New Pacemaker

What's happening?

by AgentX86 - 2024-04-22 13:15:37

A 2:1 block means that only half of the beats are getting through to the ventricles.  You now have a pacemaker that short circuits the block, so your heart beats normally.  However, since your max tracking rate is set to 130, exceeding this will cause the pacemaker to go back to a 2:1 block (it would do the same with a complete block), to keep the heartbeat under the max tracking rate. I think this is the  brick wall that you're running (sorry, NPI) into.  When you see your cardiologist/EP, press them to increase this to 150/160, or whatever he will.  You may have to lobby for much of a raise, or he may want to wait and see.

Your rate jumping doing something minor indicates to me that you also have rate response (RR) turned on.  It's sensitivity may be set way too high.  This is something that may take some work to get right. 

RR can be off either too high or too low (on many dimensions) and you'll feel like crap.  You have to find the Goldilocks point.  It might take a bit. 

A good device tech is critical here.  A good one, or factory rep, is usually better than your doctor at getting this set up for you. What's good for others has nothing to do with what's good or you.  That's why there are so many RR settings. Get to know your device tech.  Make appointments with the same one each time. It's an art and requires a high level of communication.

new pacemaker

by light - 2024-04-22 16:44:21

Tonight within 10 strides of a jog heartrate was 130  It is as if pacemaker is not pacing when jogging.  However walking up 45degree gradient under load heart rate stays at 90

Heart rate

by AgentX86 - 2024-04-22 17:24:24

This makes sense.  You don't have information about your pacemaker in your profile (it helps us), but it sure sounds like poorly adjusted (out of the box, or worse) rate response.

If your heart no longer regulates its rate (chronotropic incontenence), the pacemaker's rate response feature is used.  It could also be that you don't need rate response and it's been mistakenly turned on. If this is the case, have it turned off.  Your doctors should know this (it should be in your records).

The heart naturally uses the rise of CO2 in the blood stream to increase heart rate. Pacemakers can't do this, so (almost all) rely on motion to extrapolate the body's motion, thus oxygen needs.  You can see where this could easily be fooled (think car going down a bumpy road). The motion sensor is looking for foot-falls, really.

When you start running, your pacemaker says "oh, he needs a lot of oxygen!" beat-beat-beat-beat.  OTOH, when you're climbing stairs, you slow down.  Even though you really need more oxygen, your pacemaker doesn't think so, and you get beat-----beat-----beat-----beat.

Your pacemaker's settings have to be changed so the rate doesn't take off so fast, has a slower ramp, and the highest rate (tracking rate) adjusted.  Then there is a time it takes to decide that you really are resting, after exertion, before it slows the heart back to its resting rate.  These all have to be optimized for your lifestyle. Unfortunaltely, it will likely never be perfect and you'll have to make tradeoffs.  Stairs, and lifting/carrying heavy loads, just don't work for me.  By the time I get to the top of a flight or two of stairs, I'm gasping for air.  Pushing a wheelbarrow or hand truck, up even a moderate hill, is almost impossible. I couple of months ago I had my pacemaker set to try to make these activities easier.  Just walking from one end of the house to the other was miserable.  My pacemaker just took off running (too fast is as bad or worse than too slow). I made an appointment for a couple of days later to try something else. After a few tries, I just went back to what I had.

This part of pacemaker adjustment should be under your direction.  Your medical team shouldn't have a lot of input here (other than tracking rate). It's a quality of life thing. Only you can tell how you feel.

Pacing

by light - 2024-04-23 04:42:38

Walked a mile this morning as fast as I could (faster than jog) heart rate averaged 85-98 never above even though at an oxygen defecit. Climbing stairs rate rises only slightly. Putting on clothes this morning heartrate 95.  I can push wheelbarrows heartrate 100. Trying to get data for 6 week check.

Update

by light - 2024-04-23 05:02:51

Decided to try jogging around house this morning also. Started slowly heartrate rose to 120 but I concentrated on keeping going and sustained heartrate 120 -127 without having to stop. Maybe as another member said one needs to let pacemaker learn. I will try some sustained jogging tonight.

Good for you!

by Lavender - 2024-04-23 12:51:21

I can just envision you running around, using a wheelbarrow, making an obstacle course to test out your new bionic heart! 😆

Love your can-do attitude! You will be able to coach your pacemaker team on which settings will best serve you! 🤜🏻🤛🏻

new pacemaker

by light - 2024-04-23 15:54:47

Yes take the positive the pacemaker gave me back my life. For sure no more weights ( a risk)

However positive another door opens  back to running and how best to get pacemaker working

Half full folks never half empty.

By the way I care for two horses so have to use wheelbarrow everyday full of poop probably worse than an obstacle course!!