Pace limit


I'm new to pacemaker club and really pleased that I can have the opportunity to read of other people's experience post pacemaker implant and maybe get the opportunity to find an answer to my questions.

Having had a Medtronic pacemaker implanted last January I have been able to be a lot more active since my diagnosis of total heart block.

When I try to run however, anything above a brisk walk and I have to stop immediately. Very hard to explain my symptoms, breathlessness, light headed etc.

I appreciate that turning 50 and not having run for a few years has taken its toll but I feel this is different and wonder if the pacemaker settings can be changed or there is a method that I can use to warm up so that I don't break down so quickly?



upper limit

by Tracey_E - 2023-03-26 09:28:37

When you feel bad, is your rate exactly the same, like 120 or 130? If yes, you are hitting your upper limit and this is an easy fix. 

With heart block the sinus node (which controls the atrial rate) works normally. In a heart without av block, it tells the av node in the ventricles when to beat. With us, this signal gets blocked so the pacer steps in and makes sure the ventricles beat in sync with the atria. But it will only step in up to the programmed upper limit. They often send us home with an upper limit of 120-140 but as long as you are cleared for exercise, they should be able to turn it up higher than that. I regularly get to 170-175 when I work out so mine is set at 190 so I have a cushion. 

If your rate is going up very quickly, that can be fixed with conditioning. Run/walk intervals work best for me. My rate gets up but I can't sustain it so I walk and bring my rate back down. Over time, it stopped going up as quickly and comes down faster but I still do intervals, just longer walk/shorter run now. 

Upper limit

by Peter Plimmer - 2023-03-26 09:46:50

Hi Tracey.

Thanks very much for your kind reply and information. I feel very naive as I don't have a heart rate monitor for on the move.

I will be seeing the pacemaker team tomorrow and ask if they can turn up the upper limit.

Thanks again!



by piglet22 - 2023-03-26 10:11:55

I used to run but I don't anymore.

The heart may be willing, but the joints aren't.

You fix one thing then something else puts a spanner in the works.

I enjoy walking now and where I live, it's hills all the way and I feel that's enough for me.

Over the years I've had to give up a few things, especially the cycling I enjoyed. It's too dangerous now and both cyclists and drivers antagonise each other.

One accident of skull vs tarmac made me even more cautious.

Walking has a lot to offer, and I particularly like to watch the changing seasons in the hedgerows. I already made a note of which sloe bushes have had the most blossom which in 7 to 8 months will be the next batch of sloe gin.

Another sense of achievement is walking from one town to another or village to village. It's what people used to do before cars and public transport.

The important thing is to do something and not sit around. It lifts the spirits and if your muscles and tendons get a workout you stand a better chance of getting through something more major.

Heart rate monitor

by AgentX86 - 2023-03-26 13:53:10

Don't bother with a Heart rate monitor. Just count the number of beats in fifteen seconds and multiply by four. If you need a little more accuracy, count for thirty seconds.

heart rate monitor

by Tracey_E - 2023-03-26 16:27:50

I use my apple watch but it's really not necessary! Count as Agent said. Before I got an apple watch, I wasn't able to find a hrm that worked for me so I went by how I felt. If I could talk but not sing, that's a good level of exertion. As soon as I catch myself singing along, it's time to push harder.

If you are getting dizzy and overly tired on exertion, they will be able to tell right away when they interrogate if you are hitting your upper limit. Super common and easy fix. 

Heart rate monitor

by piglet22 - 2023-03-27 06:30:36

What has helped me get to the point of possibly seeing a pacing consultant soon to try and sort out what looks like a medication versus pacemaker conflict has been data.

The medics might hate it, or some at least, but it's information on how you are on a day-to-day basis rather than an annual checkup under sometimes stressful conditions.

They had me down as pre-type 2 diabetic based on annual figures.

By taking a monthly blood glucose test and proving that my glucose was highish but not getting worse, it's now down as non-diabetic hyperglycemia.

You could argue that it's the same thing but it's better than being dragged into weeks of diabetes "counselling."

I was enrolled on what was becoming a time-consuming two-weekly repetitive explanation of the connection between carbohydrates insulin and blood glucose. Mercifully, Covid intervened.

As a scientist I live by data and collect it every day on temperatures energy consumption and so on.

I would argue in favour of a heart rate monitor as an essential tool in managing heart related conditions, especially if you can collect and record data for number crunching.

In the UK especially post pandemic, many clinics and even face to face meetings with medics have disappeared likely never to return and it's becoming more important for patients to help themselves help the health service.

When I suggested to the GP I might make my own ECG device, she said I could always try a Fitbit type of thing, but she thought that chest strap devices were better.

You know you're wired when...

Your signature looks like an EKG.

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