Questions about settings.

Hello all. I'm almost 4 weeks po with second pm (first one removed after about 10 weeks due to pocket infection) and notice different data on device reports.
Does anyone know what "Accelerometer" means? On my first pm device report is said "on" and on my second device it says "on passive".
The atrial lead sensitivity on first pm was .25mV and second pm is .75mV.
How about the Max tracking and max sensor rate? Set at 140 first pm and 130 second pm.
I don't understand how the % paced numbers could be so different with me. My first pm was A paced 65% V paced 5%. My second pm is A paced 95% and V paced 99%. Is this something the device tech sets?
Lastly, presenting rhythm is A paced with V sensed at 50 bpm on my first pm but V paced at 65 bpm on the second pm. My lower rate is set at 50. I don't understand why V is paced at 65 on my second pm.
My first appt with "device clinic" isn't until November. Can anyone help me decipher some of this??
Many thanks.
Minnesota



6 Comments

Definitely NOT a multiple...

by donr - 2013-09-24 10:09:58

...choice quiz!

Accelerometer: A device that detects acceleration (Well, Duh!). It is part of the Rate Response system. When your body goes from being still to moving, it accelerates - just like your car when you step on the gas (W/the engine running & the transmission in gear, of course). If your body changes speeds, either increases or decreases, the accelerometer senses that & tells your PM about the change in velocity of your body. Needless to say, this device is highly sensitive, since your body does not undergo very high accelerations.

The RR device is NOT on unless it is turned on. The accelerometer still senses the accelerations of your body, but nothing is done w/ the data. I assume that when it said "On passive," that meant the same as just plain "On." Someone else may have other knowledge on that.

Atrial sensitivity: A measure of how much voltage must be present in your heart due to its native functioning before the sensing function of the PM reacts to it. Any voltage less than that & the PM will generate its own contraction pulse. Above that voltage, it is inhibited because the heart will function on its own. These numbers can be changed by the cardio.

Max Tracking & Max Sensor Rates: Another variable that can be changed by your cardio. Your cardio set them the same. One of them is the point at which the PM STOPS pacing the ventricles because to continue would mean the PM is trying to make them go faster than is practical for your conditions & the PM just monitors the HR. The second one is the point at which the PM goes into a 2:1 pacing mode, where it sends a pacing signal to the ventricles for every other beat to ensure that the body gets oxygen, At the upper level, the heart may go into V-Tach & this helps it to not do so.

Pacing %'s. This is REPORTED DATA, NOT something that can be controlled by the PM. Sorta an "It is what it is" thing. It is not really unusual for the pacing %'s to change. perhaps there was a change in your electrical malfunction between the two PM's.

Last sentence about pacing %'s makes no sense, so I'll have to guess!

I think you are mixing up %'s w/ HR's. The lower rate is a given in Beats per Minute - that's 50 BPM. It is paced at that rate 65% of the time.

Hope this helps - if not, return for more details.

Don

Recovery time

by donr - 2013-09-25 01:09:13

Jennie: You have never given your age, but you have two components working against your recovery.

First is pure inactivity & infection over a long period of time. That wil be there whether you had a PM planted or not. It's just the price you pay for inactivity. This one is age-related - the older you are, the longer it takes to recover. F'rinstance, I'm 77. My cardio told me that I could plan on 4 days recovery for every day I spent essentially bed-ridden after a surgery. That guidance has proven to be correct. If you are younger, it will not take as long, but plan on TIME & resumed activity to get over this aspect.

Second is the PM & its settings. Sounds like you may well have some if what PacerRep says is correct. These will disappear as soon as they are modified, leaving you w/ the issues in the First part.

No matter what the PM does for/to you, remember that YOU JUST GOT CUT OPEN - A BUNCH OF TIMES - & HAD AN INFECTION, TO BOOT!

Don

In the interest of science I will divulge my age... But only to you Don.

by Minnesota - 2013-09-25 01:09:25

56 but don't tell anyone. Your comment "You just got cut open!" is a mantra of mine. I keep reminding myself to give it time. I do believe a bit of tweaking is in order as well. I will report back after my appt Friday. You keep adding your 2 cents. It is greatly appreciated!
Jennie

Running late for work

by PacerRep - 2013-09-25 10:09:00

Quick answers...sorry. DonR got most of it for ya

Passive is not the same as on. On is On, passive is "monitor". The sensor writes down what it would have done but does nothing.

Max Tracking rate is the rate at which the device will follow your own rhythm at a 1:1 ratio. After this rate if your heart is going faster it will enter a wenckebach tracking and once it reaches your TARP point (don't worry about what it is) it will go into a 2:1

Max Sensor rate is the rate at which your own pacemaker will drive your rate too with the rate response feature.

It sounds like your AVD is set to short on your device, which is why your V-pacing went up. Atrial pacing just is what it is based off of lower rate.



Aha moment?

by Minnesota - 2013-09-25 11:09:27

Hey Donr and Pacer Rep! Just the two guys I was fishing for! Thanks for the replies. I knew you would enlighten me!
I have very limited experience with the 2 PMs in such a short time, but I can tell something is different with the new pm settings. I have some obvious shortness of breath and light headedness with minimal exertion - doing small tasks. Never felt that first time around. Although I lost 3 months worth of fitness my gut tells me this is PM oriented - not physical fitness. Maybe my AVD setting is to blame? Or is there another setting that could be the culprit? I know this is complicated - but it is such a drastic difference. I have to believe some setting is to blame.
will take all the info you supplied and be better able to explain my issues to doc.
As always, you guys have my unending appreciation. Love getting replies.
Minnesota

I won't tell...

by donr - 2013-09-26 01:09:28

...anyone. Dangerous to tell an old fogey like me your age - I might start calling you "Kiddo."

Promise you will not tell anyone that I had a medical epiphany after having my belly sliced open & a bunch of guts removed. I kept thinking I should be recovering faster than I was, which was abominably slow. I just was not getting anywhere (in my opinion) . Then our cardio sprinkled pixie dust on me & gave me those same words of wisdom. That was on about 15 June. It was not until about 1 Sept that I SUDDENLY started feeling better & being able to function. Now I can feel improvement nearly every day.

It's tough to accept the fact that you do not heal as fast at 56 or 77 as you did as a teenager. We have to force ourselves to remember that at that point in our lives, we were going to live forever & we were indestructible. Unfortunately, that is NOT true.

For a little sobering thought & a nostalgic memory of those days, Google on "Those Were The Days, My Friend," a song by Mary Hopkin from sometime in the 60's or 70's (I think).

Don

You know you're wired when...

You read consumer reports before upgrading to a new model.

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