Question for runners

Hi, I have a question for anyone who is a runner pre and post pm. My Medtronic rate responsive dual lead pm was fitted over a month ago for bradycardia and sinus pauses which became more marked after marathon training 2 yrs ago. Took 6 months off and improved. Went back to moderate running for 2 yrs then things got worse again so had pm. Feeling much better and happy with implant. Started gentle running at 3 weeks and now up to 5 k. I am much slower than after my last break. My questions are:

Should I expect to be slower because I have had an operation and it takes time to recover?

Could it be something to do with settings? Currently my rhr is 60, approx twice what it was prior to implant and what it was years ago after having kids and no exercise, with top rate set to 150.

I would be very grateful for any experiences you can share.

Thank you

6 Comments

Running

by Bostonstrong - 2013-09-29 11:09:34

Don't give up! It does take time to recover and for your heart to adapt to a device. It could also be the settings, check with your EP if you don't think they are great for your lifestyle. You are back up to 5 k which is great. You are doing better than you think! Got mine in June, will be running my first 1/2 with a pm Sunday. Went a little off the rails with diet and training while on vacation last week so if I'm slow I'm blaming the extra pounds I picked up in San Diego. Not the pm. Stay strong!

running

by Tracey_E - 2013-09-30 02:09:47

If you are getting stuck at 150, it sounds like that's your upper limit. 150 may be as high as it can go but definitely ask, depends what kind you have.

The hr monitor may not be accurate now. Pm's confuse them. Mine interferes and the hrm shows no reading. Others, the hrm picks up the pm spikes as well as the beats so shows a rate higher than it should be. When in doubt, count manually.

Reply to runners

by Galadriel - 2013-09-30 02:09:58

Thank you for your comments and encouragement. Very good luck with your 1/2 marathon on Sunday Bostonstrong, I am jealous! Whatever you do, it will be a PB for your pm.

Thank you TraceyE for your really kind comments. The only real problem I feel is a lack of power which maybe recovery or not getting enough at the high end setting.

Thank you EB for your observations which are very helpful and yes, I did have chronotropic incompetence where I would suddenly just lose all power, like batteries going flat, during my run and couldn't get my hr above 100 at times. This was at my worst though, 2 yrs ago. I wore my garmin hr monitor this morning and it showed my hr up and sustained at my max setting of 150 - it seemed to flatline there and I wonder if it needs setting higher. Any suggestions?

Thanks again for taking the time to respond everyone.

Rate Response Settings

by ebfox - 2013-09-30 03:09:29

Tracey is probably right, 150 is probably your upper limit.

You need to go in and ask your pacer tech to put you on a treadmill while you run and let him adjust the Rate Response settings. That could improve how you feel.

The fact that you are running 5Ks is really good, even though I know how frustrating it is to not be able to do what you used to do. You do know that all your running is the likely cause of your sick sinus (ask me how I know, I am in the same boat).

Hope this helps,

E. B.

a little of both

by Tracey_E - 2013-09-30 10:09:51

It's possible the settings could be tweaked a bit to help with your stamina but it's more likely your body is still in recovery mode. For two years, you pushed your body when you had a problem so it won't bounce back from that overnight. It's only been a month, I think you're doing great! A slow 5k is fantastic, more than most do 2 or 3 months after.

If you have specific problems when running, like dizziness or sudden extreme fatigue, then it may be the settings. Note the date and time when that happens so they can check when they interrogate the pm.

Chronotropic Competence

by ebfox - 2013-09-30 11:09:36

Hi Galadriel,

A key question: is your heart still chronotropically competent or are you relying on Rate Response? Chronotropic competence is the heart's ability to react to exercise; many people with straight bradycardia retain CC and if so, you should have less of an adjustment period.

If you are Chronotropically Incompetent, your heart does not increase properly when you exercise, and your PM has a program feature called Rate Response which raises your pulse. Getting Rate Response tuned properly for your activity level sometimes takes several visits to the pacer techs. The best way is to get the pacer tech to put you on a treadmill and then tune the settings.

But back to your original question: if you have retained your CC and are only being paced for baseline reasons, you should be able to return pretty close to your prior activity level.

Hope this helps-

E. B.

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