Follow Up with EP Tomorrow

Greetings - I had my ICD implanted 8/22/13 and have my follow up tomorrow. I have some issues I want to address and could use some input from you guys. I went into V Tach while cycling (second event in two years). They tried to fix it with ablation but were only partially successful so an ICD was put in the following day. I am 61 and for most of my adult life an endurance athlete. Marathon Runner and now Road Cyclist so my resting Heart Rate has always been in the upper 30's to mid to upper 40's. The ICD was set to 60 at first but I complained about it and it was reset to 50 before I left the hospital. After talking to my cardio and EP on the phone it was agreed that it should be reset to 40 - 45. That's one issue.
I was cleared to resume cycling on the trainer and find it impossible to get my heartrate anywhere near where it was previously. Would the Beta Blockers alone be the cause of this or would the ICD settings put a ceiling on how high the HR is allowed to go? I was already told I might just be a person who cannot tollerate BB's. I just want to know before I see him if there is something that can be done with the settings to lift my max HR.
Not that I don't trust the EP, but I really don't. I want to know what I'm talking about before I walk in tomorrow. No one is going to care more about my body than me so I want to get this right since it seriously affects my quality of life.
Thanks in advance for your input.

3 Comments

beta blockers

by Tracey_E - 2013-09-12 02:09:18

By definition, they slow our heart, that's why we take them. But it can be a fine line between stopping the racing and not letting us get up with exercise.

Find out how much you are pacing when you exercise. If you are dependent on the pm to get your rate up, then it's the pm, not the bb.

If you are increasing on your own, then you may need to get used to the meds. It takes a minimum of 4-6 weeks for your body to fully adapt. Or you may need to adjust the dose. I am super sensitive to them. I am on the smallest dose so we couldn't go lower. I tried taking it at night rather than in the morning, that worked for a while. Then the racing came back so i switched to morning, but my rate wouldn't go up. Now, I cut the pill in half, take half, go to the gym, take the other half when i get home. Convoluted, but it works for me. Don't be afraid to think outside the box.

Thanks

by Cruzer - 2013-09-12 02:09:50

I have a few things to discuss tomorrow and I'll take it from there. Jerry right now I'm struggling to hit 125 so a HR of 145 would be something I could almost live with. My pre ICD max was 165.

Max heart rate

by gleesue - 2013-09-12 10:09:02

Got this from the Mayo Clinic:

Beta blockers slow your heart rate, which can prevent the increase in heart rate that typically occurs with exercise. This means that it might not be possible for you to reach your target heart rate — the number of heartbeats per minute you should have to ensure you’re exercising at the proper intensity level. No matter how hard you exercise when taking a beta blocker, you may never reach your target heart rate. However, being unable to reach your previous target heart rate doesn’t mean you’re not getting cardiovascular benefits from exercise.

Also I’ve had a lot of work done on my heart, the Maze procedure and 4 ablations. Ablations can also lower your max heart rate. I don’t take BB’s but in a stress test the best I can do is about 145 bpms no matter how hard I try. That doesn’t stop me from working out/biking etc. as hard as I can. My PM rate is set at 50.

Good luck with your EP.
Jerry

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