Exercise capability after AV node ablation

[Pingpong21]

Why am I unable to obtain a heartbeat of more than 80 BPM.I become very tired and presumed my heartbeat would be about 140 BPM!

[BobD Volunteer]

I guess it depends on what your pacemaker is set at and if the excercise demand function is activated.

[Pingpong21 in reply to BobD]

I read an article somewhere that sometimes after an AV ablation maximum BPM can be restricted to 80bpm approx but there is virtually no literature on this subject.My pacemaker is set at the lower limit of 50 BPM but I do not know if it can be set to a higher limit. The hospital cardiology department did tweak the pacemaker to give greater tolerance to exercise but it has had no definitive effect!

[CDreamer in reply to Pingpong21]

It also depends upon the type of pacemaker and it’s algorithm. Mine is adaptive and basically doesn’t let my heart rate above 120. Soon after implant it was restricted to 80 and I found that very limiting. Part of the reason is to stop you putting stress on your heart through exercise - for good reason. Next time you have a pacemaker check ask the physiologists to optimise the settings for you or if it bothers you that much then ring and ask for an appointment.

[2learn in reply to BobD]

Hi, confused by some of replies. I was told pacemakers were to stop HR going too low but did not control upper level. I have pacemaker but if in AF my HR will go up to 180.

[Buffafly in reply to 2learn]

A Pacemaker on its own does not usually affect high heart rate. To stop your rate going too high you either have to take drugs or have an AV node ablation which will allow the pacemaker to limit up and down rates.

[BobD Volunteer in reply to 2learn]

The patient has had AV node ablation so pacemaker dependent. Whatever this set at is what they have.

[2learn in reply to BobD]

Sorry Bob not what I was told. I was told only to stop low heart rate. If it could stop high heart rate it would work on AF. This was from heart consultants at Brompton.

[BobD Volunteer in reply to 2learn]

Pacemaker yes but if you have the AV node ablated then you are dependent entirely on the P. M. I have a PM to deal with the few occasions my HR drops too low. It seldom kicks in but my consultant at RBHT(Jonathan Clagaue ) wanted me to have it for safety sake. My HR can go as high as it likes at present because I have NOT had my AV node ablated.

[2learn in reply to BobD]

BobD

How would I know if I've had AV node ablated, can't find it in correspondence. I was told I was given pacemaker after open heart surgery cos HR rate only 40 and cos of covid, expense of private health care, Xmas, etc that a PM woul solve HR problem rather than extended hospital stay for heart to recover itself.

[BobD Volunteer in reply to 2learn]

You haven't. This would generally be done about six weeks after pacemaker implant after considerable discussion with your EP. Only required if you have uncontroled AF which does not respond to any other treatment. It is a last ditch treatment as you are totally dependent on your PM at all times. What you have is nothing like what has been done for pingpong. The AV node is the body's natural pacemaker so with it ablated (To ablate to cause not to exist) you need PM to survive.

[2learn in reply to BobD]

thanks BobD

[Hidden]

Through AV node ablation, the capability of your heart to function in the normal and usual way has been destroyed, with the intention to help you. With the pacemaker, your heart is on "crutches" and try to use it as such. What exercise!? With hip replacement done, would you go to play football!? Even if "21" denotes your age, the best you can do is keeping your weight low, through eating less, and enjoying very mild physical activity.

[CDreamer in reply to Hidden]

Good analogy.

[Hidden in reply to CDreamer]

Thank you, CD! Are, all of us here, actually exercise addicts...?

[Nomis21 in reply to Hidden]

I struggle to walk uphill after my av node ablation and pace fitted without getting out of breath, weakness especially in the legs, erratic beats, flutters and a feeling of chest ache and that's nearly 7 month on at 51.

[Hidden in reply to Nomis21]

Nomis, it is kinda normal to have problems when climbing the hill or the stairs, even for people with no heart problems at all. When climbing the stairs, try not to step with the whole foot on the stair, but step on it with the front part of the foot and then , when raising the body, use the thigh muscles, but also the muscles at the rear of the lower leg. This helps a great deal - I can climb to the 5th floor without pause and without grasping for the air at all. And I am 70... If I use only the thigh muscles, I have breathing problems.

[Poochmom in reply to Hidden]

that’s what I have discovered when climbing stairs. If I concentrate on using my thigh muscles it helps a ton

[Hidden in reply to Poochmom]

Hi! Have not forgotten my promise, but no positive results... My expectation was that your problem may be caused by the dysautonomia, but as far as I could see, the medicine has the right answer - they even know the structure of these small chaps. This problem was unknown to me, but it actually exists and is well known to the DRs. Regards! P.

[BobD Volunteer in reply to Hidden]

Once upon a time maybe.

[Pingpong21 in reply to Hidden]

Thank you for the information. I am due to visit hospital next Saturday for a check on the functionality of my pacemaker, as a small batch of a certain product of monitors that I use appear to be at fault! Will ask a few questions that this discussion has brought to my attention.It appears that my original synopsis of taking things easy and enjoying life is the correct way forward. Always a hard decision for a former marathon runner and international sportsman.

[Hidden in reply to Pingpong21]

As a young, I was an exercise addict myself (now 70, after 20, I reduced the load, but continued exercising) and achieved 2 things - 1. A very "strong" heart for my small body (72 kg only); 2. Disturbed electronics of the heart, resulting in arrhythmia. At 60, I understood that I was wrong exercising that much, so stopped it completely. Nothing bad happened, I did not gain the weight because I was feeding carefully - exactly what I advised to you, I did not loose my ability to work or anything else. It is a very good thing, to be realistic and to know when to stop. Wishing you all the best! Peter

[Pingpong21 in reply to Hidden]

Sound advice, although my cardiologist has suggested in the past that I exercise in moderation to a tolerable level, as an echocardiogram test showed I had a slightly below normal ventricular output and the exercise should be beneficial.

[BobD Volunteer in reply to Pingpong21]

Always remember you must be able to exercise and talk at the same time.

[Jajarunner]

I was told after a pace and ablate the pacemaker has maximum of 80. I've tried to find out more but to no avail.

[Pingpong21]

Went to the cardiac department for a check on my pacemaker and I was informed that it will be replaced in the next few weeks as a fault had been detected in a small batch of the same make.When I explained that I was feeling exhausted after exercise my pacemaker settings were adjusted to a minimum rate of 70 BPM instead of 50BPM. Two months ago another person stated it should remain at 50 when I explained similar symptoms. Can anyone explain why two (experts) have different opinions!

I have a slightly below normal cardiac dysfunction. Does the increase in my minimum heart rate put a greater strain on my heart?

[Eastwick]

I have a pacemaker and also av node ablated. My heart rate can go up to 130 when walking very quickly. It is set at a lower rate of 60pm but goes up and down depending on what I am doing. Sometimes when swimming it will be around 110.