High heart rate

I had a azure XT DR MRI surescan dual chamber placed about six weeks ago. At first I thought the pony races i was going on after walking was my new normal. The car rides and the bumps trigger the heart to beat over 118. I can't catch my breath. I have had one check and set at 60-130. I have tried to find anything to see if this is normal. I keep seeing people talking about tweeting the pacemaker. One check and don't see for a year. I can't do this anymore. I feel my heart is going to blow up...scared to call doc and get told it has to adjust to me. Do I wait longer or call...this is so scary....


Off to the races

by AgentX86 - 2020-08-16 01:20:01

Yes "tweaking" pacemaker settings is often necessary, particularly for the more active person. From your description, it seems that you have "rate response" turned on. This is a feature that replaces the heart's natural ability to regulate its own rate in response to the body's needs.

There isn't a technology that will do exactly the same function (increase rate in response to higher CO2 in the blood), so pacemaker manufacturers try to do the same thing another way. The most common is an accelerometer in the pacemaker to measure body motion. It assumes that motion equals more work, so a higher rate is needed.  There are settings in the pacemaker software that will change the algorithm so the motion sensitivity (how much motion is "motion", dwell (how long to wait to recognize that more blood is needed), and slope (how fast to ramp up the rate). Then more settings to do the opposite at the end of the exercise period.

Since this measures a secondary aspect of exercise,  it's easily fooled. Riding in a car over a bumpy road is the same as running, for example.

To disambiguate these events the above settings need to be tweaked to recognize the difference,  or at least co.e to a compromise that is GOOD FOR THE PATIENT, within the confines of medical needs. The more active you are the harder it is to tell one action from another ant to find a happy medium.  A couch potato will be happy with an insensitive response and little variation. An athletic person will need more change and faster,  both in wait time (dwell) and rate. With this often comes some unwanted side effects. It appears that your pacemaker is set to be very sensitive, which is good for an active lifestyle but you will probably need adjustments to minimize these side effects.

There is no need to wait for your next scheduled appointment to change this. Call your device clinic and schedule  tuning session. It may take several trips to get an acceptable setup. You have to request it though. They have no idea that it's not matching your needs and wants.

Yes, definitely call but you shouldn't need to see your doctor. The device clinic should be able to help. They'll change these settings within limits set by your doctor. If you're unhappy with these limits, then it's time to negotiate with your doctor.

High heart rate

by Debbiejo - 2020-08-17 18:33:09

Thank you for your response. I will do as you suggested. 

Bumpy road syndrome

by Gotrhythm - 2020-08-19 16:57:39

Having your pacemaker speed up when you're doing nothing but riding in the car---on a bumpy road--it's really not unusual.

It's all about the method your pacemaker uses to tell it to speed up, sometimes called rate response. As AgentX says, rate response can be set to varying levels of sensitivity. 

If your pacemaker uses vibration to tell it to speed up, then any vibration will tell your pacemaker to speed up. I've experienced it with unpaved roads, and even paved roads in bad condition. Also bouncing on a trampoline, in a plane as a result of air turbalence.

I think once you know what is happening, it's much easier to deal with. At my last settings adjustment, rate response was made very sensitive. My heart rate will jump up with the least little thing--but I love it, because I like to move fast, and now my pacemaker supports that. Actually, it's so sensitive that at an organ concert I attended, the organ's bass notes would produce enough vibration to activate the rate response. It kind of added to the thrill.

As AgentX says, there isn't a right setting for rate response. It's all about what works for you.

Do talk it over with your doctor. "Bumpy road" syndrome is pretty common. Find the rate response that works for you.


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