Hi folks

Hi everyone. I've just found this site after doing some searching for a problem I'm experiencing.
I had a PPM fitted on Valentine's Day this year for Bradycardia. It is set to AAIR<->DDDR.

I've had my 6 week check and the techies say that all is well and that my PPM will learn my lifestyle and rate response etc will react intelligently. Wow, methinks.
I've been taking my dog for a walk, probably about a mile at a time, a bit hilly but not mountainous and when I get near the car on the way back I feel very lightheaded and start to see big yellow blobs in front of my eyes. I often have to sit down for 15 minutes before I feel safe to drive. I'm walking briskly but not at jogging speed.
Is this just a question of being patient and letting my PPM learn and my body get fitter? Is this normal?
I am 55 and also suffer with chronic pain but I was a very active photographer fo 10 years up until 3 years ago when I just couldn't keep up anymore. Bradycardia was discovered December last year at 31bpm.
Thanks in advance, even if it's just to put my mind to rest. My PPM (Permanent PaceMaker) is a Medtronic Azure S DR, I believe it to be one of the latest models and it seems to have an intelligent switching ability should my ventricle need pacing as well as my atrium.






by Tracey_E - 2020-05-07 12:34:22

I would give them a call and let them know what's happening. Sounds like your settings might need adjusted. 

If something consistently makes you feel bad, I would not do it until figuring out what's going on. 

UK not US

by Theknotguy - 2020-05-07 12:41:00

Since you are in the UK the rules might be different.  However, I'd still talk with the equivalent of our EP - whatever they call them in the UK.  And/or talk with your cardiologist.  You're about 90 days out so your heart and body should have mostly settled down to the new routine now.  

In the US the doctor's don't like to make changes early on because things haven't settled down.  So if they change something they don't know if it's due to your body and heart changing or if it's something they did.  At about 90 days out there should be a predictable routine.  

What the doctors and tech's call "routine" can have different meanings for different people.  I ran into problems at six years out because I upped my exercise and my pacemaker couldn't keep up.  When you first get the pacemaker the "routine" settings are for someone who doesn't walk for more than a couple of miles a day and essentially sits the rest of the time.  So if you're out walking the dogs chances are your pacemaker isn't keeping up.  You're seeing blobs in front of your eyes and after exercise it takes a while for the body to bring your oxygen levels back up to a normal level.  

Even though your pacemaker is supposed to learn what you're doing, there should be a way they can tweak it to bring you to your new levels much more quickly.  So I'd have a discussion with your EP/Cardiologist/tech to see what changes can be made.  There is no reason why you should be gasping for air after taking the dogs for a walk.  See what you can do.  

As for the dogs, keep doing the walking.  You can't beat the cold nose with the warm heart and giving the dogs a good petting session helps the heart too.  I had two dogs help me post pacemaker implant and I can't tell you all the times the dogs made a difference.  They'd always do something goofy and make me laugh.  It's hard to be depressed when you're laughing all the time.  The dogs make you exercise and that's important.  Every little bit of exercise helps.  The dogs are adaptable too.  If you can't make it the full session they are just as happy.  Main thing for them is the time spent with them.  And other than the starving dog stare when they want their treats, they don't criticize.  Which can be just as important for your mental health too.  

Hope you can get some help.  Otherwise it looks like you're adapting well.  Oh, and please give the dogs a pat for me.  

Likely need rate response adjustment

by CyborgMike - 2020-05-08 02:05:38

It clearly sounds like you are not getting the right amount of output for the exercise. I had to go in at least 6 times for adjustments after I got my PM and they originally had it set way too low for even mild exercise. I'm not back to running and feeling great, but I had to keep pushing the EPs to get it right. In the early days I used an Apple watch, especially when walking or exercising, to see and log what my heart was doing. I am not familiar with your PM model, but there are likely rate response settings that need adjusting.

Thanks Everyoner

by Allinthemind - 2020-05-08 07:51:15

Thank you for your kind responses. I spoke to the Pacemaker Nurse yesterday and she's going to arrange an appointment with a PPM Techie next week.


Si (Borg).


by mtnhoot - 2020-05-18 16:27:57

The PMs that have a closed loop system will need many adjustments to get it to go along with your needs.  I had over 16 adjustments and it was never right.  My last adjustment, just a month ago was different.  My tech told me that some of his patients had to turn the CLS off and just go with muscle response.  So I asked him to turn mine off and go with VVR1, which for me is the muscle response.  What a difference.  There are adjustments to make your heart respond faster or slower to the movements and to the rate of descent.  You might want to use the muscle response and see if that helps.  Be sure to have him wait while you go test it.  Walk a bit and find some stairs to climb for the test.  Good luck!!

Review with the techies

by Allinthemind - 2020-05-19 07:12:22

I had a good long session with the techies where we went through and tested every adjustment. My PM is set to sensitive movements and has self-adjusting steepness of response thereafter. 60/145 lower/upper rates. They are querying some sort of blood pressure drop problem as the PPM seems to be working perfectly. They have sent their findings to the Cardiologist, so let's see where that goses.


Many thanks


You know you're wired when...

You trust technology more than your heart.

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