higher upper limit pros and cons

I've gone back and read various upper-limit threads and see a lot of members struggle with \doctors/technicians to get the limit increased.

For active people who are pacing the ventricles, I can understand the benefits in a higher upper limit (so not to go into 2:1 block too soon). But what's the risk?
thanks
Erik

8 Comments

risk

by Tracey_E - 2013-11-27 10:11:25

As Inga said, no risk, it's just not typical so most do it on an as-needed basis. Some people shouldn't be getting their heart that high, in that case they'll keep the rate down to limit activity.

Ability to exercise

by golden_snitch - 2013-11-27 10:11:30

Hi Erik,

there is no risk. It just limits your ability to exercise. Feels like you hit a wall when you suddenly drop from, for instance, 160bpm down to 80bpm. Also, in most patients there really is no good reason for limiting the upper rate. Some doctors don't optimize the settings at all, and so patients end up with upper rate limits of 120-130bpm because this is a typical nominal setting.

Inga

thanks

by erik - 2013-11-27 12:11:12

That's really useful to know. I'm not ready yet to do more than stroll but I used to max out around 155-160bpm and my PM is now set at 150. Close, so I'll wait and see when the time comes.

ventricle pumping drops 50%

by erik - 2013-11-28 01:11:28

That's my understanding but use "2:1" or "Wenckebach" in the search button above for more. It feels like suddenly hitting your limit and you have to stop until your heartbeat drops a bit then you're good to go.

2:1 block

by Elleninminn - 2013-11-28 09:11:28

Eric, will you explain for me what a 2:1 heart block is? I'm relatively new to the pacemaker "lifestyle." I have a Medtronics Revo dual chamber with rate response turned on and upper rate limit of 130. I exercise only moderately.

It just means

by KAG - 2013-11-28 12:11:57

that the PM hits the upper limit and drops the pacing in half. If your upper rate setting is 130, then your PM would decrease your pacing to 65. You definitely feel it.

When I first got my PM my UTR was set to 140. I started walking up a hill and got very SOB and my legs felt like rubber. I repeated the walk using a monitor and watched my HR raise to 130's and then drop like a rock to the 60's. I felt terrible. They raised my rate to 160 and I've walked that same hill dozens of times with no problems now.

I think they're used to most PM patients being more sedate and don't think about the more active ones. If you're at all active, I'd get it raised.

Kathy

2:1

by Tracey_E - 2013-11-29 08:11:29

it means for every 2 atrial beats, the ventricle beats once.

Maybe that explains

by Elleninminn - 2013-12-01 10:12:41

my inability to walk very far. I suddenly feel tired after walking a short distance or up a flight of stairs. Could be my PM kicking in because my setting is too low. I'm going to ask about getting it changed and whether that would affect its usefulness when I go into afib. Thanks for the info.

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