Pacemakers and Museums

This post recounts an experience I had toward the end of March. In the afternoon, we went to the Farnsworth Museum in Rockland. After about an hour of walking slowly and quietly around, viewing the paintings, I began to feel a little faint and tired, so I sat down on one of their benches. Felt better after a few minutes, and continued viewing paintings. Felt tired after another few minutes, so sat down. This happened again, before I figured out what was happening.

Since I was so quiet and inactive, I was not activating either the accelerometer nor the Minute Ventilation sensor. I quickly went up 1 and ½ flights of stairs, and immediately felt normal. I continued a bit of activity in the museum, and felt fine. I have felt fine since then.

The accelerometer response factor is currently 14, and the Accelerometer Activity Threshold is set to Low. The Minute Ventilation Response Factor is set to 13.

 I asked the EP for his thoughts on this. I don’t think that we need to increase the sensitivity on any of these parameters, since we just increased them. If I go to a museum, I should use the stairs a bit more. They replied that they so no need for changes. I have a meeting with them mid-May.

5 Comments

Rate response

by AgentX86 - 2023-04-03 22:45:43

IMO. unless there is an overwhelming reason to restrict it, rate response should be a matter for the patient's preferences. If it feels good, it's good.  If rate response isn't good enough, make it so. QOL is the purpose of RR to begin with.

Have a look at rhythm disturbances too

by Gemita - 2023-04-04 05:39:00

RMarkley, it was good to hear from you.  I am sorry your museum visit was interrupted by some troublesome symptoms.  I note that you believe these were due to accelerometer/minute ventilation sensor inactivation due to inactivity but that you and your EP see no need for any changes?

While I cannot comment on your pacemaker settings which may or may not need adjusting, I do not believe it is healthy or normal to come over faint during periods of slow activity like walking viewing paintings and only to be able to overcome this symptom by running up a flight of stairs.  I am wondering therefore whether there was an underlying rhythm disturbance as a cause for your symptoms since I know you have had lone AF in the past?  

I know only too well from personal experience that when my heart rate slows and becomes irregular, if I try to speed it up by exertion I may succeed in restoring a normal, steady rhythm quickly and avoid worsening symptoms.  I wonder if this is what happened to you as you quickly went up a flight of stairs?  Anyway just my thoughts.  I hope you will receive some answers during your May meeting and that you are doing well otherwise?  Remember to stay well hydrated and if this continues you could get some additional checks, including electrolytes.

Rhythm Disturbances

by rmarkley - 2023-04-04 11:11:36

Faint is too strong a word. Just a general weakness. Not about to faint dead away and keel over.

Note from my bio that from my second syncope on May 20,2022, I  basically stayed in AFIB Had an ablation on June 21, 2022 which sort of worked.My rhythm is strange. I have a Kardia 6L. Most of the time it says I am in"Sinus Rhythm with Supraventricular Ectopy". It detects the occasional Afib, and the very occasional Normal sinus rhythm.

One Monet at a time

by Gotrhythm - 2023-04-05 19:57:39

I have more of a question than an answer. When the weak/tired feeling comes over you, are you walking or does it only happen when you have you been standing still for a few seconds?

I find I can walk easily for long distances, but something like enjoying a museum which calls for slow walking and then standing for a while to look more closely at a particular exhibit is much more taxing. I've never fainted, but the presyncopal feelings make the experience less pleasant.

In my case,  it's vasovagal syncope--though I've never fainted. Of course, like you, when I feel it, I sit down, so fainting isn't allowed to happen.

 

museum

by rmarkley - 2023-04-05 21:36:40

@ Gotrhythm

my experience is almost identical to yours. When I activated the accelerometer on the stairs, the feeling departed permanently-I just got my heart going again

You know you're wired when...

You have a dymo-powered bike.

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