Pacemaker settings.

Hi everyone I am new to this club, but I am glad I found it. I am 51 years old and very active with running, martial arts and weight training. 20 years ago I had a right coronary arterial wall tear which caused me to have a heart attack. this left me with a left bundle branch block. Even with this I continued to compete in elite level sports, However recently I have developed a heart block that seems to occur when I get to 85-90% of my max HR so my cardiologist suggested a pacemaker. I am getting this in one week so I am wondering about the settings, as I have no problem unless I am exercising at a high level, but want to continue to do so. My resting HR is 56-58...any suggestions for me?

Thanks

Coach6

14 Comments

pacemaker settings limits

by coach6 - 2015-01-24 11:01:12

Thanks for the feed back. I am rather nervous about getting my PM, so its nice to hear from others who are in a similar situation. Any advice about weight training?

Coach6

oh good!

by Tracey_E - 2015-01-25 02:01:15

Sounds like they've got you covered! Every once in a while we see someone younger get the one that only goes to 150, then they get frustrated when they can't work out.

I would have said more about weights but I saw the clock and realized I was crazy late for church. Ask about placement. If they put it too close to the surface and/or too close to the collarbone, it can get in your way when you use weights. Make sure they know you want it a bit lower and deeper. Another option is putting it between the pectorals. This is a little more complicated and healing takes a little longer, but once you heal you'll barely know it's there.

weights

by Tracey_E - 2015-01-25 09:01:40

If you scroll down the list, weights come up several times a week. Talk to your surgeon in advance about placement.

heart block

by Tracey_E - 2015-01-25 09:01:57

Heart block means your atria is beating normally but the signal to beat isn't making it to the ventricles, so when your pulse is in the 50's, your atria is likely going much faster. The pm will watch to see when the atria beats. If the ventricles don't beat a fraction of a second after the atrial beat, the pm will kick in with ventricular pacing. However, the pm will only go up to a set amount, the upper limit. If your upper limit is 140, that means if your atria is doing 150, you will only be paced up to 140 in the ventricles and your heart will be out of sync.

Several thoughts since you are athletic. They now make mri-safe pm's, which are wonderful and generally recommended for someone young. At least one of them has a maximum upper limit of 150. You do not want this one! It will limit you when you exercise because it cannot pace you higher than 150.

Most pm's out there have an upper limit of 180. There is one Medtronic, I believe it's the Adapta, which has an upper limit of 220. I would find out how high your atria gets on exertion. They may have this information if you exercised while wearing a Holter or have had a stress test. If not, then I would ask for the stress test before deciding on a model. If you regularly hit 180-200, then you may want the Medtronic with the higher upper limit.

return to work after implantation

by coach6 - 2015-01-25 11:01:35

Hi everyone thanks for all the great advice. I am planning to return to work 4 days after my PM implantation, My work involves some arm movement but nothing over head and nothing too heavy so I was wondering about other peoples experiences returning to normal daily activity after implantation

thanks

coach6

settings

by coach6 - 2015-01-25 11:01:51

Thanks TraceyE I appreciate your feedback. The pacemaker I am getting is an Adapta Medtronic Dual Chamber device. It sounds like this is the one you recommended.

Coach6

Type of block

by coach6 - 2015-01-26 01:01:49

Hi Wilma, I believe my block is Mobitz 2. I get a 2:1 block when I exercise at a high level. I have passed out once because of it. Basically my heart rate suddenly drops without warning so it is a little un-nerving. I can still exercise at a rate of 70-80% of my age related max HR

I am having a tough time accepting that I need a PM. Not too sure if I should wait but it is also worrisome when I exercise. I am also concerned because I feel good otherwise.

Thanks for your input. Hopefully your will get worked out soon.

John

You probably need it

by WillieG - 2015-01-26 05:01:58

If you have passed out once, then you probably need a PM. With 2:1 block, it can be either type 1 or Type 2. On an EKG, with missing every other QRS wave, they can't tell. With Type 1, the P wave interval gets prolonged so if you skip every other beat, it is perplexing. I just didn't want you to go thru the whole procedure just to be able to exercise at a very high level, if you were doing OK at 85 to 90%. Having a PM involves many, many doctor appts in the beginning and at your age, maybe 6 or more replacement surgeries, if they last the average 7 years. Just to be better at sports, that would not be worth it in my opinion. But if you've passed out, you don't want that to happen again.

My HR cuts in half during a block, too, but I don't seem to feel faint and can continue to bike up the hills. It is an uncomfortable feeling at the beginning, but not all that bad. I have a Polar FT7 monitor and just try to keep my HR under 155. Not quite as much fun as going all out, but it works for me. Although I exercise very much, I am a little concerned that my HR is too high. It is 110 just walking thru the house. I hoe this new doc might give me some answers to that abnormality as well.

Let us know how it goes for you.

~Wilma

type of heart bloc

by coach6 - 2015-01-26 10:01:04

Thanks Wilma, I am going to double check with my cardiologist to make sure I have my bases covered with all the right settings etc. will keep you posted

John

Type of heart block

by WillieG - 2015-01-26 12:01:23

I was wondering if your block is 2nd degree Mobitz I or Mobitz II. Mobitz II doesn't usually advance and doesn't require a PM. If your blocks only occur at HRs that are close to your max, you might want to wait on the PM. It might be easier to just not exercise quite so hard. I have not been able to have mine set properly in the 8 months that I have had it. At first, they had me pacing 69% which can cause problems for your heart in the future. Then they changed settings and now I am not paced at all and the block feels the same. Plus I have tons of oversensing and mode switches. I have never felt faint nor had bradycardia. Also, my blocks that occurred frequently, are only happening about once a month. Had I been given a choice, I would not have gotten a PM at this time. I am going to a new EP doc in 3 weeks, and may gain new insight then.

Best wishes! Wilma

Mistake

by WillieG - 2015-01-26 12:01:55

I meant to write that Mobitz I doesn't advance and typed II by mistake. Sorry...

similar symptons

by PAMMY - 2015-01-27 02:01:15

Hi coach6 - if you look at my previous postings you will see I had similar symptoms as you which were diagnosed as AVblock with effort-2nd block 2:1 wenckebach which basically means my heart occasionally missed a beat when it got to about 140 bpm. As a keen runner I found it very frustrating to have to keep stopping until my heart rate went down and then I could continue. After 12 months deliberating on whether to have a pacemaker or not and with much help and advice from this forum I decided to go for it (I was told i didn't need one if I gave up running). I have not regretted the decision so far even though I haven't run as much as I used to do due to an ongoing calf problem! For info I have a Medtronic pacemaker with the upper limit being set to 180 bpm. I had a week off work and went back to gentle running about 3 weeks after. Good luck - let us know how you get on.

Pammy

Similar symptoms

by coach6 - 2015-01-27 03:01:46

Thanks Pammy, this forum has been extremely helpful. I am going to get my upper limit set high. I only seem to get the 2:1 block when my HR gets over 144, and it is not all the time. I can be in the middle of a run and then all of a sudden my HR will drop to 74. However my cardiologist says it could worsen with age. When it hits I feel dizzy and like I am going to faint. I have passed out once when running. If I wait for about 30 secs then my heart rate will pop back up and I can run again. I think I am in denial that I need a PM.. But feedback from someone like yourself makes me feel more positive

Coach 6

Just got my PM

by coach6 - 2015-01-31 02:01:51

Hi everyone, just to let you know i got my pacemaker yesterday and so far everything seems good other than the usual soreness from the surgery. I received one that is MRI compatible. I didn't know there was such a thing until yesterday.
my cardiologist said i could start stationary cycling next week and light running in 3 weeks, but have the usual restrictions of no overhead arm movement for 6 weeks and no lifting over 10 lbs

Thanks again for everyone's helpful suggestions for me. Will keep you posted

Coach 6

You know you're wired when...

You have a little piece of high-tech in your chest.

Member Quotes

Try to concentrate on how you’re able to be active again and feel normal, rather than on having a machine stuck in your body.