardiac output of 130.

The most benign effect is that you tend to feel a bit weak with may some SOB. But remember that your heart muscle blood supply comes from that same crippled heart. For someone with a cardiac plumbing problem in addition to the electrical it could be serious.

It's interesting that the docs don't seem to be concerned, but the rehab people are.

frank

Re

by nbarton - 2013-03-25 11:03:32

I would like to chim in on this. I have had my PM for two years this may, I am proud to say that I have done P90X twice and insanity once completely through the programs. I am currently performing in crossfit games. I have had the top setting turned off and have been doing great. It was previously set at 170 bpm. I have had this setting for about 6 months and have no problem getting my heart up around 180 and fell great after a workout.

You know you're wired when...

You have a maintenance schedule just like your car.

Member Quotes

It made a HUGE difference in my life. Once I got it, I was finally able to run, and ride my bike long distances.