I have never heard this....have you

More rubbish pseudo-medical advice from the WWW

by crustyg - 2019-11-27 03:17:58

It's nonsense, and barely worth re-posting here, except, perhaps, as a discussion point to highlight how much rubbish you can find on the WWW.

Cute cats are better!

Crusty -

by ROBO Pop - 2019-11-27 03:46:17

Hah, though mockest the internet...I'll have you know I made the mistake of exceeding my rate cutoff and Mastercharge cancelled my credit cards.

There is so much BS nonsense on the net about Pacers and ICDs it's discouraging yet people keep perpetuating even the most unbelievable tales such as the one that you can never get an ICD removed.

Crusty / Robo

by IAN MC - 2019-11-27 05:22:36

You are both too cynical.  I have just heard from a man in Nigeria who wants to give me 50,000 dollars.   I'm taking the next flight out today.

I may go via Moscow because some young Russian models are desperate to meet me.

Have faith , and don't be too envious ......   the internet can be life-changing !

Ian

Bonjour

by AgentX86 - 2019-11-27 08:41:05

This tidbit of information does have a small kernel of truth to it. Depending on your pacemaker and mode, exceeding the cutoff heart rate can put your heart into dyssynchrony, which won't feel particularly good. However it's self limiting. Your heart will lose something like 20% efficiency and your workout will come to an end as you're gasping for air. On the other hand, i live with AV dyssynchrony 100% of the time. If the heart is anywhere near healthy the heart has a lot more reserve capacity.

The tidbit of truth doesn't support the conclusion, so it rates two pinocchios.

It's good to laugh

by Gemita - 2019-11-27 08:49:27

Oh you guys are so funny !  Yes the internet can be life changing but I wouldnt expect too much in Moscow Ian MC and you will be closely followed!!

Pacer2019 try out what you have read and see if it works for you, then you can come back and report your findings.

Www

by Pacer2019 - 2019-11-27 10:53:29

But wait ...... isn't this wwww pacemaker club ?l  

ignore the web is advised ....on the web ! This is getting soooooo confusing . 😂 

i felt it was nonsense so thought I would run it by the brain trust 

here is where what I posted popped up ..... looks like if you read it carefully it is a site designed to sell medical jewelry 

https://www.hopepaige.com/information/safely-exercise-with-a-pacemaker

advice on the web

by Tracey_E - 2019-11-27 11:15:14

None of us are doctors, don't take medical advice from us. We are patients talking about our experiences with other patients. 

There is good stuff, bad stuff, and kernels of good stuff  in with some of the bad stuff on the internet. Always consider the source and take most of it with a grain of salt. 

Ideally you want your upper limit to be at least 10 above where you get when you work out, that is true. It is only relevant if you have av block and your upper limit is below where you typically get when you work out. Saying to wear a monitor always is overkill. If you bump your upper limit, the thing to do is not live in a monitor, it's go ask your doctor to turn up your upper limit. 

I'm still waiting for my $5000 check from the nice man in Nigeria. 

Well said

by Pacer2019 - 2019-11-27 12:17:36

One has to always consider the source and weigh it . 
I still dont have my head wrapped around the upper limit . I have a single chamber pacemaker for heart block ...

I have been told the pacer is a gas pedal not a brake - so while it stimulates my heart to beat it doesnt limit it from beating beyond the top limit ? 

the other day I was exerting and saw I maxed around 120 which is lower than normal with same exertion... I called the clinic and discussed - the nurse said "you definitely need to be adjusted " ?

I think I'm set at 60-150 and am scheduled to be looked at on 12/11 to customize it with the thought being I'm active .

how does the pacer limit my top end or does it ?

Depends

by AgentX86 - 2019-11-27 13:59:44

It won't limit your sinus node or any sort of SVT. If you have a complete heart block, it can limit the rate your ventricles beat (really, the heartrate) by ignoring the atria completely. You won't like that. If you have sinus node dysfunction, the PM is in control so, ignoring AF, AFL, SVT, and a whole alphabet of other problems,  the PM  is in complete control. That's a lot of ifs (and I'm sure that I've left  a few out).

Added:

Even here, the PM can only make the heart beat faster. You can't go slower than zero.

Well, if we're going to have a serious discussion about this...

by crustyg - 2019-11-28 05:07:39

..then it's still nonsense.

It's true that for a significant proportion of the forum contributors who have a tendency to atrial tachy-arrhythmias, exceeding the maximum programmed PM rate will be bad as it will almost invariably mean that an arrhythmia has been provoked.  The natural history of these arrhythmias is that the intermittent ones tend, over time, to become established.  Episodes of AFib or AFlut can become established.  Working the heart hard probably does increase the rate at which these episodes are triggered, but there's no evidence that working the heart to 10% less than the programmed maximum is protective.  Suspicion, yes, but no evidence.  There's a counter argument that exertional effort with too *low* a max programmed rate might actually *increase* the number of tachy episodes, and that pacing the right atrium to a sensible, high, maximum rate might actually prevent some atrial arrhythmia episodes.

The basic model of atrial tachy-arrhythmias in athletes is that the naturally very low heart rate in the athletic heart allows small areas of atrial heart muscle to fire off on their own, which can lead to the arrhythmia.  Pacing the heart to a higher rate them swamps these clusters of cells - no arrhythmia.

The original post is very similar in tone to the guff on gym equipment ' Don't use this without consulting your Physician'.  It's in the 'What our lawyers make us say' category, but there's no *evidence* behind it - they just want to avoid being sued.

And without wishing to start a flame war, for *some* special cases, a PM *CAN* reduce ventricular rates by overpacing the atria and causing a temporary type II AV block (the Wenckebach phenomenon), so that only 1 in 2 atrial impulses reach the ventricles, so the vent rate goes down.  But it's a special case: in general PaceMakers drive *up* the heart rate, but not always.

If your heart muscle (and coronary arteries blood supply) can take it, then there's massive evidence that hard exertional effort is good for you, and you may as well enjoy being alive, assisted by the implanted tech.  But a *lot* of us on this forum have *some* sort of heart muscle problem, even if it's not been given a specific name, so getting our EP docs to agree what is a sensible max HR is a negotiation, and no-one (not them, not us) can honestly say that they *know* (based on *evidence*) what it should be, so sticking to 10% less than some figure we've plucked out of the air is nonsense.

Pacing for patients with significant, persistent AV block is a whole different discussion, complicated by the growing evidence that long-term, right ventricular apical pacing is bad for some patients, hence the massive growth in CRT and revived interest in His-bundle pacing.

We may as well live life to the full - we're a long time dead.

Well, if we're going to have a serious discussion about this...

by AgentX86 - 2019-11-29 20:44:57

"Protective" wasn't my point.  I said that running into the PM rate wall will likely feel just like, well, running to a wall.  It's not likely to be dangerous.  Simiarly, it's not a question of having a low rate to protect the patient, with some exceptions, obviously (like me - minimum 80@day, 50@night, and 130 maximum).  If the patient pushes the rate, and there is no reason that he shouldn't, sure, raise the maximum. It is there for protection, though. Your EP can make that determination.

We're dead a long time, no question.  Some of us are trying to minimize that time.

chicken and egg

by dwelch - 2019-12-01 01:06:58

If we have a problem with heart montitors working right with pacemakers then how are we supplsed to rely on a heart monitor to keep our pacer working right?

Now if you were to carry a full blown EKG around then you can certainly tune your exercise.  

Exercising at maxHR isn't a problem

by crustyg - 2019-12-01 13:51:00

I can attest that exercising at MaxHR does *not* feel like running into a wall.  If MaxHR has been chosen correctly, then other factors will become limiting before or around the level where maxHR is achieved.

And no-one in this thread is suggesting that we have a problem with heart monitors working with pacemakers - I use a chest strap for running and one for cycling (cycling one is newer, ANT+) for a number of reasons.  What I dismiss is the idea that I should limit my exercise to a level where I keep my HR below 90% of maxHR - because it's nonsense.  I do *not* wear a chest strap for exercise in order to limit my exercise, and I don't think anyone needs to.  And, dwelch, I *do* carry a portable ECG monitor.  I don't suggest that other folk should go out and buy this kit for themselves in order to limit their exercise, which was the thrust of the marketing blurb that launched this thread.

Vague statement .

by MrTech - 2019-12-02 18:53:32

Who stated ‘Always wear a HR monitor? 

Was it a company that makes HR monitors?

’Pacemakers and ICD’s typically have a cut off’.... dear me. Don’t know where to start with that. 

It’s too vague and completely depends on what pacing indication one has.

Might be useful for some, and not others. 

If someone has an ICD they may not even have a pacing indication but hitting the rate where therapies begin is completely different issue than with a pacemaker. 

If you have a pacemaker and have AV block and your tracking rate is set below what your own native atrial rate can achieve when you exercise, then yes you could find your HR (ventricular response) actually drops a bit or drops more if you push it even more. You probably would feel this. 

This has been mentioned already and is correct but there are sooo many factors and things to consider that one should take advice of their own professionals/docs/ clinics than listen to that in isolation.