Looking for a Northern CA specialist

I have an a/v block and I am now 100% paced by a Boston Scientific Advantio K063.  I am also an active cyclist, hiker and periodic skiier.

Over the years, I have had a difficult time working with my doctors office and the Boston techs to get my PM settings optimized for cycling (my main sport).  The doc's don't seem to have the time and the techs don't seem to have the experience.

Can anyone out there suggest the name of a SF Bay area cardiologist or other professional in this field who reallyr speciallizes or has a detailed understanding of  pacemaker settings and athletic performance?   I acknoweldge that a pacemaker will never be as good as my natural rythym setting but I would like to have more confidence that I have done everything possible.

with all of the athletic people out there w/ pacemakers nowadays, there must be someone who has dug into this.


Tuning a PM for road cycling

by crustyg - 2021-04-27 11:55:01

In my experience, the key requirement is an EP-doc humble enough to accept that a good rep might know more about the effects of the more complex settings and willing to set up a tuning session.  A good rep is what's needed.

My (two) tuning sessions were really run by the rep (and me, once we'd got past the Alpha-male jostling), the EP-tech was happy to let the rep make the actual adjustments and my EP-doc put his head round the door at start and end.

Two sessions, because there are two specifics that massively affect tuning a BostonSci PM for optimal RR using Minute Ventilation, and we didn't realise this for the first session, although the settings weren't far off optimal.

Send me an PM if that would help.  I run, ski, swim and road cycle.  Stopped SCUBA after the PM - cycling was taking up too much time!


by PacedNRunning - 2021-04-29 03:07:51

I live in the Bay Area.  I have seen Dr Joshua Moss at UCSF. He's very smart with programming but he's more a Medtronic EP. I have a Boston and when I went to see him, he wanted to switch me to medtronic due to issues with pacing and exercise.  He gave good reasons why he wanted to change it to Medtronic but I felt is wasn't the best idea for me.  

I had a very difficult time programming mine for exercise. My doctor and Boston Rep worked hard to get me pretty darn good for exercise. Took about 4 mos and then another 4 mos to fine tune it little by little.  Your right, it won't be like someone unpacked but it should be tolerable!  I did a lot of reading myself to help them and found good info for things to try.  Why do you have a PM? IS it for heart block or sinus node dysfuntion? I see a Dr at John Muir Health. He's an excellent doctor. He knows a lot about programming but when it got to be very detailed with exercise he allowed the Boston rep with over 20 years of experience to work with me 1:1. 

It's a shame we have to go through this to get our device programmed.  It's nice all the features are there to help us out but not a lot know how to program them for exercise or someone active.  Let the know if you need help. I would be happy to make suggestions and help.  

Reply to PacedNRunning

by airwayotto - 2021-04-29 12:06:19

I have a heart block.

It sounds like we all have problems convincing our docs to spend time on programming.  The reps are great if you can detach them from the docs.

What are your thoughts on UCSF?  I could switch but John Muir would be a litte tough as I live in Marin.

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