after pm implant..strong pulse rise and poor shape

Hello, I am 46 years old and have got one month ago my responsive ELA pacemaker with two leads, after having a complete block (to say, I have an history of successful aortic valve replacement, four years ago; and the appearance of a partial block was also identified with ergometric exercises about two years ago). The implantation procedure was Ok as well as the pacemaker test itself. However, I have a distinct problem with my physical shape. I am much weaker as compared with the pre-block and surgery period, becoming quickly exhausted in a walking. Walking with a small elevation is a problem for me. Sometimes, even a smallest physical effort may result in an unexpected jump of pulse which makes me completely un-functioning (without any problems with the blood pressure). To go up to the third floor, it is a problem too because I begin to feel a distinct heart disorder. Sometimes, just talking by phone a long time may make me a feeling of exhaustion (looks like, I should make breaks in speaking). Pacer was reprogrammed three times, yet, in the meantime, it does not look like that I can run or even go fast. Doctors claim that everything is great, and I should come three months later for the next check. For me, it looks like not great at all. So, is it possible that I have just to be adapted? If the re-programming is claimed Ok, should I expect the distinct improvement at the next 10 min, one hour or on the morning? My mechanic valve looks like Ok, as well as no problems with lungs were found. Thanks for any ideas and recommendations


ask again

by Tracey_E - 2008-07-17 07:07:38

It can take more than three tries to get the programming right, don't let them brush you off. You should not feel worse than before you got it! Try expressing it to them in percentages. I can only do 30% now of what I could do before the pm, etc.

You can also ask them to do a stress test and get you on the pm's computer at the same time. I had some problems recently and this is what it took to diagnose what was going on. I had been reprogrammed three times and had a regular stress test, and I was still unable to do the same workout I could easily do a month before. They redid the stress test with the pacer's computer hooked up and almost immediately they saw the problem. Actually, it was three small separate problems, that's why none of the settings they tried before had worked. It still took a couple of tries to get the settings just right, but at least we knew what we were dealing with.

Rate response?

by bambi - 2008-07-17 12:07:44

Hi Mikhail,
Tracey makes some good suggestions especially about talking about your symptoms and activity level in percentages. Dr.'s seem to tune into that. I would add however, that only one month out from pacemaker surgery, is not very much time for everything to settle down. You are still recovering from the surgery itself, and your heart has been traumatized as well as beating differently now. I would certainly share your symptoms and concerns with your Dr. [ or the tech who interrogates your device], and state that while you are thrilled that the pacemaker looks fine, how you feel is another story! To me, this should take top priority. It's unfortunate that it rarely does! You really have to be a "squeaky wheel" to get results. I experienced the same symptoms as you, for the first 2-3 years of adjusting to my pacemaker. As a ballet teacher who teaches and fully demonstrates 20 classes per week, I never got the rate increase I needed quickly enough. The same thing would happen when I went up any inclines during my daily walks. Once my rate response was turned on, and my upper limit was set higher, all symptoms disappeared. Tracey is right-- it can take many tries to get the settings that fit your unique needs. Just don't give up. If your Dr. treats you as a "problem patient", find another one ASAP! Good luck!

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