Pacemaker for Cyclist (Outdoor Cycling)

recommendations

by Tracey_E - 2024-08-17 15:51:03

Boston is an excellent choice for cyclists.

Number one recommendation would be to make sure you have a doctor with other athletes with Boston, someone who is used to active patients and knows the ins and outs of your device. 

A stress test, on a bike or treadmill, can be a very useful tool to get the settings fine tuned, yes. 

I don't have minute ventilation so have no personal experience, but I have my rate response (St Judes accelerometer) set very sensitive so it gets me up quickly. The downside of that is it also gets me up quickly when I get up and walk across the room. I choose to live with that annoyance in order to not have a lag time when I start working out. You'll have to see what works best for you, but yes for some of us it ends up being a compromise and there is no perfect setting that works in all instances. It's normal to take a few tries to see what is going to work best for you. 

Boston Sci devices producing rapid HR via MV from small movements?

by crustyg - 2024-08-17 18:53:16

Hi:

I've not read anything about this, and it set me wondering where this might have come from.  My understanding of MV is that it's inherently *insensitive* to short-term changes in chest impedance (which is what is measured to detect breathing rate and breathing depth => BR*BD=MV) due to the lag in detecting a difference between short-term MV and the longer term, underlying MV.  It's the difference between the two that feeds into RR => increase in HR.  Being blunt, I don't think that what you describe (donning clothing, turning over in bed) raises HR via Minute Ventilation.  Accelerometer, absolutely yes, MV, no.

A good MV tuning session for cycling should be done on a static bike, and you'll need your EP-tech and, ideally, BostonSci rep for guidance and it will take about an hour.  They should use ZIP telemetry, and ideally perform a manually initiated calibration of MV after each PM adjustment, for two reasons: i) the manual warns that MV is disabled for a while after each PM programming, and b) I know from personal experience that this is so - attended a programming session on bike, forgot to ask for manual calibration and cycled home uphill into a headwind with no RR support, which was no fun.  MV calibration can take some hours if not manually initiated in a quiet state, otherwise normally 1-2min.  You will probably accomplish 4 or 5 'runs' on the bike at various levels of effort to get the MV settings right over an hour.

You want MV set to a high response factor (at least 12, perhaps 14) with a vent threshold response of 70% with a threshold of perhaps 120BPM: you need to get your HR well above 90BPM even with easy cycling to avoid having long-term MV baseline increase over a long ride in a peloton (there will be no delta left after a couple of hours => no RR for the climbs home.  The 70% response avoids you just going straight to maxHR and staying there, but for a solo ride that's what you want.  Fitness level: Athletic.

Your bio doesn't give your age but you probably can tolerate a maxHR of 160-170BPM if your coronaries and heart muscle are healthy.  Make sure that your EP-doc gives you a sesible maxHR a few weeks after implantation (you won't get it at first while your leads bed in).  If you're in your 60s or older, you'll need maximum charm to get that sort of maxHR unless your EP-doc already some some senior athletes with PMs.

Hope that helps.

Update

by PeteL - 2024-10-02 18:11:31

I had my pacemaker (Boston Scientific Accolade) implanted on 9/30/24.  I am 67 and don't have any non-electrical problems with my heart.  Initial settings are min of 50 max of 160.  I have a visit in a week to remove bandages etc.  I have been told - no cycling for 6-8 weeks to ensure the leads bed in.  Did a 4 mile walk with my dog this morning that finished with a steep hill.  In general, I was pleased with how I felt.  Going up the hill I did notice a lag between when I started to breath harder and when my HR increased beyond what it had been.  I suspect some lag is normal.  Pre pacemaker I could barely get my HR above 100 regardless of how hard I was going on a bike.  Today it peaked at 96 which seemed reasonable.  Thanks to everyone for their input.