Running

I just got a Medtronic pm last Sunday and am pretty unhappy about it. I am only 34 and have been diagnosed with SSS. I have had it for years, as well as a fib, but have only recently decided to deal with it. I enjoy running a lot and I also work in fire. I am worried that maybe my pm is set too low at 150. I have never used a heart rate monitor but according to the equation my max hr is 148. What happens if 150 is not high enough? The pm tech says 150 is high enough but after reading some posts I have some concerns. Does anyone have experience with this?

Also I would just like to ad that this is a great site. My sister found it and told me to check it out. I have been bummed out all week and reading about other young people with pacemakers has helped.

13 Comments

Worrying

by golden_snitch - 2013-12-07 03:12:36

Hi!

You received your pacemaker just a week ago, but are already unhappy about it (or the upper rate), even though you haven't tried running, yet - well, why don't you start worrying when you have actually experienced problems? As you said, you never used a heart rate monitor before, so you don't know what your heart rate was when exercising pre-implant. Maybe it was around 150? Also, as long as your AV-node functions well, there is no way to limit your upper intrinic rate, the max. heart rate your sinus node can do. With SSS I'd expect it to be lower than normal, but it could be that you only had problems with bradycardia at rest, and that your sinus node worked well when exercising. Sounds a bit like it, because you were running before implant.

If you should ever run into problems when you get back to exercising, it's really an easy adjustment to increase the upper rate limit. In most pacers you can increase it to around 180bpm, in some even up to 200-210. So, no need to worry now.

Best wishes
Inga

Max heart rate

by JerryG - 2013-12-07 03:12:56

I also have SSS and a dual chamber PM. I am 66 years old but I still work out on my treadmill every day. There are various formulae used to calculate max heart rate but the commonly used one is 220-age for men and 226-age for women. This makes my calculated MHR 154.

My PM was implanted on 18 September and I suppose the Medtronic tech set it to 'standard' settings. I started working out again 3 weeks after implant and immediately ran into problems with my heart rate crashing halfway through my program and not wanting to come back to the zone I wanted it to be.

Had my first post implant check November 21 and the tech told me that my MHR was set at 130 and rate response was off. I was coming too close to the MHR set and was going into 2:1 heart block which resulted in the crash of the HR. I made some very impolite comments and asked the tech to set the MHR up and turn the rate response on. Tech then set MHR to 150 and turned the rate response on (with my cardio's approval; he was with us). I am now a new man again with my HR doing exactly what I want it to during my workouts; rate response working properly and as I try to stay at about 65% of my MHR, I don't get too close to the max set on the PM.

I make your MHR 186 according to the formula I use so I don't see a problem upping your max setting to 180 even (with your cardio's approval). You are a runner so you will be pushing your HR higher than I do and will need the extra beats available.

Please remember that I am not a doctor and cannot substitute for qualified medical advice but am only going by my own experience and with no other heart problems other than SSS. I did have afib diagnosed previously but it was successfully electric cardioverted and my cardio assures me that I remain in normal sinus rhythm which was confirmed by the Medtronic tech from the printout of my PM history.

Good luck with getting your settings changed to suit you.

JerryG

Heart rate upper limit

by judyblue - 2013-12-07 07:12:50

I totally get where you are coming from. I am 51 and I think I am way too young for heart problems! I got mine 10 weeks ago and am still not happy, and frankly, I may never be. We are all different in our experiences. I don't think the advice "get over it is helpful". We will get over it in our own individual time- not to be decided by anyone but us. Enough about that. I too have SSS. When I was told my upper limit was 130 I screamed "I might as well jump off the @#$% St. John's River bridge!" I have been a runner since 1987. Marathon, half marathon, 10K, 5K, etc. My heart rate regularly goes 180 even 200. I live in Florida and it gets hot, and I still run. Well, they listened and changed it to 180. I am fortunate in that my issue is strictly bradycardia. Even with the 180 upper limit, I hit 220 last weekend (it is still so damn hot here). So until I get worse, and need the pm all the time, my upper limit does not kick in to inhibit my running. But these are things they don't tell you until you push them. That is my experience. Good luck!

Upper limit

by IAN MC - 2013-12-07 08:12:54

Much as I've tried to understand it , I simply can't get my head round the significance of an upper limit if you don't have RR switched on ?

Your situation, Judy, compounds my confusion . You had an upper limit of 130 but were exceeding it, then you had an upper limit of 180 and are exceeding it apparently without any problems. So, forgetting the PM , it seems that your heart i.e. your sinus node, is happily getting your HR up without any interference or involvement from the PM.

Could someone explain please what the upper limit is for if you have SSS ; my PM tech suggested that it isn't really important at all unless RR is on.

Thanks in advance

Ian

Ian

by golden_snitch - 2013-12-07 09:12:57

SSS is not only sinus bradycardia at rest, but can very well also be sinus brady when you exercise --> chronotopic incompetence --> rate response needed. So, for some SSS patients the upper rate limit is critical, because that's the max. heart rate they can get. However, it sounds like ruribe had issues with brady at rest only, otherwise I cannot imagine him/her running so well pre-implant.

Heart block patients usually don't have the RR on, because the sinus node is dictating the pace. But for them the upper tracking rate (not sensor rate) is of great importance because if it's set, for instance, at 130bpm and the sinus node easily does 180bpm, they end up with 180 in the atria, and 130 in the ventricles as the ventricular pacer lead stopped tracking the atria at 130. Or they end up with a pacemaker Wenckebach (2:1) block, so for every two atrial beats, they only get one ventricular.

Best wishes
Inga

Ian...

by golden_snitch - 2013-12-07 10:12:35

then you're right and it's of no significance. I'm just not sure what ruribe's problem is, though I'm guessing that it's brady at rest only (and perhaps also during afib episodes). That's why I first said he/she should not complain before having tested the current settings.

Inga

Thanks for your reply Inga

by IAN MC - 2013-12-07 10:12:41

I think I have always understood the points which you make about SSS with chronotropic incompetence and heart-block patients but I still don't clearly understand :-

If you have SSS with brady at rest only ( as I do and possibly ruribe ) then what is the significance of the upper setting ? I feel that I may be being stupid about this and missing something fundamental .

Regards

Ian

It's OK

by Theknotguy - 2013-12-07 11:12:56

It's OK not to like the fact you have heart issues and need a PM to help solve the problems. I don't like the fact I have a PM. I also don't like the fact I have to use a CPAP for my sleep apnea. I don't like the limitations heart problems and sleep apnea have given me.

But I have come to love the machines and what they have done for me. I'm still alive where I would otherwise be dead. The quality of my life is better because of what the machines are doing every day.

So if you can wrap you mind around the two concepts above, I feel you'll start doing better.

In the meantime, start working with your cardiologist to find your heartbeat upper limits.

Happy running.

Theknotguy

upper limit

by judyblue - 2013-12-08 10:12:29

I agree, I cannot see why I need my rate response turned on and an upper limit. It seems pointless. I do not get good answers either. The only thing I can think of is that this condition often gets worse. Perhaps they anticipate us becoming 100% dependent, then we would need the extra functions. So far I am not limited by it. I am heading out today for a run in another unusually warm Florida day. So I will get up to 200 again.

running

by ruribe - 2013-12-08 11:12:17

Thanks to all for responding to my query. I didn't expect to illicit such an aggressive response. Having a pacemaker is new to me and I didn't mean to offend anyone by saying I am too young for one. I am simply frustrated that I have one which, I think, is a fairly normal reaction. I guess I am "complaining" about something I don't fully understand but am just curious about how it will affect my life. I figured this would be a good place to ask such questions.

I am not a doctor and although I try to understand what exactly is going on with my heart I don't fully get it. I know I have a lower limit (50) and an upper limit (150). I had a lot of pauses when my heart is at rest and apparently occasionally when my heart is cranking.

Basically I like running and have an arduous job and wanted to know if anyone else had a similar experience and how they dealt with it. Thanks again, especially to judy, for your responses.

Hi Don

by IAN MC - 2013-12-09 04:12:24

It is possible that your PM is interfering with your heart rate monitor so your heart may be fine but you are getting crazy readings. When your HR "goes crazy" try measuring it with the most reliable method ( finger on your pulse ) ; this will help you identify whether these are just crazy readings or not,

There have been other people on here who have reported the same problem with some makes of HR monitor; I use a Polar HR chest-strap monitor and have never had any problems.

Best of luck with your running ( and you, too, ruribe )

Ian

heat rate monitor

by DonFromSachse - 2013-12-09 12:12:39

I've had a PM for 3 weeks, and I am struggling with a lot of the points made above. I'm 70 and a devoted jogger (on a treadmill) and I have always made my decisions how fast, etc by monitoring my heart rate with one of those strap around the chest things. With the PM, the monitor goes crazy when I start to run. Anybody with any ideas of how to fix or get around this problem?

golden_snitch

by Stillrunning - 2013-12-21 11:12:51

what happens if you have SSS, Bradycardia, RR is on paced AV is 250, sensed is 140 and upper HR is 160 and I can get above that on my own, by the way that was a very informative answer you just gave, why don't we get that type of feedback at our office visits ??

You know you're wired when...

Trade secrets can be smuggled inside your device.

Member Quotes

This is my second Christmas with my pacemaker and I am so happy to be with my family.