Settings for cycling/spinning

I had my PM installed in January. Had bradycardia, HR in low 30's and shortness of breath. Am 61 year old female, no other meds, incredibly active and fit. Had a medtronic RR pacemaker put in- have had a couple adjustments. Current HR range is 55-155 which works well if I'm on a treadmill, swimming, doing Pilates, etc. If I spin, it is horrible. I bang on it repeatedly to get it up and I can't get it above 105ish ( My daily living setting) If I get it up momentarily, in seconds it falls back down. I'm going back to my tech but would appreciate any advice on what setting needs to be adjusted so I can spin and not be dying or pounding the whole time?

5 Comments

Hi Jfasoneholder

by IAN MC - 2014-04-13 02:04:45

You say that if you get your HR up momentarily, in seconds it falls back down. Normally this would be a good indicator of fitness if it happens when you stop exercising but it seems to be happening to you when you want to exercise more.

Some Medtronic models have an " Activity Deceleration " setting which determines how quickly the pacing rate declines to a target sensor rate when your activity stops.

Because of the limitations of the Medtronic accelerometer Rate Response feature you are being read as stopping activity so it is possible that adjusting the Activity Deceleration feature may keep you at a higher HR for longer

BUT I am assuming this is the case and i may be misunderstanding the role of the Activity Deceleration feature, You need to discuss it with your PM guru !

Going back to RR settings you can alter the sensitivity to make the HR rate of increase vary according to levels of activity but it is something of a trade-off. You could end up with it responding to the minimal movements produced by spin classes but the downside would be that your heart goes crazy if you walk upstairs or sneeze.

I agree with Inga's last paragraph.

Best of luck

Ian

Medtronic rate response

by golden_snitch - 2014-04-13 12:04:10

Hi!

Well, we have had this topic here several times. If you use the search button in the upper right corner of this page and type in "rate response", you'll find lots of messages. So, just very briefly: A Medtronic pacemaker has a rate response sensor that needs upper body movement to sense activity. Even the Medtronic techs say that, because of this, cycling can be a real problem. And I suspect that spinning is, too, because while your arms are moving the whole rest of your upper body isn't. You can try further tweaking, but it could very well be that you do not see much improvement in all sports that don't require upper body movement.

Some doctors suggest to tap on the device because this sometimes fools it, activating the sensor. But that's difficult when you do spinning. And also, a Medtronic tech told me that this tapping does no longer work with new devices, it only worked with less sophisticated motion sensors that were placed in the titanium case of the pacemaker; new motion sensors are placed on the chip inside the case.

Don't understand why cardios implant Medtronic pacemakers with motion sensors only in patients who are as active as you. As if there was no alternative. There are pacemakers which combine a motion sensor with a minute ventilation sensor. Those are better able to keep up with activities like cycling, and from my own experience - had this combination for 9 years - I can say that they also react to spinning. Last but not least, there is one manufacturer offering a sensor that is called "closed-loop stimulation" (CLS), it's based on measuring changes in cardiac contractility. I just got home from riding my bike for one hour, and my CLS sensor did a great job!

Nevertheless, none of these sensors is as good as a functioning sinus node. So, when we depend on the pacemaker's rate response sensor, we always have to compromise a bit. This can even mean having to give up some activities - but one always finds an alternative :-)

Good luck with the tweaking!

Inga

You need a stress test

by HK - 2014-04-14 03:04:00

Tell your Cardio you want a Stress Test because you are not getting the heart rate and oxygen you need during exercise. Exercise is the only way you will ever get better. You need a stress test to see how your PM functions on demand. Don't take "No" for an answer. Best of luck.
HK

I had similar problems

by JerryG - 2014-04-14 11:04:41

which are now solved after my last cardio / Medtronic tech visit on March 10. I only walk on a treadmill but also found the rate response on my Medtronic A3DR01 wasn't reacting quickly enough and also dropped off after it finally went up. I don't have the understanding of these devices that Inga does but I told the Medtronic tech what my problems were and she adjusted my PM settings accordingly (with my cardio's approval).

I am now totally happy with the way my PM is working; rate goes up reasonably quickly and stays there while I work out. I guess I am pretty fit as my heart rate comes back to 'normal' quickly once I get off the treadmill. The RR setting is not so sensitive that I have any unnecessary reactions to rough roads, stairs etcetera.

I got a printout of my readings and settings and scanned it for safekeeping. I can private message you my settings if you like.

Bushveld greetings

JerryG

Interesting 75yo

by JBM - 2014-06-05 10:06:02


This is of interest to me.I am 7 weeks out and have started to work back with Nautilus sets and all is well except on one machine where I push back weight,then my pulse jumps right up to 120 or so,while only 85 on others. The back machine is easier than the others too. Maybe it is the motion as some of you mentioned -- thanks

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