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........



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 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


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.


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.

rate response

by johnwiththree - 2021-09-27 12:40:37

This is so helpful. I have been going through the exact same thing. Was extremely active in triathlon training for years, ended up with a Metronic due to lack of time to research and my heartrate wont get up high enough during exercise.

I have an apointment with my electro for a treadmil season to work on settings. 

Thanks to all for this discussion. At least I get what the goal is here.

Its so hard to run or bike and feel like your pulling a volkswagen when it was never that hard before.


by nickhu - 2021-10-22 19:57:58

This is an interesting thread, thanks for posting.  I'm at the beginning of a similar journey, currently being recommended a PM, so this discussion resonates with me.  I'm 54, have SSS with a resting HR of 32.  I've been an endurance athlete my whole life, racing bikes on road, cyclocross and mountain bike to a reasonably high level, best result probably State Champion. 

My ability to put in hard sustained efforts really dropped earlier this year and combined with a RHR dropping to low 20's when I went in for an unrelated minor procedure got me to the cardiologist.  At first they were alarmed and wanted urgent pacemaker implantation but my stress test came back "excellent" so now they are saying I need one, probably in the next 3-6months, but it is not "urgent".  As a cyclist and one who enjoys hard efforts on rough trails as well as smooth pavement and not really a runner I am concerned about how well the PM will be able to cope with my lifestyle.  I'm glad I've been given some time to fully understand this before surgery.

Any further updates on your situation would be greatly appreciated.

Medtronic rate response

by MobileDiver - 2021-10-31 06:59:57

Great discussion. I have a Medtronic and am having similar problems with inadequate rate response and getting winded. I tried Frank's settings a while back with no real difference. Hoping that I slowly adapt and improve. Wish I had gotten a different make.

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