Pacemaker and Polar Fitness tracker

Heart rate

by AgentX86 - 2024-05-31 13:49:44

Since you don't have rate response turned on, whatever is happening is all you, unless that 17% AP comes when you're exercising. I'd think that if your heart dropped out, the pacemaker would keep a constant rate but it may go back to its minimum.  That you'd have to find in the literature on that PM, but it doesn't seem to be your problem (rate continues to rise).

I think it has to be measurement related.  The way to tell is to count it manually, then compare that to the machine.  What technology do these devices use.  Are they all electrical, or are some pulse-ox. This would make a difference. If they're all electrical, maybe throw a pule-ox (finger) reading in there too.  Pulse-ox meters can be had for about $10. They're useful to have around, in any case.

Even different EKG style monitors can get thrown off by the pacing spikes, and abnormal EKGs (like we end to have). Unless you have some arrhythmias, a pulse-ox meter might work well.  A finger to the carotid will be more accurate than any, though. 

Tracker

by piglet22 - 2024-06-01 05:51:26

Hello 

One of the things that you start to take more interest in once you have a pacemaker, is going to be measurements like your heart rate.

I've noticed over years of measuring and monitoring that simple devices like finger oximeters are at best an indication.

The pulse part of the device is the least reliable but it should be a reasonable guide if something else is going on.

A lot depends on the way the device is programmed and that will include averaging and noise reduction.

What muddies the waters is defining pulse rate if arrhythmia is going on in the background.

I'll stick my neck out and say that a pulse has to be something that significantly moves blood.

In that case, a palpable pulse by say radial pulse with fingers is the best, but not very convenient.

The closest instrument in a domestic situation to fingers is the blood pressure monitor, but if arrhythmia is significant, even that will throw up errors.

When I asked my GP about this, she could only recommend the chest strap type, despite the widespread use of battery powered oximeters in the surgery.

I'm hoping to get something like the Azure device sometime soon and hopefully a phone application to go with it.

Seeing how that performs will be top of the list.

Piglet and Agent - Thanks!

by Andiek11 - 2024-06-01 09:37:09

Interesting and helpful tidbits from you both that have me thinking.....  

I know that my EKG these days will alway look different because of the PM (activation pulses, etc.) showing up.  And perhaps that's contributing to my heart rate monitor watch's confusing output.  The devise may be sensing the PM activation pulses in addition to actual heart beats which could confuse its output.  In addition the way I understand tracking, is that (for me) when my heart rate goes above 130,(my upper tracking limit), the unit pauses and my "natural rythm" - LBBB and all - takes over.  So some of the confusing output I'm seeing is because the watch is one minute showing me a "control" rate with PM activated and the next it is sensing my natural rate (with the LBBB).  Hmmmm.... lots of fun things to track and consider.

Appreciate the dialogue!

Pulse oximiter or BP measurment

by AgentX86 - 2024-06-01 15:10:15

The problem with measuring the pule in the radial artery is that often PVC pulses are completely missed, and sometimes can't even be felt. I suggested this because it makes a third vote (two is worse than one), particularly if the other two are EKG measurements. A pulse oximiter should not be trusted for heart rate if there are any arrhythmias (pO2 readings and BP are fine).

To get an accurate count, either the carotid or femoral arteries should be used.  They're large enough that the PVC won't be lost. The PVC doesn't help push blood but it does count for HR. Pacemakers count them as a beats.

I see my rate overshoot, too, and there is no tracking. It's all RR. Confusing.

Oximiters are used in surgery because the blood oxygen is important. Pulse is taken off an EKG style instrument (with the, usually single lead) EKG showing on the monitor, just like Grey's Anatomy. 😁

Oximeter

by piglet22 - 2024-06-02 05:06:29

Interestingly, I'm looking at an erratic oximeter at 09:00 with BPM dipping to between 40 and 50.

I was feeling under the weather yesterday and and went to bed early.

It can only mean one thing, I forgot the Bisoprolol last night.

So it has proved it's worth, though I didn't need it to tell me all was not well.

It will stay in the toolki. Any ideas on how to remember the pills? I've tried everything.

Edit 

It just got worse, I didn't take any of the pills last night. I must have dropped off.

Piglet22- Med Reminders

by Andiek11 - 2024-06-02 11:51:43

As for med reminder, I set-up a reminder on my phone that uses a unique, annoying tone.  When I was taking 2 meds, I had set-up morning and evening reminders each with their own tones.  Since I aways have my phone at hand, this has worked for me - provided when the alarm goes off, I take my pill right then (or I hit "snooze" where I'll get another reminder 10 min later).  I find it funny that even now with only one prescription med (I have always taken a fist-full of various supplements), if I didn't have the reminder, I'd forget to take probably about 80% of the time.  

And if you have money you want to toss about, there are home, pill distribution machines that talk to you when it is time to take you pills.  You load up the machine once a week or so.  

And Closest to the truth about Optical HR Sessors and PMs

by Andiek11 - 2024-06-02 12:39:15

The info below is from Garmin but I'm going to extrapolate this statement for Polar - the product I have. I think this sums up the situation.  The meaningfulness of the data we see on our HR watches now, is not as great as it had been pre-PM.  (NOTE: HR straps are a different in that most of those are not optical sensors)

"Pacemakers or ICD should not impact the accuracy of Garmin Optical Heart sensor, but we cannot guarantee the accuracy of the heart rate data from our Optical Heart Rate Sensor if you have a pacemaker or ICD or other heart condition. Watches that use  Heart Rate Variability (HRV) may not be able to accurately calculate that data or related metrics if you have a pacemaker, ICD, or other heart condition."

Polar H10

by blocker44 - 2024-06-03 09:08:33

I have seen good results with the Polar H10 chest strap when I exercise. I wear it a bit lower and off to the right on my body for it to work properly. I think it is very accurate because when I begin my routine on an eliptical my heart rate will get to 140 bpm and remain at 139-140 bpm for the duration on my 30 minute workout at 9.0 METS. In the cooldown my heart rate goes to 125 bpm and goes to normal levels after my workout. The measurements on my Fitbit Versa are quite different. The upper setpoint on my Medtronic Azure is set at 140 bpm. I also have LBBB after getting a TAVR last year. I am at DDDR with rate reponse turned on. It did take about a year, four EP's and 12 visits to the device clinic to get my rate response set properly.

Blocker44

by Andiek11 - 2024-06-04 16:31:04

Thanks for the lead on Polar H10.  Not looking to spend more money (again), but if necessary at least I'll know the direction to explore.  Also sent you a private message with some questions about RR.