New to the world of Pacemakers

Hey everyone,

I just had a Pacemaker installed about 4 weeks ago.  About 2 weeks ago, I finally went for a short bike ride and I was having a difficult time to say the least!  Yesterday I went for my first check-in to see how it's performing etc. and find out that the upper limit was set at 130bpm.  Waaay too low.  After some discussion, the upper was set at 170bpm.  I don't know if it's still set too low.

My question is - has anyone had this and what they had it set at?  Did you find yourself going back to the hospital to have adjustments made?  How often?

I'm 50, in good physical shape and very active so physical activity is important to me.




Settings adjestment

by AgentX86 - 2019-08-08 23:13:20

Sure, I think we've all been back several times for adjustments.  We're all given sorta "normal" settings when the device is implanted.  Since we're all different, our heart problems are different, and our lifestyles are different, one size doesn't fit all.  PM techs try to guess the best setups but without our feedback, they're rather lost in the woods.  They also are a conservative bunch so don't like to make big changes.  They'd rather sneak up on the optimum settings.  I schedule a session right after time changes so they can reset my PM's clock (they don't understand DST) and I use that time to ask them to tune rates, and such.

Not with some pacemakers

by Gotrhythm - 2019-08-09 17:45:30

Unfortunately, many pacemakers's rate response depends upon vibration. If the vibration of movement doesn't reach the chest, as it might not, if only the legs are moving, and the feet are not impacting the ground, the pacemaker doesn't "know" to speed up. Changing the upper limit won't really help much.

Before you frustrate yourself chasing the perfect settings, you might want to find out exactly what kind of accellerometer your pacemaker uses.


You need a tune-up

by crustyg - 2019-08-10 13:05:54

Hi XCLC: I'm a keen cyclist now about nine weeks post implantation of my first PM.  My EP chose a BostonSci Accolade specifically because it has two different sensor mechanisms to feed into the heart-rate software algorithm: for cyclists the Minute Ventilation is the key one, as there's not normally a lot of upper body movement (same for skiing), which would drive the accelerometer sensor - the one that every modern PM has.

I've had two tune-up sessions on a static bike to adjust the response factors to something that suits me.  And yes, I was initially set for 50-130 with standard response factors, very frustrating.

It's *much* quicker to arrive at the settings that suit you by deliberately planning a tune-up session for your box instead of sidling up to the 'right' settings over a number of years and visits!  For runners a treadmill will do, for the dancers, just the corridor outside the consulting room may well do, for cyclists it has to be a static bike.

Pacemaker Vibration Sensor?

by xclc - 2019-08-10 13:39:48

Man, I have a lot to learn about this world!  So the pacemaker increases according to vibrations that the body does (like running) whereas cycling is less...jarring on the body so those sensors will not kick in?  Who knew?

I went for my first ride post adjustment (from 130bpm to 170) and halfway up a couple of steep hills my hr went from 170 to 115 during mid climb.  I remember asking the dr what happens if I hit the 170 threshold and he said that it would force my hr down (essentially). So I guess that's what happened.  So I'll head back on Monday to get it adjusted up.

The ride was much better than previous ones with it set at 130.  After 70km, I felt muuuch better than the small 20km rides set low.

I'll also find out what kind of PM I have and what the sensors are for adjusting. 

If I don't have the dual sensor that CrustyG has, I would guess it will take some trial and error.

Another question: I was surprised that I had a max HR set.  I wonder what will happen if I don't have a max set or if it's set too high?

Thanks everyone for your comments and insight.  It's very much appreciated.


PM Settings

by Chowchowma - 2019-08-10 15:35:43

I had my PM a week and it fired just before my first check up. Your physician or device technician will adjust based on your needs. Speak up and let them know what you need. You know your body.

Pacemaker settings

by Keithwhelpley - 2019-08-14 10:22:24

XCLC, welcome to this crazy world. This forum has been very helpful to me. I had my Pacemaker/ICD implanted 14 months ago and I too am an avid cyclist. I climb mountain passes in Colorado and NM -- or at least did. Still trying to get back

But the best advice I can offer is that never forget that the manufacturer has a tech department that will tell you about your specific device. I found that many of the hospital or dr office tecs dont have your device committed to memory and SADLY your cadiologist probably doesn't  either. Mine swore up and down that my device had a respiration sensor. I call the tec and proved right there that mine only has a motion sensor.

Calling the manufacturer with specific quesitons has been one of the best things I have ever done. While your at it, make sure you know how your device is wired. Doctors are supposed to submit to the manufacturer how it is wired becasue that is information needed for tracking problems if there are any. For instance, mine is wired for "apical pacing." That means one of the leads is in the apex of the right ventricle or the bottom where it comes to a poing.

The manufacturer teck support has been very important for me.



You know you're wired when...

You always run anti-virus software.

Member Quotes

I've seen many posts about people being concerned about exercise after having a device so thought I would let you know that yesterday I raced my first marathon since having my pacemaker fitted in fall 2004.