Lower limit of pacemaker

Hi,

I was googling around and found a link referring to the article by Frank in the Pulse - Winter 2012. Got confused about dates and commented/asked a question and it was in February! Could be that is why I don't see my comment, even under my postings?

Anyhow, if it comes up, please excuse, but I really did want to know the answer.

Here is my comment/question:

Lower limits
Comment posted by judy13 on 2012-06-01 18:49.
Frank,

Thanks for that report. How do you find a doctor to work with you though? I just had a frustrating pacer check where the guy would not even give me a copy of the report when I asked for it. I know they can just run them off or use a copy machine.

Your comments about setting it on a treadmill is something I have always thought should be done, and never has with me. I gather from your comments that if your heart rate wants to be higher than what is set that the pacer and your natural rhythm interfere with each other creating a type of arrhythmia on its own and making one uncomfortable?

Anyhow, I had a question about the lower rate. The pacer report from the remote one they did explains the histogram and gives the number of events in each rate range. My lower limit is set to 60, but I have some 30,000 events lower than 60 (24,000 lower than 50 so we are not talking "almost 60"). This is not a lot in the scheme of things, I understand, but the way I thought pacers worked it should be virtually zero events lower than 60 (I understand why I get them higher than the upper limit). This is a Medtronic Versa like you have and what I am looking at is the "Long Term A-V Conduction Histogram Report"

Thanks for your help!

Judy

10 Comments

reports

by judy13 - 2012-06-01 11:06:08

I am able to get the reports from medical records for the ones that I do remotely. So far I have not been able to get the reports from medical records when I go in. Maybe they throw them away!

LOWER LIMIT

by SUPERSALE - 2012-06-01 11:06:27

if your doctor won't give you the report talk to the nurse they might give it to you

i never ask my doctor for the report all i do go online doctor give me user name password i find all my reports there

talk to pasemaker tech nurse to check it they might give it to you

REPORT

by SUPERSALE - 2012-06-01 11:06:59


SOMETHING DOCTOR TRY TO HIDE SOMETHING..

WHY DON'T YOU ASK YOUR PM TECH SOMETHING WHEN THEY PRINT YOUR REPORT YOU MIGHT ASK CAN I HAVE A COPY OF THIS TOO??

Sorry I missed it Judy

by ElectricFrank - 2012-06-02 01:06:09

Sometimes I get busy and the posts get to far down the list.

I agree with Pookie that you have a right to the reports. I live in Calif where there are state in addition to federal laws requiring access to all medical records.

There is no universal way to find a doctor who will work with you. A lot depends on your comfort with putting the pressure on them. My approach was to put things in writing. After the first appt with the cardiologist I wrote him a letter stating that I was to receive a copy of the Initial Interrogation report and the Final Report at the time of the checkup. In my case I also stated the settings I required for Upper and Lower Limits to be set at my next appt. I mentioned in the case of the limits that I accepted responsibility for the outcome of the settings and that I would be willing to discuss my reasons for them with him. I added a final statement that unless I heard otherwise, I assumed that he agreed. If he didn't I would be looking for another cardiologist.

Another couple of tricks are to ask him to put his refusal of the report in writing, or tell him bluntly that it isn't negotiable.

The trick is to be firm, confident, and in control. I find it is better to confront the situation head on rather than trying some work around. This has the advantage of developing a professional relationship. My cardiologist has a reputation of being pretty hard headed, but after a few head bumps each way we get along great.

As for the Long Term A-V Conduction Histogram Report I don't get that on mine. This is depends on what data the EP programs the pacer to record. I have one called the Ventricular Long term Histogram which shows what you are looking for. I suspect yours is some sort of a measure of beats where natural conduction takes place, but I'm guessing.

If I don't respond to your post, drop me a Private Message where I am sure to see. it. Also, starting with 6/10 I will be camping in the mountains and out of internet contact for about a week. I'll post a note on that as it gets closer.

hope this helps,

frank

lost post -- for Pookie

by judy13 - 2012-06-02 07:06:12

Pookie,

I had expected as the post was new it would be toward the beginning, in recent posts. Apparently where it is has to do with date of original post not the date of the last added to it. So when I figured that out I decided I better make an original post as somehow I had read the date wrong when I decided to post on that thread.

In addition to that mistake, when I looked in my profile I was looking under posts and it was not there, turns out it is under comments.

So, this is entirely user error I believe, and things were listed as they were programmed to be listed!

Judy

lower limits on report

by judy13 - 2012-06-02 07:06:30

Frank,

Even if the report is some sort of mix of natural and pacer data, why would there be so many events when you are below the lower limit set on the pacer. EP said "it doesn't happen, pacer kicks in in microseconds, you are NEVER below your lower limit set".

Last night I did an overnight oximetry test, and once again the lower rate on that report was 57. Within pulse oximetry, though, that could be in its error range.

I am just curious what this all shows and the mechanism as to why it is lower than the set limit.

On reports they are required to give us them in Virginia also, though they can charge for them. It takes around 3 weeks to get them out of this group. I have a feeling the lab that handles the remote gets a far more complete report than when you go in as if the doctor questions something on it, they want it all ways from Sunday. This one the nurse just punched a button, gave that to the doctor and he waltzed in and didn't so much except said it was great. The stack of papers wasn't as thick as they sometimes get.

Judy

REPORT

by SUPERSALE - 2012-06-02 09:06:11

YOU HAVE THE RIGHT TO ALL MEDICAL REPORTS

MY DOCTOR CAN'T HIDE NOTHING FROM ME THEY GIVE ME A USER NAME AND PASSWORD SO I CAN GET ALL MY REPORT ON MY PC AND PRINT OUT AT MY HOUSE FOR FREE

IF I GO OUT OF NETWORK DOCTOR IT HARD TO ME TO GET THE RECORD IT $1.00 PER PAGE IF THEY LEFT THE REPORT IN THE ROOM WITH ME THEN I MIGHT READ IT

medical reports -- rights

by judy13 - 2012-06-02 10:06:04

I am still more interested in the lower than set limit on the pacemaker. However --

Yes, most states have some provision where we are entitled to our reports, though perhaps for a fee.

I also go down to Duke for medical things and they have a website where they post the reports -- I love that. It sounds like that is the type of thing your HMO/Network does.

getting copies of your reports

by Pookie - 2012-06-02 12:06:08

it seems every hospital (or PM Clinic) is different...some have absolutely no problem handing you a copy of your PM interrogation while others hang onto it like it's their last dollar.

I would suggest that perhaps you may do what SuperSale just suggested and ask the PM Tech; if that does not work, then I would certainly put your request in writing and send it to the head of cardiology?

Just remember: everyone has a boss.

Another suggestion: could you ask your family doctor to request ALL of your past reports???

Legally, if you live in the United States or Canada, anything in your medical records is yours!!!!

Pookie

Your "lost" comment

by Pookie - 2012-06-02 12:06:14

Not quite sure if I follow you, but are you saying you posted a comment and now it is nowhere to be found?

Pookie, Moderator/Monitor of this AWESOME site:)

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