Anyone have exercised induced heart block?

I experienced some "strong feeling" heart beats while biking up a steep hill in mid May. Heart block occurred during a stress test with 2:1 conduction. I wore and event monitor , but the reading were squiggly and nothing could be determined from that study. Next I had an EP study where my atrium was paced at "physiological rates", and they determined I had Mobitz II HB and put in a dual chamber PM during the study so I didn't have time to prepare. Now, 5 months later, I don't have this block except for biking up even steeper hills once a month. I wear a HR monitor and this happens around 160 bpm. During a block, I still feel fine. My HR drops to half (lowest it has ever been is 72) and then goes back to what is was. My PM is set to only pace after I skip a few beats so I can feel when this occurs. I am able to continue biking up to the top and don't feel that out of breath and have never fainted or had bradycardia. I was wondering if it would be reasonable to ask my EP if the PM could be turned off for the Winter when I am not biking. I feel it was put in too soon and was not needed yet. The doc says HB is unpredictable, but I can't believe that I would not have some symptom before I would succumb to "sudden death" from heart block when mine only occurs during strenuous exercise and I could prevent it by jumping off the bike before My HR would get that high. I know most heart block is idiopathic,but have read of it being caused by hypothyroidism, Lyme's Disease, narcotics, etc. The only difference I can think of in my case is that I stopped taking a multivitamin and started Claritin, for allergies. I also lost 10 lbs. and am in better shape. I have ridden 1500 mi on my bike this summer even with the 2 week time out I had after this surgery. I was just wondering if anyone has had exercise induced heart block that has gone away and if they would turn off a pacemaker for this reason. Everyone here seems to have bradycardia and fainting from low heart rates. My other concern is that I have tachycardia whenever I am walking. It is usually 110 walking from the den to the kitchen. Strange....I don't think it is caused from the PM as they said my SA node is fine and it regulates the heartbeat.

Thanks for any advice. The PM Club has been a very helpful, informative and supportive site and I am so happy that I found it.

Wilma

3 Comments

Switching pacemaker off

by golden_snitch - 2014-11-03 02:11:45

Hi Wilma!

If the pacemaker is set to pace only when you skip a few beats, and you don't bike during the winter, which is the only thing that induces your block, it won't pace. So, it makes no sense to switch it off, it won't pace anyways. It will only watch your rhythm. And by keeping it switched on, you are on the safe side in case the block deteriorates.

Best wishes

Inga

Turning pacemaker off

by WillieG - 2014-11-04 08:11:44

Thanks Paul and Inga for your information. I was thinking that I would prolong battery life by turning off PM. Although it would not be pacing, does it not use battery for sensing? And isn't it always sensing? Maybe that does not use as much energy as pacing. I did finally talk with the EP doc. He has only had a "handful" of exercise induced HB patients so he really does not have enough evidence of it advancing to warrant a PM without more symptoms, such as my case. I can't find much in the litature either so it must be rather rare. But I guess time will tell. I will let you know if anything changes!

Wilma

it's about peace of mind

by xa4c - 2015-01-11 12:01:22

Hi Wilma,
after implant in nov last year experienced the same at the first biking test and as with you, the cardiologist said my PM (Boston Scientific Vitalio EL DR MRI J277) was set to pace only of more than 1 consecutive HB occurred.
Result: HR would drop to about 70 upon any physical exercise. For peace of mind they set it now to pace every time with a max at 170. The cardiologist said this is a bit of trial and error for every patient.
Today I went for my first time to the fitness again and the 170 max is a bit of a problem as in practice it seems the PM stops pacing above 160 HR and sometimes I spike to that HR.

I think the PM is, at least for me, a matter of piece of mind. As it paces every time now I am a lot more reassured and feel I can do physically more. as others have said here before: if it doesn't pace, it doesn't harm you. not sure whether this makes a significant difference in battery life though.

take care,
Xavier

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