Crossing my PM upper limit of 145

@ted3
It sounds like your device has the exercise mode turned on. That mode will react to movement and raise your pulsing rate up. You mentioned that as goes up just walking.

About a year ago a pace tech wanted to turn my on after hearing how much I exercise. She turned it on after never having it on after almost 20 years . I found like you I did not like the feeling my heart being paced higher from just getting up or walking much less higher exercise. I asked them to turn if off and they agreed.

I do Sprint Triathlons. My heart does respond to the need for more oxygen and blood on it's own. My pluse rate though will not go below 70 as that is the resting pulse it is set at. If I did not have it at 70 it would go into 30s at rest because of medication I take.

Have you ever had a stress test after you had your device implanted? If now would discuss one with your cardiologist. Have them turn off the exercise mode and how you heart does without the exercise mode. Does it respond to exercise on it's own?

My heart (and everyone heart is different) and cardiovascular system on the stress test reacted the way it should during by raising my PR and BP up as my exertion got higher without the exercise mode turned on. I was on a 17 minute test and completed the 17 minutes.

I am a heart failure patient (cardiomyopathy caused not cardiovascular caused) and have had a ICD/Pacemaker since 2006. I do water aerobics 8 times a week, swim a mile twice a week, and ride my bike 20 miles twice a week. I do not need my exercise mode turned on and I do notice my pulse rate go up with exercise but also note that it goes down to my resting pulse rate quickly after exercise to 70 bpm where it is set at.

Thank you! I've reached out to Mayo to see if they could check my PM sooner than my June 4 appointment. When I see the Cardiac Device Team I will definitely mention the Exercise Option. At this time I have two primary concerns: 1) my heart rate exceeds the upper limit after just 1/10th of a mile while "running" slowly; and 2) my heart rate stays elevated (90 and above) for up to two hours after exercising even while sitting. Interestingly, I can get it to slow down by simply lying down. I do have a stress test scheduled scheduled at the end of June. However, it's related to my heart's "plumbing" (a different issue). But I will bring that up with the Cardiac Device Team because a stress test sounds like a good way to fine tune my PM's settings on the fly. It could save a lot back and forth wasted time. Thanks for sharing your experience and keep on with your exercising!

Can someone explain what exactly is the exercise mode? I have a Boston Scientific pacemaker and I was told there’s a motion sensor (also known as an accelerometer) and a breathing sensor (also called a minute ventilation sensor).

Both of those are turned on on my device, but after reading your comments I’m beginning to wonder if they should be.
Would really appreciate knowing what exactly is the exercise mode. The people at Boston Scientific never used that term.

@jackiet
I have a Boston Scientific ICD/Pacemaker also.
Some of the newer models have different ways to monitor your motion which signals your device you are moving and need a higher pulsing rate. That pulsing rate can be regulated to how it responds to the movement. You also mentioned breathing sensor. That is also a new type of monitoring.

What the exercise mode is to assist you with increase in exertion like exercising. Your heart and cardiovascular system needs higher rate of pulse rate when you exercise to supply addtional blood and oxygen to your body.

Depending on your specific case your heart may need to be pulsed higher for when you exercise if it does not do so on it's own. The exercise mode is designed to bring that to you by increasing your pulsing, Do you have a EP or pace clinic where you got our Pacemaker? The exercise mode can be turned off or set to what is best for you and how it responds by by your EP or pace clinic.

For me and others you have read on post is that I don't like the artificial pacing of my heart under the exercise mode. Mine would start increased pulsing with just standing up or walking. It was a quick increase and did not like that. They said could increase the thereshold of when it would increase pulsing but I had them turn it off.

My pulmonary stress tests revealed for me that my cardiovascular system on it's own was reacting to increase in my exercise by raising my pulse rate and increasing BP. Now my heart would beat in the 30s because of medications so I don't get a huge pulse rate increase above my resting pacing of 70 bpm.

Talk to our EP or pace clinic. Also you can go on Boston Scientific and put in your model and can get a full volume of information on your device. You can also send Boston Scientifc (make sure you give them your model number) a message about questions you have and they will answer them.

Thanks, jc76. I have talked to Boston Scientific at some length and they never used the term exercise mode. I’m trying to get my terms right. I will call them back and ask them if the exercise mode is what they call the motion sensor or the breathing sensor. I suspect it is the latter. Both of these are turned on in my pacemaker. The ep and I have been making changes in the settings.

So now I’m thinking maybe I should shut one of them off and see if I feel better. I also have my pacing set to 70 and 150.

These devices are super complicated and not easy to figure out. Unfortunately I had this pm inserted four years ago and only recently learned that the settings could be changed for better results.

@jackiet
I have had one since 2006. I am still learning what they record, do and can do.

Like you I did not know my device even had an exercise mode until 2023. When the pace tech was setting me up to get a MRI. She mentioned exercise mode could help with my exercising as saw I was avid exerciser. I did not think anything about it until 2 days later got God awful fast and powerful pacing of my heart. Then happened again days later and got shocked.

The only thing different was the exercise mode turned on. I asked them to turn off. They wanted to try a lower reaction to movement saying mine set to high response. I said no I don't want it on as I had no problem exercising prior to it being turned on.

I had my present one (on 3rd) in 2018. I have read and was told by Mayo Pace Clinic that newer ones have a breathing monitor (like yours) which more reflects exercise where you are breathing faster and deeper versus just moving. My exercise mode pushed my heart rate up dramatically from just standing up as was recorded by my tech doing office check.

Not a medical person but my heart is paced at 70 bpm and does not go below that. It also has the same 150 you have. I think the heart being continously paced at 70 bpm and then exercise mode kick in sensing motion, and then my heart reacting normally to increase movement was confusing my device and reason I got shocked.

My settings are almost always changed each time do an office visit. They are always changing this electrical pulse strength, or monitoring, or changins sensing. I have been told I have noise on my wires in atrial area and my device thinks it is AFIB. But it is not it is the devive picking up noise (electrical) from the wires (my wires are very old all the way back to 2006). They tell me the device is being too sensitive and they adjust what it sensitivity setting are.

Thanks, jc76. Your exercise mode is what they call breathing sensor on my device. Unlike you I only have a PM, not an ICD. Not that I even know what that means.

When I was at the ep last time they set the breathing mode to 16 (the highest rzte), then he walked me around the office to see how I felt with that setting. Felt exhausted. So then they set it back to 10 (where it had been), we walked around, and I felt better.

Next time I’m going to ask him to set it back further to see if it makes a difference in everyday functioning, as the walk around the office doesn’t always yield the best ideas. Then might even consider having it turned off. Fortunately this ep is willing to see me once a month till we can hopefully get me straightened out.

Yet there are so many other variables to deal with on this device. I find that what I’ve been doing is calling Boston Scientific every time I get a new piece of info ( like what you just told me about turning off your exercise mode) and throwing out a new question at them.

It’s all I can do. I would like this PM to work at optimum level.

Thanks again for your input.

@jackiet
ICD stands for Implantable Cardiac Defiberlator.

When you EF gets to 30 they usually recommend a ICD. When mine got to 30 I went to Mayo Jacksonville for second opinion. The EP there agreed with the ICD but also wanted to implant a dual device of ICD/Pacemaker. The pacemaker was to help with pacing of my heart as I had LBBB and electrical problems like PVCs. That was in 2006 and have had the same EP since then and on my 3rd ICD/Pacemaker.

It really sounds like you have a very good EP and is working with you on this. That makes all the world of difference.
Good luck!!