Heart rate during exercise

Hello! I would like to ask if anyone knows why during exercise when my heart reaches 138 beats the pulse drops sharply and after a few seconds returns to the previous level. Also 138 is the maximum to which the pulse rises. Once it gets there it falls sharply. This was not the case with my previous pacemaker. The replacement was made 2 months ago. 

5 Comments

Counting BPM

by Persephone - 2020-11-30 17:12:01

Hi Ranita - I'm curious what BPM counting method you are using - is it a manual count with two fingers on your carotid artery, or a heart rate monitor chest strap?  It's my understanding that other measures we might use at home - besides a holter monitor prescribed by your EP - may be not very reliable. Also, have you returned to your EP yet for adjustments after your replacement 2 months ago?  I certainly can understand your discomfort with your new feelings.

Upper tracking rate?

by Parker0 - 2020-12-01 01:36:29

If you have an upper tracking rate for atrioventricular synchrony, ie there's a maximum rate at which your pacemaker will pace the ventricles at (I'm assuming in your case it might be 140) - then the pacemaker will not track the atria >140 eg 150 so the atria are going 150 and the ventricles 140. Pulse oximetry is just crap at reading asynchrony, unless it can track only the ventricular beater. Do you know your pacing mode? (DDD, DDI, DDIR etc?)

call

by Tracey_E - 2020-12-01 10:18:59

Call and ask if they have your settings the same as the old one. Usually they do, but sometimes they don't, or it has new features and has to be programmed differently. It sounds like your upper limit has changed, easy fix. 

Answers

by ranita - 2020-12-01 17:01:45

Thank you all very much for your answers! First of all let me tell you that the reason I have a pacemaker is because I have a complete atrioventricular block. My heart does not use the atrial lead because I have my own rhythm. The pacemaker is DDDR. Also, yes I went to the doctor and she made the necessary adjustments and if I remember correctly we increased the upper limit to 160. Finally let me tell you that during the exercise I wear a polar heart rate monitor chest strap and I see my pulse in the application. I can not understand what is wrong. The truth is that with the previous pacemaker I reached up to 148 pulses, as before the implantation but in the exercise I kept this pulse without falling.

Not just the upper rate

by PacedNRunning - 2020-12-07 22:44:31

There is a thing called TARP with upper rate behavior. Depending on your settings, you may hit this before your upper max of 160bpm. Simple increasing the upper rate may not solve this problem. Ask them to calculate your TARP rate and find out at what HR will your HR cut in half.  It should be higher than your upper rate limit.  So even if your upper rate is 160bpm, your ventricles will cap pacing at this rate. meaning it won't pace higher than 160bpm.  Your TARP should not be 160bpm.  Hope that helps.  If you say TARP they will know how to calculate it.

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