Training heart rate

I had my pacemaker put in 4 weeks ago. My rhr prior to implant was as low as 27, regularly in the 30's. My symptoms were shortness of breath and I couldn't get my heart rate over 100. My training heart rate range prior to having these symptoms was 90-125.
My pacemaker is set between 55-130. I have found there is no relationship between perceived exertion and my heart rate. On a treadmill, it will go to 130 before I am breathing hard, and when I do an interval and push myself, it stays at 130. Then it takes forever to come back down, even when I am not breathing heavily anymore and would expect it to be around 90-95 ( based on old history)
When I went spinning, which was quite difficult, again there was no correlation between perceived exertion and my heart rate. In this case it was just the opposite. I felt like I was exercising relatively hard and my heart rate never went above 90 unless I REALLY pushed it. Can't figure out what's happening-- any insights?

5 Comments

charts and settings

by Tracey_E - 2014-02-06 08:02:51

First of all, once we have electrical issues and are paced , in my experience throw away the target heartrate charts and previous experience. It's all new now. Don't go by the numbers, go by how you feel. When you were really pushing it and at 90, did you feel ok?

Second, it can take some time to get the settings adjusted. You are likely using rate response which senses movement and raises your hr. Some models also sense breathing. The can adjust how quickly it goes up, how quickly it comes down, how high it goes, etc. They like to make the changes in small increments so don't be surprised if it takes a few tries to get it right.

Spinning and bikes are a challenge because your torso isn't moving so the pm doesn't realize you are exercising.

Tracey - Let me leapfrog...

by donr - 2014-02-06 09:02:34

...over you & perhaps extend an evaluation of the situation.

1) Sounds like SSS/Bradycardia, based on the RHR, SOB, & low max rate you could reach. Perhaps some Chronotropic Incompetence thrown in,

2) Settings are inapplicable, really

3) Lack of correlation between Exertion & HR says the RR is functioning - & not very well.

4) Takes forever to come back down, even when NOT breathing hard. Sounds like a messed up setting in overall RR functioning.

5) Spinning /bike sounds liek Tracey says - RR not functioning correctly.

6) Long time to resume decent end HR COULD be lack of conditioning, perhaps due to length of time it took to figure out you needed PM & had it installed.

7) You have a Medtronic PM - AHA!!!!! a clue, Dr. Watson!

If it's a 2014 Medtronic, it most likely has a dual slope RR function & NO breathing sensing in a Medtronic, so that does not come into play.

The dual slope system allows the cardio to adjust at what level it starts functioning & the rate at which the RR influence increases. IIRC, the slope even has a break point in it where it can change slope. There are all sorts of fiddles in that adjustment that can determine how you feel. After tyou have finished your workout, the PM senses that & now switches to the other section of RR control - how fast it lets your HR return to "Normal" Sounds like yours also needs a bit of tweaking. Sounds like it is set for too longa period, since you are no longer breathing hard, That clues me that your body is getting all the oxygen it needs - the delivery means (HR) just isn't slowing its deliveries yet.

8) I have a Medtronic & my cardio fiddled w/ all that business on me & improved my performance significantly. He must be correct, because I have no difference in results whether on a treadmill or bike.

9) There are two other parameters that can be tweaked - the SA Interval & the AV Interval. The SA Interval is the time the PM looks for between successive beats & the AV Interval is the time the PM looks for between the SA firing & the expected firing of the Ventricles. Either of those two off can cause you discomfort, also.

10) Next time you get on either type of bike, try rocking your torso back & forth to see if that stimulates the RR functon & improves your performance.\\Hope that I've added a bit to Tracey's analysis.

Don

Thanks

by jfasoneholder - 2014-02-07 06:02:59

Thanks to you both for your comments. I've always used my THR for exercise and weight control and now it's so hard to figure One other question is how does your heart rate with a PM correlate with calories burned. I used to know that the harder I worked and the higher my heart rate, the more calories/minute burned. Is there any correlation now and if not, how do you manage weight with a PM?

weight

by Tracey_E - 2014-02-07 10:02:48

It's all pretty much a guess so probably not too far off. I track what I eat, estimate what I burn exercising between using a fitbit and logging my workouts on myfitness pal. I don't know if it's accurate or not, but it the tracking helps me keep in line and the fitbit makes me fanatic about getting enough steps in every day. If you eat the right foods, stop when you're full, drink plenty of water, exercise hard... your weight will work out. Don't stress the details.

Work with your doc

by COBradyBunch - 2014-02-27 12:02:21

Sounds like you got the out of the box heart rates. Work with your doc and tech to get them where you want them. If you have no other issues other than electrical you might be able to go with a much wider range and a lot higher max. Don't know age and other info but I was 50 when I got mine and it was set at 70 - 120 out of the box. I am now set at 50 and really no max (apparently there is one but I should never reach it) with a RHR of about 54 and my most recent max was about 174 on a climb chasing some of the mountain goats in my cycling club.

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