Hi there - 4 wks. ago received a Biotronic 2- leads pm due to a Bradycardie - 3 degree AV block.The cardiologist reassured me that i could continu with my cycling on a 80-85% compared with what i was used to.- have raced on a high level all my life - 71 years old.Yesterday went for my first spin on the road - little scared i admit  ... pm. is fine tuned to a setting of 50- 175 bpm .Q- is it  normal to feel a little lightheaded/dizzy - a feeling i'm having to go through a temporary barrier coming in to a zone of > 140? Q- or is this just a case of adjustment of the heart versus the pm? Everytime i increase my speed, staying within the above mentioned paramtrs. I experience this barrier/wall i have to go through. Looking forward to comments &




I have the exact same sensation when cycling

by crustyg - 2020-06-20 10:05:51

*Assuming* that your SA node is still working well, and it responds correctly to the demand for more cardiac output, and with a well adjusted dual-chamber PM for CHB (==3rd degree HB), you shouldn't have any problems.

However it sounds as though you are not getting enough of an increase in cardiac output for a while until something catches up (your PM, probably).  And this gives you a 'wall' to get through.

I have SSS and if I am riding on an easy section (or worse, free-wheeling down a hill before a steep section) my PM lets my HR drop to high 50s, low 60s.  Then I work my legs and after 3 or 4 pushes I feel terrible, my HR slowly comes up to 90-100bpm I feel weird as the lactate washes out, and then my HR carries on increasing to my max and the strength comes back into my legs and all is ok.

My conclusion: your SA node isn't what it should be and if you have rate response enabled it's taking a little too long (mine has a built-in pause) to increase, OR you haven't got RR enabled (seems unlikely).  I've had a careful static bike tuning session for my PM and it's about as good as it's going to get.  I live with the unpleasant moments, they don't last for long.


by Moussa - 2020-06-20 11:51:36

Thanks for your quick response.The Sinus node is okay - no other malfunctions were mentioned except that the heart had a 100% pump function  + valves.You wrote extactly what I experienced- riding on a level stretch the bpm dropped significantly and promptly increased on the ascent.I think that patience is here a positive healer and must wait until my next checkup and will discuss this with the cardiologist or the technician.Most  cyclists who were in the fast lane this is a common trait " patience ". The articles I've been reading on this subject vary so much............. Your test tuning on a static bike sounds like an excellent idea and will be primarily my first question te raise-gr

The wall

by AgentX86 - 2020-06-20 12:59:48

You may need some more tuning.  Couch potatoes don't need to have their pacemakers fine tuned but the more athletic you are, the more you're going to have to get it dialed in.  Some of this, of course, is going to take time for you to adjust but you need everything you can out of your pacemaker, too.  Don't be shy about demanding changes to your settings and by all means, study up on the technical aspects of your pacemaker so you can tell them what to try.

As far as your heart  rate coming down too fast, if your SI node is in-tact, (the Bradycardia is wholy caused by the heart block) this isn't the pacemaker.  In this scenario, the pacemaker is just a wire routing the electrical signal around the AV node.  However if you also have a problem with the SI node (chronotropic incompetency), the PM's "rate response" setting might be turned on and some adjustments to the dwell time need to be made.  Your best plan of action is to get a copy of your settings and study it along ewith the technical manual for your pace maker.

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