Hello everyone!

Very refreshing to have such a civil and sincere bunch of like wired people with a common interest. I had a Biotronic 2 wire pacemaker put in just six weeks ago. I have type two heart block which caused several fainting spells caused by very low HR. So glad to have the PM which gives me the piece of mind that something is keeping my HR above 60 and it's doing that very well. So the low end is set to 60 and the high end at 130. I'm 75 and still in fairly good shape. My problem is not unusual from my reading on this forum. If I'm walking in the yard my HR will jump to 130 within about 200' and that's a pretty brisk walk. It's not so bad on a sidewalk but many times I'll get a fluttering and very often a tightness in my chest. Also I was on my riding mower and when I went over a bunny area my HR shot up to 128 very quickly with a very uncomfortable feeling in my chest. From reading on this forum it seems to be the rate response which I agree with. After walking for awhile things are more comfortable and my HR seems to fluctuate between120 and 130. I've read that some people have the RR turned off if the natural heart Elevates the heart rate enough without RR. I had a stress test before the PM was installed so I'm thinking that should tell the Dr if we could try it without it. Would anyone have an idea of what my ideal HR should be if my resting rate is 60?

Just before PM installed I spent $9000 on a new mower so would like to use it again! Thank you in advance for any help. I'm going in for an adjustment in the morning. 

5 Comments

Rate Response

by AgentX86 - 2023-06-20 23:26:16

Hi Sticks, not glad you're here.  But welcome to the club no one wants to joing.

Yes, it sounds like you have RR turned on.  If your only problem is a second degree block (Mobitz II, I presume), I don't see why RR would be used at all.  It aslo seems that it's set to maximum sensitivity.  There is something funny here.  Perhaps your cardiologist wants to make sure that the block is all that's going on.  Bradycardia from a heart block alone, is completely fixed by a pacemaker.  If there is something going on with the SI node, as well, I can see RR being turned on.  The bumpy ride raising the heart rate pretty much nails it down.

Yes, I'd discuss this with your cardiologist. Instead of telling your cardiologist, ask. Ask why it seems to be turned on.  Describe the symptoms and tell him that it's really affecting your QOL.

Telling a doctor anything isn't a smooth move.  They're the experts and have been studying for a decade.  Some get severly PO'd at Dr. Google. Use it to form your questions and you can get the same results without ruffling feathers.

Stress Test

by Penguin - 2023-06-21 04:37:13

Hi NYinthesticks, 

Welcome! 

You've clearly had a good read of forum posts and it's good to know that they have helped you deduce what may be going on. 

Was the test you had a Stress MRI or an exercise test on a treadmill wired up to an ECG? 

You should be able to ask for the report / results from any test.  Chronotropic incompetence (CI) is the diagnosis to look out for in the report. CI - if you don't already know - means that your heart doesn't manage to raise it's rate appropriately on it's own when you exercise. RR is the pacemaker setting used to treat CI.  This is why you need to know whether or not it's been diagnosed. You could discuss with your doctor in the morning. 

Some people  on this forum have also mentioned that their Biotronik device is very sensitive to rate increases even with RR turned off.  I don't have one of these devices, so can't comment on setting adjustments to help, but I'd certainly ask your cardiologist / technicians for adjustments that might lessen the effect. 

A repeat exercise test now that the PM is in situ might be helpful. This would enable techs to adjust settings as you experience symptoms. This is really helpful as otherwise you may need to go back and forth to the pacing techs to report back on how settings suit.  It can take time to get settings right sometimes. 

Let us know how you get on. There are several very helpful members on here with Biotronik devices. Hopefully one of them will reach out. 

 

 

Rate Response

by Lavender - 2023-06-21 13:00:18

My rate response is turned off. The cardiologist said that I don't need it. 

In time, they'll adjust your settings to suit you. Things are going to improve! 

Rate response

by Newyorkerinthesticks - 2023-06-22 12:05:11

Thanks for the good information and advice! I did go in yesterday for an adjustment and had a technician from Biotronic that I hadn't seen previously. He listened and poked around on the screen and asked me a few questions and I very humbly asked about the possibility of just turning the RR off. He actually thought that it might be a good idea but wanted to check with my Dr. My Dr thought that it was a good idea and put me on a tread mill just to make sure that my heart would increase enough without the help of RR. Everything looked (worked) well so I'm very happy with the results! Thanks for the advice to not go in with "both guns blazing"!! I think that a little humility in life goes a looooong way. 

Thanks again. 

Biotronic RR

by Tem - 2023-06-24 23:44:49

I have the same issues with my Biotronic. Rate response is turned off. If I use my Massage Chair my heart rate rises quickly when the chest is massaged. If I lightly tap my pacemaker the heart rate jumps. Told Cardiologist & Tech., both had no explanation as to why. These units appear to be very sensitive even without rate response on. 

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