Running after surgery

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Lesneski

New member
Joined
Aug 15, 2019
Messages
2
Hey all! I’m new to the site. I had a failed TAVR with subsequent replacement. I ended up with endocarditis and had a repeat replacement last Sept. After my last open heart, I developed complete heart block and had to have a pacemaker inserted (mine is epicardial due to DVT). I then also developed a fib and had to start beta blockers. I’m an avid runner and I’m having a lot of difficulty getting my stamina back. I was previously running between 10-15 miles a day and now can barely run 3. My cardiologist keeps telling me that I should just be happy that I can run at all but I’m truly frustrated that I’m not able to increase my activity. He told me it could be from either th beta blocker or the pacemaker but that I can’t change medications and the pacemaker is permanent. Any advice on what I can do to try and increase my physical stamina?
 

Duffey

Me and Granbon
Joined
Sep 29, 2004
Messages
5,122
Location
Far side of the moon
If I understand correctly, you’ve undergone three valve replacements, the first via TAVR, a second when the TAVR was unsuccessful, and a third after endocarditis? How long since your last replacement? There’s a heart forum dedicated to helping members regain their previous level of physical fitness following heart attacks, valve replacement, etc. It was called cardiacathletes but the name may have changed. Several VR members belong to it too so hopefully they’ll be able to offer more help. Please keep us updated on your progress.
 

btlRickas01

Member
Joined
May 2, 2015
Messages
6
Location
Chicago western suburbs
Hey all! I’m new to the site. I had a failed TAVR with subsequent replacement. I ended up with endocarditis and had a repeat replacement last Sept. After my last open heart, I developed complete heart block and had to have a pacemaker inserted (mine is epicardial due to DVT). I then also developed a fib and had to start beta blockers. I’m an avid runner and I’m having a lot of difficulty getting my stamina back. I was previously running between 10-15 miles a day and now can barely run 3. My cardiologist keeps telling me that I should just be happy that I can run at all but I’m truly frustrated that I’m not able to increase my activity. He told me it could be from either th beta blocker or the pacemaker but that I can’t change medications and the pacemaker is permanent. Any advice on what I can do to try and increase my physical stamina?
It sounds like you've had a rough trip. I had my AV replaced and ascending aneurysm repaired four years ago. Before that I started running at age 50 because of my heart condition and never looked back. I'm nowhere near your level but I try to maintain a 9-15 mile week. I had problems getting my stamina back partly due to meds and trepidation on my part and I'm sure age plays a factor as well (I'm 63).

I'd say your cardiologist is partly correct in that you should be happy you're running, but if your cardiologist isn't more supportive then I would certainly be in the market for a replacement. I'm on probably the lowest level of meds the doctor is comfortable with and I feel like they don't affect my stamina or performance. I had trouble just getting the cardiac rehab people to let me run, but I was in fairly tough shape yet. They did have me on a treadmill running before I left. It took me weeks to be able to get back up to 3 miles and I was constantly watching my HR.

I've heard of the cardiacathletes before but never looked into them. They seem to be based in England but probably have groups throughout the world. It might be worth your while for you can talk to some of these more seasoned athletes, even if it is just long distance.

I'm sure you'll get your stamina back just be careful the first year. Get your meds adjusted if practical. The last thing a cardiac runner needs are meds to slow their metabolism, if you're like me your resting HR is probably in the 40s. Good luck with your recovery.
 

DachsieMom

Well-known member
Joined
Mar 3, 2015
Messages
274
Location
CT
I don’t have a pacemaker and am no longer on a beta blocker, but it does slow your heart rate. Hopefully you can build up slowly to where you were.
 

vitdoc

Well-known member
Joined
Apr 16, 2017
Messages
48
Location
Southern Ca.
I have had there open hearts the last being a new ascending aorta and replaced aortic valve. I developed 3rd degree heart block and also needed a pacer. The pacer followed my normal rhythm. Later I got Afib. The pacer recognized the Afib which in my case was very rapid. I then went into a paced rhythm that was varied via motion sensors in the pacer. The sensitivity of the motion sensors can be adjusted to allow for fairly rapid heart rates with motion. My guess in your case is the Afib is not too rapid with the beta blocker and when you run your heart rate may be too slow. I bicycled and literally had to bounce around to get my rate up. With running pacers usually respond much better to the jerky motion. Talk to the cardiologist to see if you would function better with a pacer derived rhythm rather than following your Afib.
 

vitdoc

Well-known member
Joined
Apr 16, 2017
Messages
48
Location
Southern Ca.
I forgot about one other issue with pacers and 3rd degree block. Normally the electric impulse is initiated in the SA node and travels to the ventricles via a right and left bundle so that the right and left side of the heart get stimulated nearly simultaneously. With typical pacer placement in most people a wire is placed JUST in the right ventricle and the left ventricle gets stimulated by signals that travel from the right ventricle. Hence there is more asynchrony between the right and left ventricle contractions. In people in heart failure two leads are placed one in the right and one in the left to achieve better synchrony and better cardiac output. BUT even for those of us who are not in overt failure two leads work better than one. Currently the standard is not to use two leads in non failure patients even though two work better than one right sided lead. A number of years ago I convinced my electrophysiologist to place a left sided lead in my heart. My cardiac output went up about 20% with the left sided lead! And I was not in overt failure with an output that went from 45% to 55%. I am not sure why using dual leads is not more widespread. It may be that the left lead is usually placed by electrophysiologists rather than the average cardiologist due to the increased technical ability needed. So these are the dirty secrets of the pacer world.
 
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