pacemaker - walking

Hi all,

I am seeking some help on heart rates when walking. I am almost 70 and  I have a Boston scientific K185 which was inserted in January 2015. Have complete heart block and AF all the time  but asymptomatic.   Prior to the BS I had a Medtronic with rate response only. Had that for about 8 years.  The Boston Scientific has minute ventilation and an accelerometer and I have found with cycling that the combination works very well and consistently has my heart rate up pretty high– on a to our bike ride averaging about 144.  This compares to the Medtronic which some reason did not pick up the vibration on the bike and so heart rate was always very low.

Also do  gym work where I do a 30 minute session a couple of times a week with a trainer on weights. Hr is pretty good and goes up and down so that when I am putting in an effort hr kicks up fairly high.

Problem I have however with the K 185 is walking.  When doing a 45 min walk while the heart rate goes up initially after about 15 minutes it starts trending down to initially 80s and I end up finishing walk at a rate of about 67 with an average over the whole walk of about 75.  During the latter part of the walk feel quite lethargic because of the low rate.  Have a very good technician who deals with the settings and had a number of sessions with her on trying  to get walking rate right using treadmill but while the cycling has been very good it is just walking that I have a problem with.

Looking for any help in trying to work out how to keep the rate up on the walks.  I did try walking briskly and swinging my arms and while that did work on one walk with quite a good heart rate seems to be the exception rather than the rule.

Any ideas??


Probably need a little tweaking of settings

by crustyg - 2021-04-04 13:27:22

Hi: I have Accolade, carefully tuned for road cycling, works very well.  Running (before my hip stopped me) also worked well - the accelerometer does a great job.

Swimming, and walking up hill: not so great.  Not enough movement for the accelerometer to detect and feed into RR, and not nearly enough change in MV for that to produce much of an increase.

Two things might help: ask them to *increase* the Recovery time for the Accelerometer - so any increase that you do get will last for longer.  The default is 2min, I think.  Ask them to increase that to 3 or 4min.  Secondly, consider asking for the MV Response Factor to be increased, and check the Ventilatory Threshold setting (you don't want this too low).

There's an interesting phenomenon with BostonSci during the blended response (i.e. both Accelerometer and MV are driving RR): until the MV signal is larger than Accel, the net effect of blending actually reduces the overal RR effect.  Once MV is larger than Accel, then suddenly RR shoots up.  Trouble is, MV takes about 2min to really increase: it's designed that way to stop a few deep breaths from pushing your HR up.  Nightmare on short downhill sections on the bike =>HR drops, so next hill HR is too low.  Breathing deeply (rather than faster) for about 30s really *does* increase the effect on RR, and you can use this to drive your HR upwards.

Feel free to send my your settings privately, if you think that might help.

Hope that helps.

pacemaker - walking

by bab - 2021-04-06 03:01:00

Hi Crustyg - many thanks for that.  Your comments help a lot.  Will ask the technician for the settings and perhaps try what you have suggested - have already had a few tweaks and will go back to them re the recovery time on the accelerometer.  Yes understand the issue with the blended response and wil have a go at that deep breathing and see what happens.  

Again - many thanks

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