Frank Analysis

Frank- this is primarily for you (but anyone else that can interpret the settings, feel free to comment). After getting my new ventricular lead 3 days ago, I mentioned that I was still feeling skips and that one reason I called with a problem was the large number I was having during exercise. Below are the changes made. Can you explain them and give me any idea of what to look for once I resume normal activity? I haven't noticed any skips since I've been home but do occasionally feel jumpy in the chest (for lack of a better description) but detect no skips or irregularities.

Under Intrinsic/AV:
Paced AV changed from 170ms to 240ms
Sensed AV changed from 170 ms to 200ms
Search AV+ On
Max Increase to AV 110ms
Rate Adaptive AV changed from Off to On
Maximum Offset -40ms
Under Atrial Lead:
Sensitivity changed from .5 to 1.00
Sensitivity Assurance changed from On to Off
Under Ventricular Lead:
Amplitude changed from 2.5 to 2.25
Sensitivity changed from 2.0 to 4.0

Thanks in advance for your Frank analysis.

Harry

4 Comments

Settings

by ElectricFrank - 2011-06-06 01:06:33

Harry,
Since this is the first programming session since getting the pacer the new settings are likely just replacing the default ones that are in a new pacer with more appropriate settings for you. Its not uncommon to have some funny beats with those default settings.

Give it a try for a few days and see what happens. I don't see anything unusual in the settings so they aren't trying to fix something.

Another thing I've wondered about is the effect of screwing the leads into the heart wall. It could irritate the location for a short time and create arrythmias. I've never seen anything on this. It's just one of my guesses.

good luck on it all, and keep us posted,

frank



Arrhythmias

by Sue H. - 2011-06-06 09:06:09

After my pacer implant, I had a lot of bouts with atrial fibrillation and Drs went right to the "drug cure"...beta blockers.

Well I didn't take them and started internet searching and somewhere I read, I think on Medtronic's site in an obscure posting under news releases where it said that some patients will experience abnormal rhythms after an implant because of the leads attaching to the heart and heart becomes irritated. But after time, the heart settles down and a-fibs or other abnormal beats become less and less.

Good luck and keep us posted on how you feel.

Sue

Frank & Magster

by Creaky - 2011-06-06 10:06:51

Frank- You're probably right, but just to clarify my situation. My PM was implanted Sept '10; the default settings were adjusted after 6 weeks, in Nov '10; I had a good winter skiing and snowshoeing but in late April became lightheaded on a walk. That's when they discovered I had an "early lead failure". They tried to do a work around by making the lead unipolar but that didn't work. The lead was replaced last Thursday June 2nd. I assumed, and the printout pretty much confirmed, that they kept the November settings not the default. I was having skip beats before being discharged so the nurse made these new adjustments, and they do seem to be working.
Sue- I think you're right as well. I've felt pretty jittery, but each day seems to be improving.
Thanks to you both for the response.
Harry

More

by ElectricFrank - 2011-06-07 12:06:46

I missed it that this wasn't a new pacer. Must be old age sneaking up on me.

The irritation issue from lead attachments that Sue and I mentioned sounds more like it since you did have one lead replaced. Re-reading your earlier post I notice that the EP couldn't remove your bad lead. Again I'm guessing, but that makes me wonder if they didn't try to remove it before giving up. If so They likely did some tugging and pulling to try to get it out, which would also create irritation.

So, bottom line is give it a few weeks to settle down.

Sue, thanks for the info on this one. Always good to have a confirmation of my weird ideas. LOL

frank

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I had a pacemaker when I was 11. I never once thought I wasn't a 'normal kid' nor was I ever treated differently because of it. I could do everything all my friends were doing; I just happened to have a battery attached to my heart to help it work.