Maybe I need rate response

I'm pretty new to this and learning, 4.5 weeks after Tectronics dual mode PM install. Was told it was a rate responsive model. I have total AV block, so my PM is totally pacing my ventricles. All is good doing things around the house, my HR increases as expected. Last week I did a trial walk in my neighborhood. Short story is that going up hill I get short of breath, feel like I'm walking with weights on my legs and my HR drops into the low 60's and stays there until I get back to my recliner. Then jumps up to 100's, and settles down to the low 80's (normal resting for me). I did this twice with the same results. I am overweight and out of shape so would expect my body to request a higher HR.

I posted this last week ("heat and humididty?" in exercise) and Don gave me a good explaination of what could be happening but I needed to know more about my PM settings.

Yesterday I got a copy of my PM interrogation report. Mode: DDD, base rate: 60, Upper Tracking: 140. I did have a few short events reported. They said they were either atrial tachycardia or afib events. Short duration, shortest 8 sec, longest was 45 sec. They are going to monitor for now.

I've been reading postings for rate response and I'm thinking that changing my mode from DDD to DDDR would help with the shortness of breath. Any thoughts on that? Would RR interfere if I'm having an event (artial tachy or afib)? Or just let me carry on with exertion?

I got an appointment to see my cardio nurse Wed, 17th, to check if I should keep trying to do more exercise and or need a reprogram. Would be great to hear of any experiences or thoughts on this.

Thanks
Kathy

4 Comments

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by Grateful Heart - 2013-07-16 07:07:45

I was waiting for Don to come along but he is probably out chasing that bear again....or maybe a squwabbit. (Long story if you weren't here a week ago but if you do a search on here for squwabbit, you will see what I am talking about.

Anyway, if you can't duplicate the problem in the office, ask if they would put you on the treadmill while the tech monitors you so they can see what is happening. There are many settings that can be adjusted for you. If you also have SSS, you would need the RR on.

You may also want to ask your Cardio about Cardiac Rehab. It's a great place to start for beginning exercise after PM or ICD's.

Let us know how it goes at your appt., good luck!

Grateful Heart

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by boxxed - 2013-07-16 09:07:30

What are your pacing percentages on your report? Good way to tell if RR would be a benefit.

Saw the cardio folks...

by KAG - 2013-07-17 08:07:55

...today and explained my situation to them. Tomorrow I see the PM tech and see if any adjustments are called for. All the info I've gotten will help a lot.

I asked about cardio rehab and was told that in my case insurance won't cover it since I only have problems with the heart's electrical system. The PM is the fix so insurance doesn't think anything else is needed.

I will be checking to see how much and maybe just pay myself.

Saw the PM techs today

by KAG - 2013-07-19 12:07:47

I went over my symptoms with them and after much discusion on how my particular PM model works they adjusted my UTR to 160. I'll be testing it out and see if anything else is needed.

They did recommend that in my case, sinus node working and total AV block, that I didn't need RR. They said that it can cause conflicts with the sinus node and could give me undesirable symptoms.

I'm understanding that this is an incremental process and it may take time to get the best settings for me.

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But I think it will make me feel a lot better. My stamina to walk is already better, even right after surgery. They had me walk all around the floor before they would release me. I did so without being exhausted and winded the way I had been.