motion detector and adaptive is crap

I had my pacemaker in 2006. I was pacing 1% of the time but now I am completely dependent on it. The adaptive algorithm that medtronics has implemented is very crappy and needs to be removed since it creating more problems than it is fixing.
Medtronics should really abide by KISS in this case.
What is ever worse is the implementation of the motion sensor that kept me up all night. Every time I toss and turn in bed at night it brings my plus up. I had the creature feature turned off.
Now the adaptive is bothering me. It looks like I have to replace the pace maker. One thing for sure it is not going to be medtronics.

3 Comments

Adaptive

by ElectricFrank - 2009-09-06 01:09:20

Before you get too upset with the pacer let's check on the settings.

First off, what is your condition that requires the pacer? The mode you are talking about is called Rate Response. It is only needed if you have sinus (atrial) pacing problems. If you don't need it then it should be turned off. This would be true if you have AV block (or heart block as it is sometimes called). The mode is usually designated as DDD mode. In this mode the pacemaker senses the atrial beat and uses it to time the ventricular beat. It is very simple and effective.

If Rate Response (DDDR mode) is needed because you don't have a reliable atrial rate, then there are a number of adjustments that can be programmed to try to approximate your needs. The problem here isn't the pacemaker, It is the settings. The most common problem with a newly implanted pacer is that they left it set to the factory default settings. These are chosen to keep almost anyone alive, but are far from optimum. The other problem is that most cardiologists are not very good at making these adjustments. I have found the Medtronic reps are the best. You may have to ask to have a session with one.

Bottom line is that the Medtronic (or any modern pacemaker) doesn't have one adaptive algorithm. It has settings for upper and lower, rate of increase, rate of decay, etc. I see you are a software engineer so you will understand what I am saying.

I do both software and hardware and early on built my own ECG with a frequency response high enough to see the pacing activity. I finally specified the settings I wanted for my Medtronics Kappa 701 and things have been great ever since.

Drop me PM if you have any technical questions.

frank

Agree with Frank

by golden_snitch - 2009-09-06 02:09:34

Hi!

Frank is right: you should first try to find out if you really need the rate response, and in case you do, several adjustments can be made. There are a couple of possibilities, and it might take some time - and a patient cardio/pm tech - to figure out what's best for you.
To give you one example, there is a setting that defines your level of activity: it says something like "very low", "low", "moderate", "high" etc. Now when it's set "low" or even "very low", the rate will increase much faster because this setting is meant to be for patients who are not in a good shape, don't have much endurance. When you are not well trained, you need this faster increase of the heart rate. But if you are active, running etc. it should be set at "moderate" or "high", and if it is the rate won't go up that fast. I have had lots of problems with this feature as everytime I would just go to the supermarket etc. my heart rate went up to about 140bpm. I have had it changed to "high level of activity", and now it's just fine.

I have always had a dual-sensor rate-response so I don't really know how it feels to have the so-called accelerometer (motion detector) only. I have an accelerometer plus a minute ventilation detector, and I can either have both switched on, or the accelerometer or the minute ventilation alone. And then there is a range of settings for those sensors. So just in case you keep being dissatisfied with your rate response, you might at your next regular pacer change ask for a pacer that has two sensors.

How come you are now up to 100% pacing when you had only 1% when the pacer was implanted? That sounds strange. I mean, heart blocks can get more frequent as time passes by but from 1% up to 100% is pretty big increase.

Best wishes,
Inga

Suggestion

by ElectricFrank - 2009-09-07 01:09:38

The way I handled the RR initially was to test its sensitivity by "Twiddling" the pacer under my skin with my thumb and index finger. I could quickly drive my HR up to the limit. I showed that to the cardiologist and Medtronic rep. I told them that I must be in terrible shape for that to get my heart racing. They got a good laugh out of it.

It's quiet on the forum tonight. I guess everyone is taking advantage of the long holiday. Being retired I stay home and do my travels on week days.

frank

You know you're wired when...

You have rhythm.

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