Running and Settings, low Max HR

I received my first PM (Boston Scientific Altua 60) Jan 16th 2009.

My story: I've continued running but been overly tired in general for the past few years. My Dr ran a lot of blood tests but couldn't find anything wrong except for High Blood Pressure and a Low Pulse usually in low 40's at Dr visits. He kept me off any medications that might lower my pulse since it was already low.

I went for a blood pressure/ cholesterol check up with my GP on Dec 19th and ended up being sent on to see a cardiologist.. My GP wanted the cardiologist opinion on my slow heart rate and some feelings of almost passing out I've been having lately. When the nurse took my pulse it was 35 and then my Dr got 37 and he did a EKG which showed a 32. The cardiologist said they can easily increase my heart rate by putting in a pacemaker but wasn't sure that was the cause of my almost blacking out. He gave me an "event monitor" to wear for a month so they could get readings from my heart when I have a near blackout incident.

When I called in and did the playback over the phone of my last 5 readings, the tech said it was "very interesting" and he was surprised I hadn't passed out - he said he wasn't a Dr but asked if someone was with me and he expected I would be going into the hospital. A nurse from the Minnesota Heart Clinic called me and moved an appointment up to the next morning.

I went to see another cardiologist at the Minnesota Heart Clinic on Jan 16th at 7:45 AM and he was sure I needed the pacemaker due to my slowing heart rate (about 20 on some readings) and especially the 5+ second pauses I was having quite often. So sent me immediately to the Hospital for check-in. They did the procedure at about 1:30 PM that day. So now my heart beats at a regular rate of 60. The PM is set at 60/130.

I found this site when I got out of the hospital and have been reading a lot of good information but have a few questions. I have been running for the past 3 years 5K's - Marathons. Slow, but completed 5 marathons in the past 2 years. I will go in for my first follow-up next week with a PM tech and a nurse practitioner, my first cardiologist visit will be in 3 months. Based on what I've seen especially from running related posts, I will need to talk to them about modifying the settings - possibly turning off the rate response setting and lowering the 60 and raising the 130.

Can someone explain the rate response feature? Will that make my heat rate go higher than it did before and could that be a good thing or is it only for someone whose heart rate didn't go up at all?

Does anyone have any opinions on what I should try and get changed so that when I start running again I won't have too many problems? In my case, pre-PM according to my Polar HR monitor I had a fairly low Max HR - Has anyone dealt with that and what that might mean to the settings I need? I usually showed a low around 40 before I started running and then in my 5K's and Marathon's even with a sprint at the end, it only got up to the 120's - looking back at the readings I could find for races I had one with a high in the 130's but the rest were lower. I did a echo-treadmill stress test about 2 yrs ago and I had to run a long time and about as hard as I've ever run to get it up to the 135 they said I needed to hit.

I was wondering if the rate response setting will get me up to the 130 max setting faster and cause problems? If I have them raise the max to 160 or 170 with the rate response left on is there a chance I will be able to run at a faster pace with a higher heart rate?

As far as lowering the low from 60, what would be the advantage of that? Longer battery life?

I appreciate any comments you can give me?

Thanks,
Don


9 Comments

diagnosis

by Tracey_E - 2009-01-24 02:01:46

Low heart rate is a symptom, did they tell you what's causing it?

If you have an av block, then your atrial rate is fairly normal, you just need help so the ventricle keeps up. In that case, you may need your upper rate raised. Many of us have it higher than the standard 130 they send us home with because our atrial rate gets higher than that when we work out.

If your problem is atrial, then rate response may help you. Rate response is when the pm senses movement and raises your hr. If your atria won't go up high enough on its own, then this will get it up higher. If you have a block and your atrial rate (the body's natural pacemaker) is normal, then rr may compete with your own hr and make it harder to work out.

Have you tried walking yet? It's probably a bit early to run but if you start easy you should be able to get some light aerobic exercise now. I wouldn't worry about the numbers just yet- both your settings and target hr- just try a light workout and see how you feel. It may be that your settings are fine as they are.

Some people don't like the low setting as high as 60 because it feels too fast but many of us are fine with it. If your problem is a block then the lower limit is irrelevant, the upper limit is what matters most. How much impact lowering it has on your battery life depends on how much you use it more so than what the setting is, but battery life, imo, is not a reason to mess with the settings. The right setting for you is where you feel best and what is safe for you, not what will make the battery last longer.

No Diagnosis

by DonSoule - 2009-01-24 04:01:04

TraceyE Thanks for the information - they didn't give me a diagnosis such as AV block - the Cardiologist just said there were multiple pauses and I needed a pacemaker - he was very brief - I'll be sure to ask at my follow up. I'll do some walking on my treadmill before the follow up and see how I feel on a fast walk and if my polar HRM chest strap still works with the pacemaker - I've read here that people have had problems getting a HRM reading due to the pacemaker signals.

hrm

by Tracey_E - 2009-01-24 05:01:05

I've never been able to get a hrm to work with a pm but others have so you may still be able to use it. I finally got a ring version from Brookstone that works ok. Not great, but none of the others worked at all and beggars can't be choosers. :o)

Pauses are a good reason to get a pm! If you skip a beat, the pm will make one, fairly straightforward. If the pm is just filling in missed beats (tho a hr of 20 is a LOT of missed beats!), that doesn't sound like an atrial problem or a block.

Holter Moniter

by BillMFl - 2009-01-24 07:01:42

Works with a pm but what a pain in the butt to wear one. I have several times and hated it. You are such a smarty Tracey! I'm gonna shut up and let you and Frank do the talking. :)

holter

by Tracey_E - 2009-01-24 09:01:08

yeah, holters are annoying! They're for diagnostict purposes and definitely work with a pm. We were talking about the heart rate monitors that you buy at a sporting goods store to wear when working out. A lot of them either dn't get a reading at all, or don't get an accurate reading with pm's.

ahhhhhh

by BillMFl - 2009-01-24 11:01:27

me so stooopid sumtimes

haha ya but

by BillMFl - 2009-01-25 08:01:38

My wife would want one with a remote control and on/off switch. :)

me so stooopid sumtimes

by ElectricFrank - 2009-01-25 12:01:24

Maybe a brain pacemaker? That's what my wife used to tell me I needed.

frank

USB Port

by ElectricFrank - 2009-01-26 11:01:54

Better yet a USP port so she could download her agenda for the day! On second thought she could also check into what we are thinking!!

You know you're wired when...

The mortgage on your device is more than your house.

Member Quotes

I had a pacemaker when I was 11. I never once thought I wasn't a 'normal kid' nor was I ever treated differently because of it. I could do everything all my friends were doing; I just happened to have a battery attached to my heart to help it work.