Doctors Lounge - Cardiology Answers
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Forum Name: Cardiology Treatment Modalities
Question: Dual Chamber Pace Maker
|ElaineK5 - Mon Mar 31, 2008 11:40 pm|
I am a personal trainer with a new client who has a dual chamber pace maker. When I put her on a bike for 3 minutes to watch her heart rate it went from 90 to 192. Most of my unfit beginners will only go to about 120 doing this same test. Her respiration was fine and she felt fine. I sent her for physician’s approval before working with her. Her doctor said “obviously this trainer has never worked with anyone with a dual chamber pace maker before”. He also went on to say that it was perfectly normal for her heart rate to be that high until she becomes more fit.
This goes against everything I have learned as a trainer. I want to tell this client to get a second opinion, but want to make sure my thinking is sound. I have done some research on the web, but have found nothing specific enough.
thanks for your help.
|Dr. A. Madia - Fri Apr 04, 2008 3:41 am|
Hi Elaine K,
What is the age of your client? Because in younger patients the upper heart rate set IS in the range of 170-190 so as to enable them to carry out vigorous physical activity. Dual chmbar pacing is all about this variable heart rate as against the older single chamber pace maker where heart rate cannot go beyond a fixed ventricular rate set in the pacemaker.
When a person exercises, the physiological mechanism will cause the sinus rate in the atria to rise. In dual chamber pace maker the lead in the atria will sense this and allow the ventricular lead to stimulate the ventricle at this rate subject to the upper limit programmed in the device.
I hope this is helpful.
|ElaineK5 - Sat Apr 05, 2008 1:53 am|
Thanks for your response.
My client is 47 years old. The trouble is that she was not exerting herself at the time that her HR went up to 191. She had only been riding the bike on 0 resistance for 3 minutes -- she wasn't even breathing hard.
|Dr. A. Madia - Sat Apr 05, 2008 7:13 am|
In that case your client does need her pacemaker to be checked by an electrophysiologist.
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