Restrictive cardiomyopathy and odd pacemaker behaviour
So, I went for the first stage of a heart transplant assessment on Tuesday -- mostly tests I'd had before (chest X-ray, ECG, ultrasound) but also an exercise test wired up to an ECG and monitoring breathing and blood pressure and oxygen sats.
As expected, my results showed (quoting the tech) 'you're rubbish at excercise'. Not really a surprise as persistent breathlessness and inability to exercise are why they're considering me for a hear transplant.
However, discussion with the consultant at the end of the process was interesting.
1. I have restrictive cardiomyopathy, and have had for 10 years or longer (although this is the first time it's been diagnosed.) 'Longer' is because it was probably the cause of my atrial fibrillation, which started being symptomatic in about 2004 and was what led to my pace and ablate procedure in 2018. (Procedure worked fine to stop me feeling the AF symptoms, but didn't cure anything else, unsurprisingly given the RCM diagnosis.) Next stage of transplant assessment is on hold pending investigation of the cause of the RCM -- no point in giving me a new heart of I'm going to trash that as well.
2. My pacemaker may be contributing to the problems exercising. At the start of the session on a fixed bike, heart rate rose as expected from 60 to 100/105. However, it then fell back immediately to 75/80 and stayed there stubbornly no matter what I did.
The Transplant Centre are writing to my cardiologist (who is also an EP) to suggest he investigates -- he only got involved in my case in February this year so he wasn't involved in any of the previous diagnosis/treatment or the implanation and tuning of the pacemaker, but he's pretty on the ball, so I'm hopeful I'll get an appointment some time in the next century (given Covid-19 restrictions :) )
Just curious however -- has anyone experienced anything similar, or can they suggest what settings might be awry? Boston Scientific L110.