atrial overdrive

So, does anyone have experience or knowledge about atrial overdrive programing? I have had a pacer for 14-years (second one) and have been in afib/ flutter for a loong time. I have recently developed central apnea along with insomnia. Been to the sleep study, blah, blah. But I have been told about this reprograming to my good ole' pacer that may help. Read up a little and it sounds scary. Well, here I am after a long absence .....

3 Comments

Atrial overdrive

by golden_snitch - 2014-07-15 03:07:30

Hi!

Atrial overdrive is not possible when you are in atrial fibrillation. The pacemaker would have to stimulate atrially at rates higher than 400bpm to overdrive the Afib, and that's just not possible. It can overdrive atrial tachy and flutter that runs at atrial rates up to around 200-240 bpm, or probably a bit more, but all pacers have a maximum rate at which they can stimulate, and that rate is too slow to overdrive Afib. Also, if your Afib is already permanent, chances that you can simply overdrive it or stop it by cardioversion, are rather low, unfortunately.

Atrial overdrive is not scary at all. I mean, when it kicks in your heart is already beating fast, so it simply goes a little bit higher than the rate of the arrhythmia, and then slowly the rate is reduced. Works in some patients, but not in all.

Medtronic and some other manufacturers also offer a feature called "atrial preference pacing" (Medtronic) or something like that. If switched on, the pacemaker will always pace you in the atria a little faster than your own (intrinsic) rhythm is going. Thereby, atrial tachy-arrhythmia episodes are supposed to be reduced, because the intrinsic rhythm doesn't get a chance to get going, it's always overdriven by the pacemaker. Again, works in some patients, but not in all. But if you are in Afib all the time, this feature will definitely not work for you.

Inga

thanks

by painthorse - 2014-07-15 09:07:29

I think I kinda thought that would be the case, but I wanted to ask anyway. I am waiting to get a second opinion sleep study for this central apnea. I'll be seeing my pacer doc later today and I am now prepared.
Hope all is well.
pat

Central apneas

by Minnesota - 2014-07-24 09:07:31

Hi Pat. I have a PM for Bradycardia. I also experience central apneas at night. They are very alarming. 2 sleep studies failed to explain but ruled out sleep apnea. I am interested in what you find out about your case. I am hoping it might help me.
Jennie

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