First Data Dump Today

I had my first interrogation today (8 weeks post-placement). I have a secondary AV block. Low end is set at 60; high end is set at 140. Dual lead pacer. It is DDD ( I valildated that today). The tech said lowering the 60 setting wouldn't save any battery power and said that if my heart rate was over 140 (from exercise which I do a lot) it wouldn't matter. This doesn't sound right to me from some of the comments I have read here. Battery life right now is predicted to be about 6 years. And, when I am really working hard aerobically, I am feeling slightly light headed. Thoughts? If something wasn't working right would it have shown up in the data dump today? She said everything was working fine. And, overall, I feel really good. And, it seemed that the tech has zero authority to change any settings. It would have to be the cardiologist orders. Correct?

3 Comments

My first as well

by realkarl - 2010-01-20 10:01:01

I have a biventricular pacer, with three leads. It's only been 9 days since my implant, but they did a data dump and minor adjustments today to Paced and Sensed AV Delay, based on the recommendations for optimal settings from the St Jude programming device. "They" consisted of a pacer-doc (or tech, not sure) and a rep from St Jude, since my device is a new model. It was interesting to see histograms detailing average heart rates, and daily graphs showing how much I exercised (measured as time spent in elevated heart rate zones).

Mine is set to DDD mode as well, lower limit 60, upper 170. It's pacing 98.5% of the time, since I need the Cardiac Resync Therapy pacing both ventricles (due to my LBBB). The leads were placed really well, and they estimated a little over 7 years lifetime based on the little data collected so far. I have a Merlin@home monitor that checks the basic function nightly, and a bigger data dump every month.

Settings

by ElectricFrank - 2010-01-21 12:01:03

The tech is wrong about the effect of your lower and upper limits. The lower limit sets how low your HR can go when you aren't active. With someone who is in good shape it isn't uncommon to have your HR drop below 60 particularly during sleep. Having your HR forced to 60 at these times can affect how well you sleep and the battery use is directly related to your average HR.

The upper limit is actually called the Upper Tracking Limit. With second degree block you may have natural pacing part of the time, but require pacing the rest. During the times when you are pacing naturally the upper limit has no effect since the pacer has no way to withhold beats. However, when you are being paced the pacemaker enforces the upper tracking limit by skipping beats. It is likely that this is what is causing your slightly light headed feeling during aerobic exercise. If you try to push past the 140 limit your heart starts skipping beats at a time when your body needs the blood flow. It is not only uncomfortable, but I have never felt good about it. Not only is your body getting shot changed, but so is your heart.

There are two things that you can do about it. If your heart is otherwise OK, and your age supports it the limit could be turned up to 150 at least. If not then use a HR monitor to keep your HR under 140. In fact I've found that I need to target at least 5 bpm under my limit, because there seems to be an overshoot when I stop.

You are right about the cardiologist needing to OK the changes. You may have to put some pressure on him to do it. Mine was was originally set to an upper of 120, which was terrible. Even a brisk walk into the wind would create chaos. I finally wrote the cardiologist a letter that he would either move me up to 140 and then to 150 or I would find another one who was willing. They also had my lower set to 70 and I told them I wanted it down to 55. I'm 79 yrs by the way so my numbers will be lower than yours. The change made all the difference.

Hope this helps,

frank

Rate response!

by Hot Heart - 2010-01-24 02:01:47

Hi firstly is your rate response on or off? I felt not so good with mine switched off, great with it on.


Ive got 3rd degree hb, fit 56year old fem, had no idea id got any problem. Think my settings are the same as yours, do a bit of hill walking, walking on treadmill but no running, 140 is adequate for me, but if you are into more aerobic exercise perhaps it should be highered.

I asked about my lower level being turned down a bit to conserve battery, doc said, as yours did, that it wouldnt make any difference. In fact thinking about it logically, if our heart doesnt go below our low level then we arent really using the battery, set it lower, we will go below it more and will probably use more battery!

HH

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