More settings questions

I have never been advised to any upper limit settings. I know that my PM is set at 50 so my heart doesn't go below that...but that's about all I know.

I am confused because other people are asking about upper settings. Are their different PM'ers that have low settings and high? And perhaps that I just have a model that only has lower settings?

What happens when a person gets to their high setting number? Say if your high setting is set at 130 and you hit 130...what does the PM do for you? I always thought the PM helped you not go below a specific BPM but couldn't do anything if the BMP got really high....

It may seem like a silly question....sorry if it is.

Thanks,
Wendy

4 Comments

not silly

by Tracey_E - 2010-01-10 08:01:07

Limits are confusing! All pm's have both an upper and a lower limit but they're not always relevant to everyone. You pace so little that your upper limit is probably irrelevant.

If your heart goes faster than the upper limit on its own, the pm will just sit back and watch, it can't prevent it and it doesn't hurt anything.

In my case, my atrial rate is perfectly normal but my ventricles never get the message to beat so every ventricular beat is generated by the pm. The pm can only pace as high as my upper limit. So, if my atrial rate goes to 150 but I'm set for 130, I'll be skipping beats and feel yucky.

PM Settings

by SMITTY - 2010-01-10 09:01:43

Hi Wendy,


Hi Wendy,

All pacemakers have a high and low setting and these settings are adjustable. In my case when I got my PM it had a low setting of 80 and a high setting of 120. What that meant was when my heart rate dropped below 80 (which would have been all time) the pacemaker went to work and gave me a minimum HR of 80. The PM continued to help maintain a steady HR rate until my HR reached 120. The PM then took itself out of the picture, except it would continue to monitor my heart function and in case its help was needed it would again step in. Over the years the low setting has been from a low of 45 to a high of 80, depending on what the doctor was trying to accomplish.

You can find out from the person that does your checkups what the settings are but I expect you will need to ask the doctor why he chose those for you.

Smitty

Upper limit

by ElectricFrank - 2010-01-10 10:01:59

Unless you have some condition that causes your atrial rate to go too high, which would then send that rate on to your ventricles, there is no reason to have an upper limit. Since most pacers don't have a way to turn off the upper rate the only way to get it out of the way is to set it to a high enough value that it is never reached.

As an example in my case the upper tracking limit is set to 150. At nearly 80yrs I'm not likely to hit it. I've heard of younger folks having theirs set as high as 200-220.

Be happy you don't hit it. Like Tracey says it feels yucky.

frank

Upper rate limits

by pacemaker writer - 2010-01-11 12:01:15

If you have a dual-chamber pacemaker (atria and ventricles are paced) the device is set up so that your ventricles will be paced in sync with your natural atrial rate as long as your natural atrial rate is fast enough.

This is a good thing because it assures that you get one atrial beat for every one ventricular beat ("AV synchrony").

But what if your natural atrial rate is high? Well, to a certain point, the pacemaker will try to keep up. For instance, if your atria are beating naturally at a rate of 100 beats a minute, the pacemaker will pace the ventricles at 100 bpm just to "keep up."

But what if your natural atria rate gets very high, say 180 bpm? That does not happen to everybody, but there are some people who are prone to it. In order to keep the pacemaker from trying to pace the ventricles at 180 bpm, an "upper rate limit" is set.

If the upper rate limit is 120 bpm, as soon as your natural atrial rate goes over 120, the pacemaker paces the ventricles at 120 bpm (at the limit). This causes a loss of AV synchrony (you will start to have more atrial beats than ventricular beats). The pacemaker then goes into what the manual would call "upper rate behavior."

Upper rate behaviors are ways the pacemaker is set up so that your atria--which are going very fast--do not really interfere with ventricular pacing which is essential for your heart's pumping ability.

There are actually 2 upper rate limits: a maximum tracking limit (max track)--which is what I described here--and a maximum sensor limit, which means that if you have a rate-responsive pacemaker there is an upper rate beyond which the pacemaker will not pace you, no matter how hard you exercise.

If you are not prone to natural high atrial rates and aren't doing extreme sports, you may never use these limits. They're mainly in place to protect you from being paced at very high rates.

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