Resting rate

I had a resting rate for years between 40 and 50. Competitive triathlete and cyclist. Had an athletic heart condition for 30 plus years and believe I still do. Have had flutter off an on for 8 years, mostly off. Jan 2017 sysmtoms of bradicardia began, pretty common for athletes. 7/17 got a dual lead medtronic pace maker. resting rate was set at 60 BPM. Now it is set at 70 BPM? If I still have an athletic heart condition, why 70. Now, flutter and fib are back. I cannot tell it and still go anarobic daily! Any reason not to drop the rate back to 60 or lower 55, 50? Still have a heart that will get the job done at a lower rate and less stress on the pace maker! Thoughts. I am 75 now and don't compete unless some yahoo messes with me!  !  


8 Comments

Choice of lower HR isn't really a consideration for PM longevity

by crustyg - 2020-05-25 18:43:47

Let's park the idea that your lower HR limit in some way extends the battery life of your PM: it doesn't in any meangingful way - so having a lower rate limit of 45bpm versus 70bpm won't make any difference to your PM's battery life. There are other PM settings and activities that are *way* more battery draining than your lower rate limit.

If you have good AV synchrony then I think you're right: a large heart beating at 50bpm could easily provide you with a sensible cardiac output (and hence BP to keep all those important tissues supplied with oxygenated blood).  In fact, overpacing your heart *may* give you artificial hypertension, which isn't great.

Factors to consider: do you get any dizziness when standing after being seated for 20-30min?  Do you feel dizzy at the top of the stairs if you decide to get up and use the upstairs WC?  Can your HR increase sufficiently quickly when needed from a low rate like 50bpm?  Does your EP doc understand that you feel comfortable with a lower HR?  Does your PM have a lower rate for sleeping at night?

I suggest you chat to your EP team and ask them why they've chosen this lower rate for you and request that they lower it.

Resting rate

by thejoe056 - 2020-05-25 19:44:39

Thanks, the PM does not have a sleep lower rate that I know of! I had flutter off and on since 2012. It came back shorty after my PM resting rate was increased to 70 BPM, which I was unaware of! Also the upper limit was reduced from 180 to 150! I have no concern about the upper, all I ever needed to kick some kids butt was 160 which was about my max! My common sense (?) tells me that my heart would like a lower rate than 70 because it is still athletic.  I appreciate your advise, my EP guy listens. I know I am not your regular PM patient, and he knows it very clearly! Now that Dyno power is just a few clicks away on my PM might as well check all the possibilities? Some punk still needs to show respect to an old man! Cut the talk, show the walk!   

70bpm

by AgentX86 - 2020-05-25 19:57:49

This is certainly a question for your EP/cardiologist.  I would have asked right off the bat.  They first set mine at 80bpm (even though I was used to 40-50), which didn't feel so great.  My EP said that there was a high incidence of SCA in similar cases and that 80bpm for a month, then 70 for a month, then whatever avoided the problem (never got below 70 and am back at 80bpm for 2+ years).  I'm not suggesting that explains your situation but there are reasons for what they're doing.  You need to let them know that you'd like to, not only know, but understand what they're doing to you.

Note than an "athletic heart" is not always a good thing.  It means the heart is enlarged and the muscle walls have thickened.  If this is really due to endurance exercise, it is most probably benign but not always.  It can and often causes arrhythmias, particularly AF.  Again, you should have a relationship with your cardiologist such that he'll explain what he's doing, whay he's doing it, and before he does it.  I've found the best way to do this is to be able to talk to them at their level.  If you're interested enough to do the research, you're probably interested enough to know the details.  IME, doctors actually prefer to have a two-way dialog with their patients.  "Informed consent" and all...

70bpm

by thejoe056 - 2020-05-25 21:27:45

Thanks, getting the paddles Thursday to stop Afib! Thickened walls, do not think so! This subject has been covered. Think this is a temporary fix, but life is a tempory fix? Can't wait for covid 19? But, I am blessed with Vitamin D overload! Not adjusting well to the "New Normal" old school attitude! Just Say'n. Love Joe.

 

DCCV

by AgentX86 - 2020-05-25 23:26:36

My first cardioversion lasted for almost seven years, then it was all downhill from there (second didn't get me as far as the recovery room).  Yes, it's a temp fix but you might get lucky too.

"Thickened walls" mean that the heart muscle mass has increased.  In athletes this is caused the same way as six-pack abs but that's not the only cause.  I didn't mean that yours was a problem, only that "athletic heart" isn't necessarily a good thing.  I know couch potatoes who think they're good to go because they have an "athlete's heart". Tain't necessarily so...

BS on the "new normal".  The "old normal" was normal enough for me (if the marketing department had to put "new" in front of it, it's not improved).

DCCV

by thejoe056 - 2020-05-26 11:07:27

Ha,Ha. I would say we are from the same genetic generation!

AF

by Jackw - 2020-05-30 11:21:14

Ask your EP but I have the impression that some EPs raise the resting rate to try to minimize af. I had af. Got paddles once but it didn't last long, about 6 weeks. Then got an ablation which worked beautifully. No af since and that was 6 years ago. BTW, I am 74 and run and ski.

Resting rate-Crazy Afib/flutter?

by thejoe056 - 2020-06-01 21:02:09

Well, got my pace maker 7/17. dual lead for bradycardia. 8 years of flutter off and on, mostly off! Returned about a year ago, not sure why, but my resting rate was cranked up to 70. I have an athletic heart, worked fine much lower! I did not know it had been increased! Well, flutter came back after the change.  Seeking a cure, my cardiologist played with the pacemaker jacking it way up to see if the heart would reset into signus rhythem! Did not happen! After the attempt I went into Afib, which I had never had before! Ok, now we get to get Eltro-cardioversion, to cure the probeml. OK, so show up for the ZAP! Not so quick, now back in Flutter. Oh goodie, now ablation! Was this ever a long day. Ablation schuduled as the last proceedure, as a bonus got leaky valve repaired and a ZAP to the left Ventricle which also in flutter. Day end, back in sinus rhythem, with a cure for the left still ramaining. Now Chapter two. got home and drugs wore off. Level 10 pain set from the proceedures. Thoughts of 911 and suicide (Ha,Ha) had serious elevated levels of troponin in my blood from the proceedures. Google it! End of story, but the road of heart issues is filled with potholes, even with the best Doc's on the planet! Adventures of aging! Just a thought, Getting old is getting old? !    

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