HR Limits

My ICD upper limit is set at 190 bpm. If I accidentally go over by 20 or 30, will it automatically pace or fire? Or does it intervene only if it senses an abnormal rhythm, (i.e RV tach)?

5 Comments

limits

by thomast - 2008-03-29 05:03:36

Mine is set a lot different, if it exceeds 130 it looks for abnormal rhythm, if it detects it it trys to step it down, will try 6 times, if it does not succeed it does nothing just waits, if it goes back to normal OK, if it exceeds 150 then I get zapped. Had an episode in Feb. where it suceeded in 3 trys, had an episode in Nov. where it tried 6 times and failed, but returned to normal after 2 minutes. So everybodys settings are different.

limit

by WDC6736 - 2008-03-30 09:03:39

Thanks, I'm going to see if the doc can up my limits just in case.

recent advice

by mo-dixie - 2008-03-30 12:03:53

Mine is set for 136 to detect and 188 to shock. I have 5 series of pacing bursts before I get the 35 j therapy.
On a visit in Feb. to Mayo clinic, when advised I needed to begin exercising to help my HF, I asked about the possibility of raising my heart rate and getting smacked. I asked the very question you are, does the ICD detect only VT or VF high PPM or just start therapy if heart rate enters above the threshold. He said that the device only recognizes when the heart rate has reached the threshold area, not if it is abnormal rhythm. That did it for me---I didn't want to start trotting on a treadmill anyway. He said I needed to get a personal moniter to detect heart rate, start slowly and watch to me sure I did not go above threshold area. I am still thinking about it. I know in the past, I had used a treadmill that detected heartbeat and would back off when it reached 120. When it gets warmer I may get a moniter and begin some slow strolling and try to build up endurance. Hope this answers your question.
Love and light,
Mo-Dixie

limit

by Pacedsince1983 - 2008-04-03 09:04:36

I had an exercise test yesterday which showed that as soon as i hit my upper limit (165) i was automatically knocked down to 145. At this point A/V synchronization also stopped. So this shows that with my programming (Guidant Vitality) i can push to the limit, but that i cannot keep up the exercise level as (a) the device does not let me stay at the required rate level and (b) there is no synchronization between the chambers.

rates

by WDC6736 - 2008-04-05 01:04:20

My EP actually has it set at 222. I suppose that's good but I know I'm capable of 230 safely in a stress test. All athletes are different, especially elite athletes. I lasted around 23 min. and quit because I thought I'd gone far enough. I don't know too much about what triggers a RV tach during exercise, but I'd like the doctor to give me an extra 8 bpm for peace of mind. However, an EP Study induced VT at 262 , so I'm not sure if he will cooperate. Otherwise I'm still afraid to try anything, even with a HR monitor. Before the ICD, I could be cruising at 150 or 160 and then it could rise for a brief second over 200 before settling back down to "the right zone." Once I even saw something as insane as 243. And this is just a 1-2 second spike that would quickly drop usually after slowing the pacea bit. I read some elite athltes can train around 200, but they probably don't have an abnormal ECG or an ICD to worry about. Most of the time, my HR would only shoot up only at the start of a race or 10k tempo run @ 5:00-6:00/mile, and as I warmed up, it would actually decrease to about 170- 190 as I ran faster. As expected it wouldn't begin to increase again until the very end. Very often, running slower raised my HR more so than running faster.

Still paranoid that I could easily reach my upper limit and subsequently be paced, reducing my performance, or shocked unnecessarily. But who knows? Maybe this brief spike I occasionally see on my Garmin IS from the RV tach, but if that's the case, I ran competitively almost 8 years without a problem...until one day a couple months ago. Doc doesn't want me on the road again, but I plan to negotiate my extra 8 bpm to match my tested MHR. Not saying I want to gamble with my life, but it would be nice if I didn't have to worry about zapped if I ever do return to sport.

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