upper limit

Has anyone found the upper limit on their pm impairs there ability to exercise? When I run it seems that I have a real hard time catching my breath. If I slow then I can catch my breath.
I have asked the tech to turn off the upper limit on the pm so that my bpm can go as high as it needs to. But she seems reluctant and has it set at 170. It hink my heart wants to go higher.
Is it possible to turn it off? What is the upper limit that others have? My diagnosis is sss resulting in bradychardia.
Take care friends
Rusty

6 Comments

PM Limits

by SMITTY - 2007-08-12 05:08:53

Hi Rusty,
If I understand pacemaker settings, they will not limit your heart rate. Now I want to point out that I said pacemakers and not ICD because slowing down a heart rate (V-Fib) is their job. The upper and lower settings do have an effect on whether the pacemaker helps keep your heart rhythm steady or not.

For example, let’s stay your PM range is 60 to 140. What this says is if your heart rate drops below 60 the PM will provide an impulse as often as necessary to keep your heart rate at a minimum of 60. Even that does not guarantee that the PM will be helping every beat. Since it checks to see if the heart’s natural PM is sending out a signal before it sends out one it may not be necessary for the manmade PM to send an impulse for every heart beat.

Now let’s take a PM with a 60 to 140 range and your heart normally never goes below 70. Even at this rate the PM is monitoring your hearts natural PM and sends out an impulse if the natural PM does not send out an impulse. The manmade PM will continue this operation until your heart rate exceeds 140 BPM. Then it takes itself off line until your heart rate drops below 140 BPM. No matter if you are having PVC, skip beats or whatever, so long as your heart rate is above the 140 setting (in this case) your PM is not going to help.

Of course there is always something to complicate things and in this case it is those PM that have the rate response activated. In this case the PM will be sending out impulses to make the heart rate increase when it detects activity that it determines requires a higher heart rate than the heart’s pacemaker is providing. However, even with the rate response feature activated the manmade PM will take it self off line as mentioned earlier when the heart rate exceeds the upper setting.

As for turning off the upper limit setting, yes, I think that can be turned off, but I don't think the lower setting can be below 30, or at least that is what they told me when I asked to have mine turned off completely.

Now, we I shall wait and see if someone has better information for you than I have offered. All I am doing is passing on what I have been told about my PM as for about five months I have been having holy hell with my heart rate. My settings are 60 to 100 and my heart rate is in the low 40 to 50 range more often than it is 60. My upper rate never exceeds 95 and yes I have to be very careful about my activity or I may find myself sitting when I don't want to sit.

Good luck

Smitty

Changing upper limit

by johng - 2007-08-12 06:08:24

Rusty,
the Tech. is being careful, that's a good sign.

Your underlying Heart condition may have dictated the original decision on the settings.
I suggest you check with your Cardiologist and get his/her approval.
Also your medications will have an influence on this decision.
It sounds like you are ready to stretch the boundarys
Good luck,
Johng

Upper Limit

by hotform - 2007-08-12 11:08:37

Rusty,
They set the upper limit on mine at what is truly my upper limit. Which is 220 minus your age. I had trouble in the beginning with that and the whole rate response system. A little bit of tinkering with the system over a couple of sessions and I was running without any problems. It helped that my doctor was also a runner and understood and that he sat in for my tuning sessions to get me what I needed. Be patient, but also persistent and you should get it where you feel comfortable. Rick

Can they slow it down

by boatman50 - 2007-08-13 09:08:19

Hi Rusty, I don't think a pm can slow your heart down. When I first got mine I was told the upper and lower rates were set at 140 and 55. I was upset about this because of rowing and the tredmill and lifting where I could get my heart over that no problem. The nurses at the pm clinic said absolutely the pm could slow it down as did the cardiologist. I could not believe this and when I went to the EP I asked. he explained it like this:
the lower rate will not allow the heart to go below whatever that setting is. Simple enough. If your heart still has its own ability to increase its rate then it will do so no matter what the upper limit is, in fact with my pm upper set to 140 I got to 165 on the tredmill at the pm clinic. If your heart can not beat faster as you need it (say when you run) then a pm that has Rate Response will raise the heart rate up to and not above what the upper setting is, in my case it was 140 but my hearts own electrical system overruled that and went to 165 on its own. As Smitty said that is for a pm, not an ICD. Hope this helps, good luck.
Mark

Hi Rusty

by rosep - 2007-08-29 04:08:52

I've had my pm reset three times since it was fitted in March, The last time I had a new technician who as great and really took my lifestyle and exercise into consideration. I had tried graduating from an upper setting of 120 to140 but still got out of breath within 2 minutes of starting any exercise - he put it up to 185 and I've been fine ever since. He explained all pm's come with basic factory settings that need to be tweaked to suit the person. As my natural heart rate was going above 140, my pm could not "keep up" with it so cut out until my heart had slowed to a pace where it could rekick in - this simple way of explaining it seemed to make sense to me, as I'm not one for dwelling on the technical side of things!!
hope you get yours sorted to suit you - take care Rosep

ready to push the limits

by gevans - 2007-10-12 11:10:21

Hi Gang, I just found this site and immediately registered. I'm only 2 weeks post-op but the swelling is gone and I've resumed biking (and was walking from day one). I was a competitive distance runner for 45 years so I'm chomping at the bit to race again. I have a PM currently set at 60-105 but my cardiologist is aware of my excessive addiction to aerobic activity and said it will just stop feed-back when I exceed the device's programmed upper limit (which I'm sure I've already achieved several times).

I was diagnosed with Sinus Bradycardia and the Holter revealed afib at night when my HR dipped below 30bpm. For the past few years I noticed that my legs would feel heavier when I tried picking up the pace, or I was more fatigued when I upped the distance, so I just assumed it was part of the aging process (now over 60). Now I'm sleeping so much better and I seem to have more energy and vigor. I hope its not just a placebo effect and that I will be able to "regain" my speed and stamina of a decade before.

Are there any suggestions aside from the "don't rush it" that I get from my doctors (and family members)? I know I won't be able to lift or swim for a while, but the device seems "seated" in my chest much better than at first and I'm between race walking and almost jogging (don't tell my cardiologist) and am sure he will let me beging running (easily, I know) on my appointment next week. But I sure would like to hear from some actual "over-achievers" out there about pitfalls in their training. I don't especially want to use "trial and error" when the latter may have serious repercussions.

Thanks for your time,
Gary in Ohio

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