Curiosity on settings

I was just curious as to what others low/high settings are.... I'm set at 60-120. I go for my next interrogation Wednesday, and am considering asking for my low rate to be bumped up. For the most part, I feel good with my settings. I am able to exercise, but require to take more breaks. I am okay with this, as overall I feel my quality of life has greatly improved. I do suffer from fatigue, and was wondering if bumping my low rate up to 70 would be beneficial, or if that would just create an entire new set of issues. Thanks in advance for any input

7 Comments

Enrique

by Tick-tock - 2014-05-12 01:05:13

I am also concerned about the sleep disturbance. My first pm, it took a few tries to find my happy/medium settings. I had a lot of issues in the beginning with becoming dizzy with changing positions, so I am a bit hesitant to change. I guess worse case , I can always change them back. As far as answering my question, you did;) I was basically curious as to other members settings:) hope you can find your perfect number:)

Settings

by Enrique - 2014-05-12 01:05:24

I would think that if you feel tired when you exercise the issue could be with the response of the PM to increased activity.

My settings are 50 - 130 and I am also asking if I should bump up my low setting, but for a different reason: I don't get tired when I exercise, but when I stand up after being quiet for a while, or when I get up in the morning, it takes me a while to recover my breath (I am quite fit). Perhaps a higher low setting would help, but I am worried that this may have a negative effect on my sleep.

I'm afraid that I didn't answer your question, but maybe other members have some info on this.

Settings & Sleep

by Chase - 2014-05-12 02:05:21

My PM was put in Feb 2014. The settings are 70 and 120. I have not had any problems sleeping.
Chase

Lower Setting

by IAN MC - 2014-05-12 04:05:24

Hi Tick-tock Your lower setting should be fairly close to what has been your normal resting pulse throughout your life . This can be within quite a range , usually somewhere between 55 and 100 bpm . What was your normal resting rate ?

If, for example, throughout your life , you have had a resting rate of 70 bpm then every organ in your body has been accustomed to the oxygen levels supplied by that heart rate. If suddenly, a PM guru, in his infinite wisdom decides to set you at 60bpm then every organ in your body will receive less oxygen than it did before ( when your HR falls ) ; the result is likely to be tiredness particularly when you are resting.

Throughout my life, my resting pulse was 60bpm but they set me at 50bpm. I persuaded them to raise it a few weeks ago . The difference for me has been quite dramatic . I was frequently falling asleep in the evenings after dinner now I am not !!!

The only downside to raising the lower limit is that the PM battery life may be slightly reduced. But if you have it set it too high then this would tire you in a different way ( I believe this happened to donr and he may well comment )

Have it raised and see how you feel.

Ian

PS Your upper setting of 120 is incredibly low but I don't know your medical background; you may have heart issues which justify this low setting.

Using the normal calculation this would be the max heart rate for someone 100 years old !

Thanks for the intro, Ian...

by donr - 2014-05-12 06:05:46

.....I came out set at 80 & 120. I was a natural 72 all my adult life. Just before the procedure the EP asked me what I wanted to be set at & I told him 72. Well, he knew better than I where I should be set & put me at 80.

I felt ALMOST great all the time, BUT at about the end of the second week I felt "Wired" all the time. I did NOT know what my HR lower limit was set at.

Went to see my Cardio for the first follow up visit & told him about this feeling & then they did a download & discovered my HR setting at 80. I complained vociferously (A polite way of a 'Yankee saying he pitched a hissy fit!) & he dropped my setting back to 75 & told me to go out & walk around the hall for ten minutes & see what the effect was. Did the walk, came back & sat down & felt relaxed.

I suffer from two interacting issues - SSS (Brady) & PTSD. We had to find a lower rate that would help me feel comfortable physically as well as mentally.

The mental aspect was that at the too high lower limit, I felt constantly "Hyper alert" because my heart was running too fast when I was expecting to be calm. I called it the "They're coming through the wire" syndrome (Brought the PTSD home from Vietnam).

Ian said it all when he suggested that you wanted to be set at a lower rate very close to your natural rate pre-PM. I see that you have a single chamber PM for SEVERE Brady (Your words). That tells me that you are very sensitive to that lower rate & would probably be fatigued if it were set too far below your natural resting HR.

Consider the following situation: You were a natural 70 pre-PM. You are rustling around doing your little thing being a student nurse & would have been running at 85 - 90 from the same level of activity Pre-PM. BUT - due to the Brady, your HR keeps dropping below that & the PM does nothing to help you out till it tries to drop below 60, where the PM steps in. You could be having the situation where you are really running quite a low HR for the level of activity you are experiencing. That equals fatigue.

Now you can have the "Sleep" function activated that allows your PM to be set for a lower value for your normal sleeping hours. MOST PM's have that capability.

Further, you did not say, but there is a condition called "Chronotropic Incompetence" That's a fancy Greek word meaning your heart's SA node is incapable of speeding up to meet flow rates necessary to support your level of activity. It goes along w/ Brady sometimes. That can cause fatigue (In addition to other problems).
My humble experience tells me that you want to be set at a lower limit JUST a tad above your Pre-PM resting rate. That will keep you from ever falling below it when the PM does its assigned duty.

Save battery - that's CROCK. If saving battery is so darned important, why not set the lower rate at about 35? That would allow you to survive & have a nice, long MISERABLE life while doing so. The PM is used to restore you to a comfortable, functional existence called "Life," not a miserable survival. No one can predict what a lower rate that is 5 BPM higher will do to battery life. (We read in here all the time about someone who started out pacing 10% of the time & suddenly they are pacing 50% of the time. Totally unexpected - who can predict that will happen? Their question is always "Should I be worried?") It's a trade off - 7 yrs , 3 mo of a life slightly akin to being in a coma or 7 yrs of normalcy. To me, that's YOUR choice, not the Dr's!

Donr

Mine was 60-120 initially

by Grateful Heart - 2014-05-12 12:05:13

I was a natural 57 bpm many years ago when I was a runner. I don't know what it was after 4 BBB's (bubbly baby boys), each 2 years apart with the last 2 being 17 months apart. I was a little busy having too much fun with them to keep track...but I digress. :-)

I've since learned that we should all know our numbers.

So when the EP asked me what my resting rate was I went by 57 and he set it at 60.

That was 5 years ago but a few months later after my ICD settled in, I felt SOB as if I couldn't catch my breath. So he set it at 70 and for me it made a big difference. My Upper Limit has been raised a few times too. 130, 150 and now 165.

We're all different so try it and see. It can always be set back to 60 if you don't feel better with the change.

As far as the battery depleting faster with the higher rate, I agree with Don....if you need it, you need it.

I recently saw my EP for a few adjustments and he asked me twice if this was the original generator that he implanted. It shows 5 years left and he was surprised since I'm 100% paced in the ventricles and almost 100% in the atria.

I'll be very happy if I get a total of 10 years out of this battery. I did tell him I'm shooting for 15 years though. A little optimistic I know.

Grateful Heart

Thanks!!

by Tick-tock - 2014-05-14 12:05:26

I go for my interrogation and EP visit tomorrow. I agree that quality is better than quantity . I am not to concerned if my battery lasts 5 or 15 years :) I think I'm going to try it at 70 and see what happens. Worst case scenario, it doesn't agree with me, and they turn it back down.

Grateful Heart: 15 years; you are quite the optimistic... I love it! Wonder what the record holder is? I'm going to have to google that!

Donr: I always look forward to your responses!!

Ian: I too am curious why my upper limit is only 120.... My previous upper limit was set at I believe 150 or 160. That was when I had my original pacer placed in sept 2013. I then had afib episodes which lead me to an ablation, lead extraction and pacer revision due to other issues.

I will keep you all updated on my visit!

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