upper & lower settings

Sorry if this is a dumb question but i'm new to this heart problem thing and the world of pacemakers and stents. Since having a heart attack with complete heart block on christmas last year and getting these devices implanted i've had a few chest pain issues... only happens after a hard workout on the treadmill or exercise bike. Taking nitro doesn't help... and the pain (in center of chest) usually goes away in a matter of days. I just found out today in cardiac rehab that my pm is set from a lower limit of 60 to a high limit of 130. Could going over 130 cause this to happen?

5 Comments

upper limit

by Pookie - 2014-05-28 08:05:48

I'm just guessing 130 is a bit low for someone who is exercising. However, there is no reason why your PM Tech (or whomever adjusts your settings) couldn't raise it to see what happens.

There are A LOT of members who do exercise and I'm positive they will have a better answer than I.

Take care,
Pookie

another question

by highdesert - 2014-05-28 10:05:47

I'll ask my pm tec for sure... next visit is in Oct. Another thing i'm cofused about is what happens when your heart rate goes over the pm's high settings? My heart rate monitor has read close to 150 a few times during a good workout... why ever bother setting a high limit to the pm if my heart can overide that number?

Well

by KAG - 2014-05-29 11:05:22

I'll describe my situation, as I've experienced this.

I have total AV block, no other issues, and my sinus node works fine (that's the heart's natural PM). So my PM has Rate Response Off, and my lower rate is 60. Originally my upper rate was 140 (I'm 59 and fairly active). When I first started walking outside and going up hills my rate would hit that 140 and I felt it immediately. No pain, just very SOB and my legs felt like lead.

What happens is the PM does just what it's programmed to do. It hits that upper limit and drops the pace in half. So my rate went from 140 to 70, boom. Much less oxygen, so SOB and feel like crap. Why do this? Well it's a safety feature in that if your sinus node starts racing the PM will keep the ventricles from beating to fast.

Typically they set the upper rate fairly low and many active folks have a problem, but it's very easy to adjust the upper rate. Mine is now 160 and I've not had any problems. 130 does seem low.

As far as your measuring 150, what are you using to monitor? Many times measuring devices have problems with the PM and you get erroneous results. If you are going over the upper limit then I'd say that your AV isn't totally blocked and the AV node is pacing your ventricles. The PM is just monitoring then.

Not sure why you're having pain, especially lasting for days. I'd get that checked out.

Hope this helps
Kathy

my experience also

by rnff2 - 2014-05-31 12:05:02

I have 2 degree heart block and have also experienced hitting my high set limit and having the pacemaker cut the rate in half. Boom, feels like you get punched in the chest. It is not a good feeling. In my case I almost passed out, had chest pain and severe nausea. My pacemaker nurse and MD agreed to increase my limit to 220, which is as high as my pacemaker will go, to prevent it from happening again.
For starters I would see about getting you upper limit increased. As for the chest pain, it could be muscular, but its hard to say, I would get it checked out. Have you told the rehab nurses??? If so I'm surprised they haven't contacted your doctor with this information.

Good luck.

Thanks

by highdesert - 2014-06-01 12:06:46

The ist time it happened it felt like i got punched in the middle of the chest... like i got hit by a hardball. Nitro did nothing and after a couple weeks the pain had gone. By then my cardiologist appointment came and he checked things out... said it wasn't my heart. It's happened a few times since but not as bad. The rehab nurses are checking into it to find out if a upper limit adjustment could help.... hopfully that's all it is.Thanks for the replies.

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