motion response

I'm sure it has a technical name but the motion response on my now 8 day implant was turned down at first check because it would soar to 150+ whilst I was walking the dog.
By the time I walked out of the hospital I knew things had considerably improved.
I asked if this could be switched off altogether as my issues are slow heartbeat when at rest (down to 20bpm) and pauses mild compared to many max 3.7 secs suspected 1st degree block. One tech appeared in favour but his boss wanted to reduce and come back in 5 weeks.

As an athlete it is not uncommon for my HB to hit 150-165 and , so far as we know, my heart always responds appropriately to my becoming active. HIstoric Garmin data shows initial rapid increase with a gradual upward slope as the training session continues. unless I am doing a gentle work out when it stays around 130-5.

What should I look out for that may indicate that, even at the lower level this motion response is not helping/counter productive and is there any chance that the heart will begin to depend on the PM for motion response and give up that function meaning it cannot be turned off in the future.

Many Thanks and thanks again to those who responded to my initial posting this site has been such a help already and I found it less than a week ago
Nick

5 Comments

Hi Nick

by IAN MC - 2014-11-21 02:11:05

The technical term is " Rate Response" and you can either have it switched on or off.

You only need it on if you are "chronotropically incompetent " i.e. if your heart rate doesn't increase as it should when you exercise.

This is usually caused by a lazy sinus node. But, because there are various degrees of sinus node laziness there are, in turn, various sensitivity settings for the Rate Response function.

Like you I am a runner and for the first 2 years post PM my sinus node seemed to be fine so I had RR turned off; unfortunately my sinus node seemed to deteriorate causing my HR to level off at 90 bpm so I then had RR switched on and had various tweaks while I ran on treadmills ( all done on the NHS ). I am now happy with the RR settings . In essence, it now puts in extra beats when I hit 90.

You ask a good question as to whether your heart will become reliant on the RR function but I think if you had it on unnecessarily you would feel so bad that you would be dashing off to the PM clinic for an adjustment

If you are still hitting 150-165 , chances are you don't need RR on but the best way to find out is to have a session on a treadmill while you are wired up. Do you feel while you are running that you need to go above 165 ?

Best of luck

Ian

I had RR turned off

by rolson - 2014-11-21 04:11:05

Tech turned on my RR in hospital day after my implant, not really explaining why. I felt horrible and could not function, even a little bit. Couldn't walk as my heart would soar and tons added beats, terrible, for a week and a half. As soon as it was turned off I felt much better, like instantly. I think you would know if you needed it and if you have it on and don't need it I know you would know.

THanks both

by Nick.k(uk) - 2014-11-21 06:11:22

Thanks Folks
Rolson I had less aggressive symptoms to those you describe and took to wearing my Garmin HB monitor hence I knew what was happening.

Since having it turned down I do feel better than I did but still not as good as prior to the implant.

Ian I have not started back running yet I agreed with my partner that I would wait two weeks after one hospital said I shouldn't exercise at all beyond walking for 6 weeks.THis was generic advice and not tailored for me.
(The one where the op was done said two weeks)

Two days before the implant I was training hard but not completely flat out and during the reps my HB was regularly hitting 160-165 which suggests it's not too lazy.

Did I feel I needed to go higher? certainly I did not feel I could hold that effort any longer …(hill reps) but was that my Heart or fitness level? Obviously at the time I never really gave it a thought beyond holding back a little because I knew I had an implant in 36 hrs and didn't really understand what was wrong.

My settings go to 185, after some earnest discussion (protestations on my part). so I guess after a period getting used to running again a max heart rate trial is in order (Yuk). Presumably though, without the MR switched off I will not know if it is man or machine increasing it.

Thanks again Folks talk soon.
Nick

Mine is off too

by Many Blessings - 2014-11-22 09:11:47

Hi Nick,

My rate response is off. Originally, it was on but I didn't feel well. They tried adjusting it both up and down just to experiment, and I still didn't feel well. When they shut it off completely, I felt great, so that is where it stays.

Talk to your cardio doc and PM tech to see if they will try turning it off to see how you do. When mine was changed either way, I knew if it was better or worse as soon as I tried normal daily activities (walking across the parking lot, climbing stairs, etc.)

If I were you, I'd have them turn it off, then go out and try walking fast around the parking lot or block, and come back and let them know how you did. If you did better, keep it off. If you felt worse, they can change it back and try experimenting with changing other settings. My guess is it's your RR and it will be an easy fix. Let's hope so!

Good luck!

THanks MB

by Nick.k(uk) - 2014-11-23 11:11:17

That is a good idea and if I cannot organise a treadmill test as Ian above I will suggest it.
It's much better since they turned it down but I still feel uncomfortable after some low level exertion and actually not great in between unless I'm simply sitting quietly for a while.

If this is as good as it gets I'm not going to be awfully happy but the real test will be when I start running again next week.

With it not having been long since implant it is difficult to be sure whether how I feel now is simply anxiety related, but I really don't think it is.

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Today I explained everything to my doctor, he set my lower rate back to 80 and I felt an immediate improvement.