From 160 to 60

Hi there,
I had my PM implanted 3 month ago because a complete AV block do to a complications after a "normal" ablation. My PM is reading my normal pulse and I have a max. limitation at 160, My doc told me that in 5 month we can try to go a bit higher but I have to wait.

The problem is that I used to do lots of climbing and hiking. Now I'm starting with easy tracks and I'm getting use to all the "new-strange" feelings. One thing that's bordering me a lot is that my pulse is going up normal (up to 160) but then, if I force a bit more, is jumping down to 60-70. I thought that the PM was able to adjust the readings of my normal heart pulse (probably higher than 160 at some moment) to 160, but the think is that is going down!! Do you know if that's normal? It's possible to adjust the PM better?

Thanks and sorry again for my English (I'm from Spain)

4 Comments

very possible

by Tracey_E - 2008-11-17 04:11:29

Tell your doctor what is happening and ask him to program the pm. There are several things that can be happening, and simple reprogramming will fix all of them! A condition called chronotopic incompetence is when your atrial rate suddenly drops, then goes back up again. That does not feel good when you are exercising! Or, you could be getting your atrial rate a lot higher than 160 and the pm is deliberately putting you into a block- they do this as a safety feature intended for people with arrhythmias. I have had both of these and I felt fine as soon as they changed my settings.

I am at 170 now. It took a long time for my doctor to allow me to go that high! I also have a block, and am fairly young and active. We make our pm's work harder :o)

p.s. your English is much better than my Spanish! You are very easy to understand.

Simple

by ElectricFrank - 2008-11-18 01:11:07

The upper limit is enforced by the pacemaker skipping beats when you reach the limit. So when you reach 160 it starts dropping beats and if you force it enough it will actually do a divide by two. This is not a good situation as the cardiac output drops at a time when it is needed the most. I had this problem when mine was first implanted. The upper limit was set to a ridiculously low upper limit of 120. I'm a biomedical engineer and have built my own ECG so I hooked myself up, got on the exercise bike and verified what was happening.

My suggestion is that you keep your HR about 5-10BPM below the upper limit until you can get it set higher. I have noticed that my HR overshoots a bit when I slow down so I allow for it. I'm 78 yrs and in good shape. I have my upper limit set to 150 which is a bit high for my age. I just want it out of my way. I regulate my exercise level to keep my HR around 140 and never have a problem.

By the way I also have 100% AV block. It is one of better problems to have because we still have our natural pacer for the pacemaker to trigger from.

frank

frank

Thanks

by llobet - 2008-11-18 12:11:09

i've been talking with the doctor, and you are right. I've something on to avoid arrythmias. he told me that he wants to keep it like this for the next 5 month, and then he will switch off the option. So, I have to wait a bit and keep my upper limit below 160.

thanks

Glad it worked out for you.

by ElectricFrank - 2008-11-20 12:11:49

It sounds like a good idea. The fact something happened to your heart to affect the AV bundle makes it prudent to not push things immediately. A HR over 160 is really starting to push things.

frank

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