Anyone with a Medtronic Azure XT SR MRI Sure Scan out there that's a runner?

Been with a PM for almost a year and am struggling to get back into running. The doc was able to put only one lead in the lower chamber. 


12 Comments

returning to exercise

by Tracey_E - 2019-11-06 20:50:24

I have a different pacer, but most of us face the same issues. What's happening when you try to run? Do you have heart block?

edited: found your other post, sorry to hear you are still having problems. Have you done a stress test? Get on the treadmill and let them watch what happens when you exert.  For me, that was the most efficient way to get the settings adjusted. 

Probs running

by SNORTINGDONKEY - 2019-11-06 22:09:03

They did put me on a treadmill once but I am not sure they did it right. Plus they didn't really try modifying the settings after looking at the results.

The problem I am facing is that I am huffing and puffing after running a few yards..I am (was) an endurance athelete and could run 6-7 miles at a sub-11 min/mile pace...now I can barely run 3 miles at a 15 min/mile pace. At first I thought it was because my PM was driving the HR is too high but in hindsight I think it might be something to do with pulmonary function(?) 

it's possible

by Tracey_E - 2019-11-07 08:53:12

To start, I would want an echo to see if my heart function is the same as it was before.

I would want a stress test to see what my heart is doing when I start to huff and puff. At that point, am I pacing or beating on my own? Is my bp and O2 sat normal?

I would want a holter to see what my heart does over a 24 hour period, if it catches any anomalies. 

If none of that catches anything, then I'd ask about a pulmonologist, also go back to my GP for general blood work, etc, to see if anything else is going on that's not cardiac.

If my doctor isn't paying attention, I'd get a second opinion in a different, unaffiliated practice. Ideally, a board certified electrophysiologist who is active themselves and has other younger, active patients. I've had problems with couch potato doctors who don't see the importance of being active and write me off as asking too much. I've had well meaning, perfectly wonderful doctors who didn't have other patients like me so they were stumped. Some were more willing to dig deeper and do some research than others. 

The particular model of pacer you haven't isn't as important unless you have one with one of the newer, tricky rate responses, which you do not, Medtronic and Abbot/SJM are fairly straightforward.

treadmill

by Tracey_E - 2019-11-07 08:55:14

Ideally you want to be on the pacer computer with the rep present while on the treadmill. They can make changes and you can test it out immediately. I've done that twice when tweaking it wasn't getting us anywhere and I had to keep going back. 

There are a couple of PM vendors who have products that work really well for athletes

by crustyg - 2019-11-07 15:59:55

My PM was tuned for me with a set of exercises on a static bike to calibrate the Minute Ventilation feature that feeds into Rate Response.  It could as easily have been a treadmill - although a simple accelerometer usually works well for running.  We adjusted my settings 3 or 4 times because of the exercise (with the vendor's rep present) to get the parameters optimised for me.

Answers...

by SNORTINGDONKEY - 2019-11-07 18:28:13

Hi!

They did put me on a treadmill with the rep present but I don't think they tweaked the settings more than once...it was kind of weird. Asked me to try it out on the road.

I am paced 100% of the time.

I did think about going to a pulmonologist...my BP is normal and O2 sat was normal too. 

I do have an echo appt next week...I will bring these questions.

Running

by Dh13 - 2019-11-10 16:20:18

I have that pm.   It’s been about 8 weeks since the implant.   I started to run  but pm needed to be adjusted.   I have not tried out the new settings yet.   I’ll let you know how it turns out.   Update.  Had my settings update while on treadmill with Medtronic rep.  My running is better    I still feel that my upper limit could be boosted a little more.  Right not it tops out at 155. They also adjusted some sensitivity settings.  My usual run is 3.8 miles I'll be happy if I can get to 12 minutes per mile

Interested

by Pacer2019 - 2019-11-14 23:19:23

I'm only a few weeks in.  I was extertimg hard on 10/19 .... ended up in hospital that evening then inserted on 10/22....so it's fresh.

i was in great shape so I dont feel like I've lost too much in that short time - I'm known for stamina and mobility non the court.

i have been walking 2-3 miles a day and it feels ok.  The other day I was on an indoor track and decided to run or jog a couple of laps. That felt fine.... I track my heart rate with a Garmin and that night notice my heart was beating 175-180 when I was running !

i have never been in that heart range..... the amazing thing is I didn't feel it ...usually in that ranged you can even talk and are breathing mightily.

wonder if that was because of my pacer ?

running

by Dh13 - 2019-12-03 12:40:39

I am able to go about 2 miles without stopping.  Still struggling with hills.  But much better than before the PM.  I amy still need the settings to be tweaked again but I am working on my conditioning as I did not run for 8 months.  I am not a hard core runner.  Usually about 3 times a week.  usual path is 3.8 miles with moderate hills.

Same Problem

by Mike417 - 2019-12-05 13:26:25

Snorting Donkey

 

I have the same pacemaker (and only 1 lead), and had the identical issues.  When they got the rep in she told me that the pm will not allow me to get back to hiking/backpacking.  So after a year with the MM I am getting it swapped out for Boston Scientific - that one has 3 accelerometors and detects breathing rate to pace. (The EP doc finally agreed they could do that).

When they put me on the treadmill they said that everything was working fine - but it wasn't.  Just speed walking the pm was not accelerating my HR well enough.not to be out of breath.  If your SPO2 is good it is your heart not pumping enough to get the blood to your legs.

Give a call to MM patient services, and tell them the issue.  From the guidance I got from them I had the PM lab adjust my settings so I can go up hill and not have my HR decrease, or not decrease as much).  But, the pm will not kick-in if I  am carrying a pack, going up hill on a trail, or even on a slight incline.  Just the nature of the beast.

MM Azure

by Mike417 - 2019-12-05 16:40:10

I found my settings.  Note, every time you visit the EP lab get a print-out of your settings, and not just the ones they changed.

My diagnosis was SSSyndrome/Chronotropic Incompetence.  My resting HR was 42, and my max was 105, and I could not go upstairs in our house without stopping to rest.

These settings are a little aggressive, so you may have to insist.  You can always get them adjusted.  BTW, I am 67, but have a higher than usual HR because I always exercised.  And I need to be able to out run a bear if I ever needed to :-)

Lower HR= 60

Upper hr=160

ADL rate 105

Optimization Off

Activity Threshold  Low

Activity Acceleration  15 sec    (this is the latency time before the PM kicks in.  Factory setting is for 30 seconds, and low is for 15 seconds. If you pick up pace it will take 15s before your PM kicks in).

Activity Deceleration Exercise

ADL Setpoint  5

UR Setpoint 50   (This setting determines the slope or rate of increase in HR above the ADL rate.  This is a little aggressive, and you may feel more comfortable with a setting of 60 or 70.  The higher the number the slower/more work it will take to get your HR up to the maximal HR.)

Good luck,

Mike

Thanks!

by SNORTINGDONKEY - 2019-12-16 07:24:00

@Mike417

Thank you for the settings...I did see the tech and he finally agreed to turn the rate opt feature off. It does seem a little more predictable now.

There are a couple of settings you have that are interesting. For me, the ADL setpoint is 25...that's a huge difference from yours which is 5. My UR setpoint is even more interesting because we noticed that it is 201. HOWEVER, in the UR settings screen, the highest the tech can set it to is 180-something. He didn't know why my pacemaker setting shows 201 or how it was even possible. 

I did try to run a few times but unfortunately it's still not good. Although my HR does not seem to be high now, I am huffing and puffing within a few hundred yards. So the question I have now is this: is the issue with the pulmonary function and I have been barking up the wrong tree all along? I don't know how much HR has to do with breathing rate. I intend to google it. 

The doctor also told me that I'd be the perfect candidate for the leadless Medtronic Micra Marvel that's coming out next year. It's meant for people that have normal sinus rhythm and complete AV block. Basically, it detects the SA node signal and beats the lower chambers in synchrony. My issue it that they could only get in one lead and so there's asynchrony between upper and lower chambers of the heart. 

When do you intend to get the Boston Sci?

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I, too, am feeling tons better since my implant.