Pacemaker settings for Swimming after 6 weeks

  I also have questions about my Pacemaker settings prior to swimming again. I was told in my first follow-up appointment that my settings were 130 and 60 BPM. During the last 6 weeks I have been walking at a fast pace for 5 to 6 miles at a time and I do not feel winded at all. I quit ether because I run out of time, get bored, or my legs get sore. All I did for exercise  6 years prior to the Pacemaker implant was swim.

  Now that I am ready to start swimming again, probably later this week, I am wondering if a high setting of 130 BPM is appropriate for me. I understand that a Pacemaker only increases my heartbeat, so what will happen if I reach 130 BPM as I am swimming and the Pacemaker stops pacing?

  Additionally, I feel like I should have a lot of questions regarding the various settings that my Pacemaker has related to endurance exercising, does anyone have any insight into what I should ask, or request of my physicians? 


2 Comments

You're on default settings for a new PM for SSS+brady+CI

by crustyg - 2020-01-13 09:16:22

Hi: you're almost certainly on the default settings for your PM.  At your first post-implant check you can ask for the max heart rate to be adjusted upwards - depending on your heart health 160bpm might be appropriate.

And depending on your natural rate when not being paced, and what symptoms you had before the PM you might want the minimum rate lowered, perhaps to 50 or 55bpm.  Many athletic folk who are used to life with bradycardia find sleeping a little difficult if their HR suddenly goes from the 30s to 60.

What does it feel like if your HR is not able to go as high as needed?  It may feel like breathlessness, or your muscles may start to feel a bit weak or jelly-like, or if you really push hard you may feel slightly sick as the muscles produce a tidal-wave of lactate.  So if you launch yourself off the end of the pool with a vigorous leg kick, and push hard with your arms in f/c you may get 15m down the pool and feel terrible!  Your PM is still pacing you (at the maximum set - 130bpm) but your muscles won't have enough oxygenated blood so you push them 'into the red' - i.e. into anaerobic metabolism.  For you this might be normal, for others it feels awful.  Anyone with chronotropic incompetence (CI) - the inability to raise your HR as needed - who has done a Bruce Protocol treadmill test knows how unpleasant it feels.

But you won't do yourself any harm - it's not as though this will trigger some problem with your PM, and your heart will carry on pumping as normal, driven by your PM.

Settings: depending on your EP doc's experience with athletic patients it might be simpler to explain what sort of exercise you are accustomed to doing, and for how long, pointing out how healthy your heart is (assuming no ischaemic heart disease) and take the conversation from there.

Always take a thumb-drive with you, and ask for all of your PM data and reports to be written to your thumb-drive and then you can examine the data at your leisure, start to read the manufacturer's documentation about your PM and ask good questions at your next PM follow-up visit.

Thank you

by Johnny63 - 2020-01-13 17:44:03

Thank you, that was very helpful! 

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