Auto LifeStyle ?

• by DonSoule
• 2009-04-23 10:04:02
• Exercise & Sports
• 3250 views
• 6 comments

I have a Boston Scientific Altrua 60 S602 pacemaker. It's a fairly new model which received FDA approval in May of 2008 but I think it's just a rebranding of a Guidant Insignia I Ultra (model 1291) . I found a system guide for each of these online and they read almost word for word the same - the only difference I could find was the AV delay goes up to 400ms on mine and it went up to 300ms on the Guidant model. So, I'm guessing they just put out the Guidant Insignia under a new name.

I'm hoping to get my PM fine tuned for long distance running - I'm signed up for a Marathon (26.2 miles) in June but so far I can't run any more than a very slow 3 miles. I've run 5 marathon's in the past 3 years so I know what it will take to finish this distance.

I was implanted with my PM on Jan 16, 2009 for Sinus Node Dysfunction and have had two pacemaker adjustments since then but the techs I've seen including 2 different Boston Scientific Reps don't seem to know how to adjust the rate response sensors for running. I was A-paced 100% and V-paced 60% at my last pacemaker clinic check-up. At my last check-up the techs admitted that they had never worked with a runner or very active person before.

Currently they have my accelerometer sensor turned on but as soon as I start a slow jog, my HR jumps to my max rate which is now set at 150 - I may need that available for sprinting but I would like a lower rate for long distance running and only go to my max rate when I am going all out.

They did not turn on my MV sensor - did not even tell me there is one.

Since then, I've found a manual for my pacemaker online and it mentions the MV sensor is useful for long distance running.

Quoting the manual:
"To allow active patients who exercise for a long duration (e.g., long-distance runners) to maintain an adequate sensor-driven rate throughout the exercise period, the baseline (long-term average) is fixed for up to 4 hours when the sensor rate is above 50% of the programmed rate range ([LRL + MSR] / 2). For example, if the LRL is 60 ppm and the MSR is 120 ppm, the baseline average will freeze when the heart rate exceeds 90 ppm (180 / 2). After a maximum of 4 hours or when the sensor rate falls below the 50% point, baseline adaptation will be re-enabled. This feature is always active when MV is used."

There is also an "AutoLifestyle Feature" that can be turned on that will allow the pacemaker to self-adjust the accelerometer and the MV sensor to a person's activity level.

Again to quote from the manual:
"The AutoLifestyle feature will adjust the MV Response Factor and Accelerometer Response Factor to adapt the sensor-driven pacing rate to correspond with the patient's actual measured activity. The measurement of exercise intensity and frequency is determined by measuring MV and accelerometer values during patient activity."

I know a lot of people have dealt with similar problems related to the rate response accelerometer being turned on at implant and their HR going up to the max rate when they exercise. I've read about this in other post but the typical response it to just turn off the rate response feature. In my case, I feel that I need the rate response. I just want it to work correctly for running.

My questions:

1. Has anyone had an MV (minute ventilation) sensor turned on and how did it work for you?

2. Has anyone used an "Auto Lifestyle" feature and did that work?

I appreciate any comments anyone has related to these rate response topics and especially if you have experience with a Boston Scientific or Guidant Insignia and used any of these features.

Don