Pacing when exercising with intermittent heart block

MTR

by USMC-Pacer - 2023-06-26 14:24:18

Sounds to me like you are hitting your Max Tracking Rate (MTR) or upper limit. When I hit mine (frequently) :) - it knocks me back down to 80bpm. It results in the most annoying, workout ending feeling like someone punched me in the stomach. Fortunately, it is an easy fix in the settings unless there is a reason they won't increase it. I'll be having mine increased (again) at my next appointment.

Good luck, hope this helps :)

Hard to know

by Penguin - 2023-06-26 16:21:25

It's hard to say because we don't know which settings are already in place.

The hard beat you feel could be a PVC.  I feel them as a bit of a thud. 

Max tracking

by AgentX86 - 2023-06-27 00:15:37

That's what it sounds like to me, too.  It should drop exactly in half, which in your case would be 65-70.  This is close but if it really is exactly the low limit, got me. Your tracking rate seems low but it's not unusual to set it this low until the patient bitches.  There is a lesson here.  Squeaky wheel...

Pacing & Exercise

by Highplaces - 2023-06-27 06:15:04

Thanks everyone. It does sound like it migh be to do with Max Tracking, my max tracking setting is set (from memory) at 160. I know I had to push a little to get it raised from 120 at my first appt after implant. They didn't want to set it any higher because of my age. Altho I used to get up to 180 or so when mountain walking, I didn't feel confident about going against medical advice.  Reading posts from fellow users both here and on fb has been so helpful and informative - wish the NHS would point them out to new patients.  Will see what happens on Friday. Feeling very hopeful. Must remember to ask for a copy of my settings!

Settings or whatever

by piglet22 - 2023-06-27 06:23:00

I've just had half a day in resus since waking up to a thumping heart and a heart rate hitting 220-bpm.

So in a 6-month period, I can go from 37-bpm and blacking out to 220-bpm.

And still they tell me the PM is working.

UPDATE on Pacing when exercising

by Highplaces - 2023-07-04 08:48:27

Thought I'd update what happened at pacing clinic last Friday in case it helps anyone else. First the info and good news.  I have a Medtronic Attesta device fitted last September for heartblock,set to DDD mode at 50 min night-time and 60 min with upper tracking rate of 160 max the rest of the time. If I understood the technician correctly the upper limit meant it would allow the heart to go up to 160 if it was my own heart rate (intrinsic rate?).  However it seems I am now 99.6% AV paced, and the "upper sensory rate" was set at 130bpm and was what caused me to hit a wall at 130bpm and drop down to around 65bpm when climbing hills.  This upper sensory rate has now been adjusted to 150. I don't yet fully understand the difference but if it works  -Hurray!

The not so good news is that they picked up that since the middle of June I've been in Atrial Flutter at first only for a few hours a day but for the previous nine days it had been all the time.  It is not being passed to the ventricles but following an ecg a cardiologist was brought in and told me it puts me in danger of having a stroke and handed over a prescription for blood thinners and a warning it could turn into the more serios AFib and I might like(!) to consider an ablation although this could also bring on AFib later down the line. The sunshine went out of the day somewhat.  A year ago my only sympton was a reduction in exercise tolerance. Currently trying to find out more info about all of the above whilst giving myself a pep talk along the lines of don't you dare feel sorry for yourself, look how lucky you've been so far....

Thanks for the update

by Penguin - 2024-01-03 05:04:02

Hi and thank you for the update. 

Pleased to hear that the settings adjustment has helped you. 

There are quite a few posts from people considering ablations for a.fib. I can't comment personally but if you use the looking glass icon (tabs above) and search you may find quite a few posts. 

I'd also suggest that you put up a new post with your news posted here, as you will get more responses that way.  Few people will see this update otherwise. 

Best Wishes