Closed Loop System

I am 57 and just had a Biotronik Edora 8 DR-T implanted on Oct 11th, 2019. I am very active and was enjoying running, biking and swimming when all of this unfolded. It all started about a year ago when on a run I felt like I was going to pass out. My legs felt like they were encased in concrete and I had a feeling of impending doom. At first, it only happened when I ran, but then started happening when I swam. It was intermittent for a few months but then in September, it began to happen more and more often until I went to my doctor. One thing led to another and here I am with a pacemaker and still having trouble.

I took the first week off from surgery to recover and then on the second week I began to run again. I went from running 2 miles and feeling like junk to 10 miles a week and feeling pretty good. On week 4 I went out for a run and felt like junk again. It felt just like it did before the PC and I began to wonder if the leads came out. I went to my doctor and he assured me the PM was working fine. However, he adjusted the unit to give a better range, but this did not help, so I went back again and he switched it to the "Closed Loop System". That was 2 days ago and I have not yet tried running because my unit randomly goes up to 140 bpm (as measured on a pulse oximeter). It has been all over the place for the past two days, getting down as low as 49, up to 140 and usually around 88-110. He prescribed Metoprolol Succ ER 25mg as a beta-blocker to presumably lower my pulse, but it does not seem to make a difference.

Does anyone know if this is normal to prescribe a Beta-blocker for this reason? Does anyone know how long it takes for it to be effective? I am having a hard time not being able to work out the way I use to. Does anyone else have a similar experience?








I have

by Pacer2019 - 2019-11-25 01:03:14

not experienced what you describe but I have taken that beta blocker and that dose . 

I think 25 mg is a low dose but it generally does it’s job to slow the heart rate . 

Ive been on it 12 years after a heart bypass. 

Last month when my heart rate was 40 they took me off of it a few days thinking that had become the culprit - heart rate was unchanged ... I have a PM and I’m back on it 

As aside - it is a banned substance by the ncaa for one sport ......shooting .  Shooters want a slow steady heart rate - NCAA says no metroporel allowed ! 

If im you I would report your situation to your doctor 👨‍⚕️.... maybe I need a lather dose yo slow you down ? 




by Kettlebell man - 2019-11-25 03:40:20

The symptoms you described were very similar to mine. Prior to this happening I was active in a lot of things. Running, lifting, boxing training and swimming. It's been 8 weeks since PM was put in, and I just now started on a walk/ run program. It seems a lot of folks are jumping back into things a little too quickly. I live in Germany and they really push the 8-12 week waiting period here. I know it's hard but in the long run I think it's best. I'm sure some will disagree, but glad I waited for things to heal properly. 

beta blockers

by Gemita - 2019-11-25 05:58:02

Hello, I am assuming you have heart rhythm disturbances and that these are not yet under control ??  A beta blocker is usually prescribed to calm everything down and to reduce our heart rate when it goes too high during arrhythmias.  

I believe a beta blocker can work very fast within an hour or so, since some beta blockers are used as a pill in the pocket for arrhythmias.  Metoprolol 25 mg is a low dose so it may not be strong enough for you but anything higher might make you feel lethargic and drop your blood pressure too much.  I see your type of Metoprolol is extended release which will give you a more even release of the med over a 24 hour period.  I would ask your doctors if Metoprolol is the most suitable beta blocker for you, or whether you would be more suited to something else??  A calcium channel blocker like Diltiazem can also be used and is preferred by many I have been told.

I have read that athletes are very prone to getting AF for example, since although exercise is very good for us, when we push ourselves to our limits it can cause atrial dilation which can lead to AF.  Increase in adrenaline also occurs with exercise, another trigger for AF and that is why beta blockers and other rate control meds may work to calm everything down for some of us.  But of course our pacemakers cant do anything about a decrease in blood pressure that will occur with beta blockade which is what I find so difficult.  

You are still early days after your implant and I wouldn't advise pushing too early.  It will take time to get your pacing under control.  Any medication too is bound to affect you and of course if your arrhythmia is not well controlled, this will also cause many difficult symptoms.  Good luck




Closed Loop System

by IAN MC - 2019-11-25 09:40:01

Try doing a search . Enter CLS in the search facility ( the small magnifying glass next to " LOGIN / LOGOUT " ) and you will find really useful posts on the CLS system of rate response.

Once you have had adjustments done to optimise the CLS settings, it is apparently an excellent system to help runners and cycllsts raise their heart-rates physiologically .

As you know, the system is unique to Biotronik and apparently also  responds to stress and raises heart-rate accordingly.



by sk288702 - 2019-11-30 09:34:16

Hello so CLS is proprietary software for Biotronik Pacemakers it's designed to help mimic emotional responses and raise the heart rate accordingly.  For example it you were in a stressful situation and your heart worked normally your heart rate would rise.  But because your heart may or not function properly the pacemaker tries to mimic this by sensing emotion.  For some people it's great but I had it turned on and it was a nightmare the first weekend.  It would go off for no reason like when I stood up or brushing my teeth or for whatever.  They can choose how aggressive the setting is and mine was at medium.  They turned off that and the accelerometer (motion detection) and since then it's been much more comfortable.  In fact if they hadn't I probably would have ripped the PM out.  Haha.  I am not sure why they wanted it on or why yours was not on by default but for me it definitely helped turning it off.  

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