recent pacemaker insertion

I was recently diagnosed with sick sinus syndrome based on EKG and 30 day event monitor. I am a long term endurance athelete. My heart rate dropped down to 29 BPM, though I felt no symptoms. I saught consult as my heart rate stopped going to target rates while running and biking and having to back off of my workouts. It seems that things happened very quickly and before I knew it, I was having a medtronic PPM implanted. I did not know that it was reactive to motion and not my breathing. I had shared with my Dr. that I was very active. I am now suffering from PPM remorse as I feel I should have had a minute ventilation PPM inserted. My next appointment is on Sept 3rd.......where I am hoping to have many questions answered........


7 Comments

Questions

by Persephone - 2021-08-29 22:13:49

To borrow heavily from a famous movie line, there is no remorse in PM implantation.  Keep faith that your medical team will continue to help you.  Prepare a log of your questions and listen to their answers.  You'll get through this together and figure out PM settings that work best for you.

Medtronic PM settings for biking, running etc

by ar_vin - 2021-08-29 23:00:11

First, welcome to the club you never asked to belong to.

Too bad you were misled to believe you would get a PPM that would respond to your breath (like the Boston Scientific Accololade minute ventilation (MV) etc) but you got a Medtronic instead. All is not lost!

While the MV based PMs might be better, the Medtronic PMs *can* be tweaked to provide decent rate response in the case of athletes with SSS and chronotropic incompetence (fancy term for heart rate doesn't rise with activity). I should know as I have the exact same PM as you do and I've been able to get my PM settings tweaked for my outdoor pursuits: running, hiking, backpacking, cycling etc. It will take some patience, education and persistence on your part. Start with educating yourself about your PM and the settings available for it - Medtronic freely provides all it's manuals for download on their website.

A good place to start is:

https://www.medtronic.com/us-en/healthcare-professionals/products/cardiac-rhythm/pacemakers/azure.html


There are a number of excellent threads on this site about Medtronic settings.; please search and read through them carefully.

Some links to relevant threads:

https://www.pacemakerclub.com/message/40048

https://www.pacemakerclub.com/message/37472/hr-dropping-while-on-climbs

Member @frankmc2 has an excellent PDF write up on settings for Medtronic PMs - get it and understand it throroughly.

Ask questions here about anything that's not clear once you do your homework.

*Only then* approach your EP and device techs to have your Pm settings tweaked for your specific needs.

We're always here to help!

Medtronic pacemakers and endurance sports

by AgentX86 - 2021-08-29 23:59:04

Depending on the activity, an accelerometer-based pacemaker can do quite well. They should work fine for running and similar activities where the upper body moves (jerks, really). It might take some real work to set it up for cycling and things like comptetitive swimming might be a bridge too far.

While your EP should have known your needs and accomodated your lifestyle, often they have no choice. Often (usually?) they're under contract with one supplier and/or don't  have the resources to support more than one.  It's not just about implanting a device but also the training and support after. As part of the contract, some larger hospitals will have a factory rep on-site.  This isn't just a car salesman, rather someone who really knows the innards of each of the devices and knows how to get the mos out of them. Yes, it's about money (everything is) but it's also about overall outcome. Implanting the device is often the easy part.

What I have learned ............

by IAN MC - 2021-08-30 07:45:46

Like you , i was into endurance sports ( running marathons, distance cycling etc )  , developed SSS and was fitted with a Medtronic P.M. 10 yrs ago.

I went through a period of Pacemaker remorse , wishing that I had  a dual-sensor Boston Scientific P.M. instead.  But along the way I have learned :-

- the Medtronic sensor which detects motion / vibration isn't TOO bad for running providing that you have the Rate Response settiings  adjusted while running on a treadmill.

- the Medtronic can handle mountain biking better than road....the rougher the surface the better !

- I now play lots of tennis and golf and am never aware that I have a pacemaker

- once you are fitted with Medtronic leads , E.P's are not very keen to fit a different make of box so you are encouraged to accept it ....... but it really is perfectly OK for almost all activities !

Although a pacemaker will never be quite the same as a normal sinus node , your Medtronic should, over time, make you lose that remorse.

Best of luck

Ian

Medtronic adjustment

by justjoe - 2021-08-30 09:34:34

I feel for you. I had the exact same thing happen in April, and had to get a pacemaker without any time to consider or research. My heart rate normally in 50s or even 40s since I started running 15 years ago suddenly was dropping below 30. The doctor mentioned one brand of pacemaker based on my actiivty, but I ended up with a Medtronic installed. 

I was having trouble keeping pace, my legs felts very tired, and my heart was pegged at 140 then sometimes if I kept pushing it would jump to over 200. Last week I had them make more adjusments now that I understood this better. They raised the upper limit the pacemaker would pace from 140 to 160, and used a medium setting for how fast it would get there. They can set the upper limit and the pacing for how quickly it gets there. I ran a 10k this weekend, felt great, fastest pace in two years including pre pacemaker. Now the pacemaker did peg at 160 after a few miles -- which may mean it goes up faster than my heart would have if it was working -- but first time I could keep pace and not feel dead legs, light-headedness, etc. It's a learning process for me, I can't judge my run or pace on the same criteria I used to, but now believing I can't get back to running better, and planning to learn more so I am prepare to make suggestions at my next adjusment. 

Thank you

by pjb8084 - 2021-08-30 14:36:07

Thank you so much everyone for shaqring. I still have a lot to learn. I have a fu appt this week and will try to get some answers.

Thank you again.

Learning

by Persephone - 2021-08-30 17:03:00

Yes, it seems that the we more we know, the more we realize how much we don't know.  Give yourself time to adapt to your PM and figure some things out.  Neither learning all of the details about the PM nor getting setting adjustments to make things better for you are going to happen overnight, but you can work with your medical team toward these goals.

You know you're wired when...

Your ICD has a better memory than you.

Member Quotes

Yesterday was my first day mountain biking after my implant. I wiped out several times and everything is fine. There are sports after pacemakers!