Heart Rate Drop

I'm a 62 year old cyclist who recently had a pacemaker implanted after aortic valve surgery. When my heart rate reaches 160 BPM, the pacemaker quickly drops my rate below 100 BPM, making it very difficult to continue climbing a hill. I've had the Medtronic Techs adjust the settings and thought this problem was corrected. But it happened again last week on a very long uphill. Has anyone else experienced this.

4 Comments

Hi Fishman

by IAN MC - 2013-07-11 01:07:29

There is a special " Rate Drop" setting where the PM puts in extra beats if the HR falls too rapidly . One regular poster on here, Casper, had it switched on and it changed her life ( for the better )

Do you know if you now have it switched on or not ?

Ian

Complete heart block?

by golden_snitch - 2013-07-11 02:07:11

Hi!

If you have the pacemaker because of complete heart block - I think this is not an uncommon complication after aortic valve surgery -, then your pacemaker will put you into a 2:1 block as soon as your upper rate/upper tracking rate is exceeded. This is kind of a safety feature to prevent atrial tachyarrhythmias from being passed on the ventricles. Your natural pacemaker, the SA node, which is located in the right upper heart chamber, is probably going faster than 160bpm. In heart block patients, the pacemaker usually watches what the SA node is doing, and then makes the ventricles beat at the same rate. However, when you reach your upper rate limit, the pacemaker stops tracking the SA node, and puts you into that 2:1 block. At a rate of 160bpm, that would put you down to 80bpm.

What about setting the upper rate limit a bit higher, for instance, at 170 oder 180 bpm? Apparently you are very active, so I don't see why you could not have your upper rate limit increase to the max that the pacemaker allows.

Good luck!
Inga

Rate Response

by TRL28 - 2013-07-11 07:07:16

Hello! I had this same exact issue and it was horrible. They turned my rate response on which they told me in turn wouldn't allow for my rate to drop so rapidly and it worked :) I actually stay at my max rate now with exercises or climbing stairs, etc. This isn't typically needed with CHB's however works in my case. Hope you get this figured out because I know how awful it can make you feel. It also caused my EF to decrease from 60 to 42% however within 2 weeks after the changes I was back up to 60. Good Luck and don't stop until it's fixed because it definitely is possible! (Ask to get on a tredmill while your hooked up if they don't believe what is happening or playing it off!)

Hmmmm

by Casper - 2013-07-12 01:07:49

It's sounds to me you definitely need to have your settings adjusted.

What is you upper rate set at?

I don't think it's a Rate Drop Response causing this issue, because that would cause your heart rate to increase for a specified amount of time.

My Rate Drop Response is not turned on, because I have a fast heart rate recovery, and don't require the intervention.

I agree with Inga (as usual) and see if you can get your upper rate increased, I know my doctor has even removed my upper rate limit, and my lower rate is set to 40bpm.

Good luck,

Casper

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