ADL setting

Hi,
I am delighted to find this site. It's taken quite a while to find workable settings for my medtronics pacemaker, inserted in 2014. I love to hike and as I slow my pace to climb hills, and simultaneously need more heart rate, the HR of course drops because activity sensors sense less kinetic activity. It's been a problem and has cramped my style. It's complicated by orthostatic hypotension, which can be triggered just by stopping and standing still or initiating movement. So I manage and do a few workarounds for both of these.

My electrophysiologist recently raised my ADL setting to 96. But it seems to take more than a bit of activity for me to reach a HR of 96. Just puttering around the house won't do it. And the threshold setting is at the lowest, so it shouldn't take much for the pacer to sense "activities of daily life." Anyone have experience or expertise with this?

Thanks,
Joe

2 Comments

Rate Response

by BillH - 2016-02-15 03:02:37

ADL is the heart rate the PM when it thinks that body is working at "typical daily activities".

There is a number of different adjustments that effect they rate response.

I don't know the specific but they include things like how much activity that its needs to sense before starting increasing the heart rate, how fast it increases it, and how it responds for activities higher then ADL.

Probably need to work with the PM tech to adjust it using trial and error. Since probably can't get them to come out to where you do your climbing you will have to simulate it.

Try using stairs. Some moderate rate stair walking, some fast stair walking, and try going up 2 steps at a time slowly to simulate you climbing.

Also some PM have a way to record what the rate response senses. And it can be played back and changes in the settings can be simulated. Ask about this.

Also some PM have special features to help with orthostatic hypotension. Ask if your unit has that and if it is optimized for you.

What are your set points?

by parmeterr - 2016-02-15 04:02:42

This is the ADL set point and the UR (Upper rate) set point.

My ADL is 110 with a upper rate of 145. My low rate is 60. My ADL set point is 20 and the UR is 70. They are fixed and can not move.

Most people have floating set points which move depending on their activity. Mine are fixed. They do not move no matter how much I exercise. With floating set points, the more you exercise, the set points increase until it may become impossible to reach the upper rate.

Thank you.

Richard

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