Rate response setting


I've had my pacemaker for 1 year, I'm unsure as to whether I need my settings looked at, or I just need to improve my fitness 🤣

Is there an easy way to tell if 'rate response' has been activated?

I gather that helps keep the device in tune with what your body needs through exercise?

Any feedback is welcome,  with the way things are, all outpatients appointments are waaaaaaay behind at the minute so a bit of advice would be great!!


You need to know your settings

by crustyg - 2021-01-06 13:14:41

People have PMs for different reasons, and need different settings for a) their heart condition, b) their lifestyle.

Many of us (at least those who frequent this community) make a habit of asking for *all* of their PM settings and reports every time that they have a session with the EP-techs or whoever does the PM management.  A USB memory stick is very useful.

Armed with this information, and a little bit of information about yourself, we are better able to help answer your question(s).

Me: yes, I've had my PM tuned specifically for road cycling. An hour long session on a static bike with EP-tech and BostonSci rep in attendance.  Hard work, but well worth it.

rate response

by Tracey_E - 2021-01-06 13:16:31

Have you seen a report from the pacer? If rate response is on, it will end wiht R, like DDDR

Depending what kind of device you have, it senses raises the rate when it senses movement. Most of them work on motion, a few use breathing. 

If you are exercising hard and your rate is not going up much, it may not be turned on. Why did you get the pacer? It's helpful with sinus issues but often not turned on with av block. 

Three ways to find out if RR is turned on :-

by IAN MC - 2021-01-06 13:35:39

i)  Ring up your pacemaker clinic and ask them.

ii)  As Tracey says , if you have any documentation referring to your PM settings a 4 -5 letter code containing the letter R in 4th position is a dead giveaway

iii)  I see you have a Medtronic pacemaker , so do I. 

If the RR is switched on,  then a sensor is activated which responds to vibration and upper body movement . When you exercise,  the sensor triggers off more frequent heartbeats and your HR goes up.

If you firmly tap on your pacemaker  with your forefinger 20 or 30 times , this fools it into thinking that you're exercising and you will be able to measure a definite increase in heart-rate if your RR is activated.

Let us know what you find out.




Rate response

by LMurphy - 2021-01-06 13:36:26

Thanks for your responses, I'm based in northern ireland and our review clinics here are brief and give zero reports back to the patients.

I got mine fitted after OHS when I developed heart block.

I've only had one review since it was put in, and to be honest I wasnt aware there were so many settings that could affect exercise capacity .

I will be asking more questions at the next one!!

This is my second heart surgery and it took a while to get back to full fitness again, so I might just be being impatient 🤣

The rate is def goin up with exertion but at times feels slow.

Once you determine if it is on, then make sure it is set right for your level of exercise

by jds66 - 2021-01-06 14:45:01

Beyond determinining if it is activated or not, you will want to have the level of Rate Response tuned best for you. 

They give you default settings to start, but you may find that those are too sensistive, in other words, just walking up some stairs your heart if beating way too hard for what helps you. In that case, you want the sensitivty and aggresiveness of the setting turned down.

Conversely, if you find you dont have the heart rate you need to do activities, you may need the setting to be more aggressive. 

So, knowing it is on is one part of your equation. You then want to customize it for you. If you cannot get appointments too often with the techs that will adjust that, make the best of your visit. 

Walk up some stairs after the tech adjusts it, tell him what you feel. If they wont let you do that, walk in place, try to get that heart working, so you can see what each setting feels like.

Heck, if you can do it to the level of crusty and get an exercise bike in the room or treadmill to work with while they adjust it, then that would be premium, but most will not be able to do that.

Good luck

Rate Reponse

by AgentX86 - 2021-01-06 18:35:38

If your only problem is a heart block, it's doubtful that rate response is turned on.  Your sinus node would be perfectly capable of modulating your heart rate, and better than any rate response algorithm could. 

A healthy sinus node reponds to the amount of CO2 (sorta the opposite of O2) in your blood stream.  The more CO2, the faster the SI node tells your heart to beat.  This is far superior to measuring how much your torso moves or how you breathe.  If your siunus node is functional and you have RR turned on, the two can fight each other.  This can cause all sorts of problems.  Some here have had this happen.  For some reason it was switched on and they felt horrible until it was turned off.  The EP wouldn't have turned RR off if it were needed.

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