how does PM know you're exercising

I have complete block at av node, resting HR of 33, no other cardiac conditions. I play BB and run. Dr. says this is the easiest condition to correct w/ a PM., all the PM does is complete the circuit.
My question is, when my HR increases during exercise, is it the atria telling the PM to speed up and how much to speed up, or is the PM "deciding" how much to increase the HR.? As I understand, the atria is trying to tell the ventricle how fast to beat, but the signal doesn't get through. If all the PM does is complete the circuit, can the HR still be controlled by the the atria?
Thank you

3 Comments

rate response in pacers

by golden_snitch - 2009-08-03 01:08:38

hi there!

if you are very active, you should get a pacer that works has a dual-sensor rate response. that means in addition to the accelerometer, it has a minute ventilation sensor (some have a so-called QT-sensor in addition, but it's not that good). The accelerometer is quite good in reacting when you need a faster rate suddenly. however, when you ride your bike for a while, go running etc., the accelerometer can't guarantee the steady rate you need, and that's what the minute ventilation can do.

yes, if you have a working sinus node function and "only" the permanent heart block, the heart rate can be controlled by the atria, and then pacer will just complete the circuit. however, whenever the pacer "feels" that the rate is not fast enough, it will kick in. can happen even though you have a normal sinus node function, but generally the pacer is "on demand" and only kicks in when you really need it.

if you have a say in what pacer model to get: i have a sorin group reply dr, and it works great. i actually chose it myself, and all the doctors said it was the perfect choice. it has a very good rate response.

all the best,
inga

PM with an AV block

by E from Spain - 2009-08-03 05:08:26

Hi,

I have a complete AV block. I’m using a dual chamber pacer (Medtronic kappa) and I have no problems when exercising (running, climbing, kayaking…). The PM follows the atria rhythm. I have a normal pulse of 50 and the PM is on demand. If for any reason my heart goes under 45 (my lower limit) the PM starts pacing. Otherwise, the PM follows, on demand, with an upper limit of 180 bpm.

I don’t need to play the Tarzan or anything. The PM follows the rhythm of the heart.

Enjoy your PM,

HR Increase

by SMITTY - 2009-08-03 12:08:21


Hello DW,

If your heart rate increases with exercise that probably you have the rate response feature turned on. The PM has and accelerometer which detects body movement and after a few seconds will it increase the heart rate. The length of time it waits to increase the heart rate and the maximum amount of increase the PM will give is adjustable.

To check this feature without exercise gently tap your pacemaker or play Tarzan on your chest and this should increase your heart rate. Also, hen you start to climb stairs, you can use the Tarzan game to kick up your heart rate before you start up the stairs. That can reduce the SOB we some times see after climbing stairs.

Smitty.

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