Questions to ask

Good Day, All.

Next month I will have my 2nd annual in person PM check at the EP Lab. I have AV heart block and had fainting since a teen. Some VT pauses lead to a PM in May 2022. I have a genetic family history of sudden cardiac death (etiology unknown despite testing). I have a Biotronik Edora 8 DRT.

My question. I receive periodic device monitor reports, the last one being 42 pages long. SInce I will have the chance to speak with the EP TECH and my cardiologist, live - are there any basic questions that you all generally ask during the appointment? I am thinking more in terms of generic technical questions about the tracings - the reported fractions, pacing or whatever.  I know this is a bit of a loaded question related to one's own medical issue but thought I'd put it out there ahead of time so I have time to research ahead of appointment. I am in the medical field as a scientist but my career nor education have not been remotely related to cardiology although I have always had an interest. Thank You in advance.


3 Comments

Some questions

by Gemita - 2024-05-05 12:01:38

Skigrl, there are lots of “potential” questions to ask at an annual follow up, depends what is most important to you?  For example are you able to exercise and exert yourself as you wish, or do you feel your pacemaker is holding you back?  If so, you could ask what more could be done with your settings to help you to achieve your daily exercise goals?  You could also ask one or more of the following:-

1.  Could you please confirm whether there have been any recorded events during the year, like atrial or ventricular high rate arrhythmia episodes, signs of any bradycardia or pausing from irregular heart beats for the cause of any continuing syncope? 

2.  Could you confirm the percentage time I have been paced in each chamber, for example right atrium, right ventricle?

3.  Could you please confirm that the battery and leads are both within normal limits and are functioning satisfactorily?

4.  Could you confirm if we need to make any adjustments to the settings?   If so,  what changes and why?

Before seeing your Cardiologist/Electrophysiologist, it might be helpful to keep diary notes of any difficult symptoms you experience, giving dates and times when you notice these occurring.  Correlation of your symptoms with a pacemaker stored ECG report would be priceless.  You should report symptoms like:-

dizziness or lightheadedness, fainting or loss of consciousness, palpitations, breathlessness, slow or fast heart rates, chest pain, poor exercise tolerance, noticeable twitching of muscles in the chest or abdomen, frequent hiccups 

Your pacemaker downloads can then be checked to see whether your doctor can identify the problem?  Don’t minimise symptoms if they are really troublesome.

You could take additional evidence with you to any appointment from any home monitoring:  e.g. copies of ECGs from self monitoring, blood pressure/heart rate readings, oxygen levels, during symptomatic periods. 

As you have the print out of all your settings, you could ask about these if there is something that is concerning you?  I find if we have done our homework and ask some relevant questions, our doctors/technicians will be more than willing to engage with us.  Good luck

questions to be concerned with or not

by new to pace.... - 2024-05-05 12:05:02

My way of thinking is if i am feeling fine.  No questions to ask.  I ask for the quarterly transmissions.  At that point can see how things are going.  Most of the time everything seems ok.  I do have the occasional A-Fib or Vt but nothing really jumps out.

new to pace

Questions to ask

by skigrl3 - 2024-05-06 22:38:03

Thanks so much for your responses.

Gemita, I do like your questions esp #1 and #2. I will definitely inquire. I have been feeling pretty good since I got the PM almost 2 years ago so fortunately symptoms have been relatively few.

To your point, new to pace -  I think because I feel so much better since I got the pm, I had relatively little to ask at my 1st checkup. This year, I will do some research on Gemita's questions and ask away at my appointment.

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