Conventional dual chamber pacemaker V closed loop stimulation

Hello everybody,  I have had a conventional dual chamber Boston pacemaker for 14 years and am due a change, I have been listed for a Biotronik closed loop stimulation pacemaker, if anybody would like to share their experiences of CLS it would be appreciated, I have read some things online but there is no doubt lots I still don't know, I'm just used to a low setting (of 50) for bradycardia but it sounds like there is an upper limit too? I exercise regularly, weights and cardio, at least four times a week, could this upper limit and whatever the CLS does at that point affect me? Don't understand the point of that part of it. The research says that the CLS reduces Vasovagal syncope, in 14 years I have only ever had 1 actual fainting episode during which my pacemaker didn't work, multiple occurrences were it did and I knew it was working at the time, what are other people's experiences in terms of fainting regardless of your pacemaker, and if the CLS has made a difference to that over the conventional dual chamber 



CLS and upper limit

by AgentX86 - 2020-01-12 20:45:35

AFAIK, CLS taps into the vagal nervous system help set the heart rate with feedback (the closed loop part) from the autonomic nervous system.  The pacemaker may or may not use an accelerometer for rate control, as well.  The idea is to more closely match the heart rate to the body's needs than can be done with an open loop system (accelerometer or minute ventilation).  It's my understanding that unlike the open-loop systems, the CLS system can increase heart rate due to stress (fight or flight). All of these systems are rate adaptive means for those with chronotropic incompetence.

In either case, the pacemaker has to protect the heart against the pacemaker driving the heart into tachycardia. The upper limit is there to keep the heart from going faster than your EP thinks is safe for you.  If you hit that limit with exercise, it'll show in your interrogation report and you can negotiate a higher limit with your EP.  It is there as a protection measure, though, and you may be in for a fight. 

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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.