upper rate

Hi All,

I had an interesting event yesterday that may interest you. I posted this on FB.

Finished exercising today and an hour later my heart rate was 130 and two hours later, the same. Hmm, that's the upper rate of my pacemaker. Darn. Went to see the pacemaker tech and he said WTF. (very reassuring) He reset the pacemaker and all is good now. Damn computers! Oh, he changed the upper rate to 150 and told me that the next time it clamps there, hold a magnet on the pacemaker for 5 seconds to reset it! I'll just hug my stereo speakers :-) Ah, technology.

7 Comments

Verify That

by TW - 2012-08-17 04:08:28

Thanks, EB. Will do.

Verify That

by ebfox - 2012-08-17 04:08:42

That qualifies as the most oddball pacer tech advice of the week. You might consider discussing that with your EP, I am kind of doubting the self reboot with magnet advice. WTF Indeed-

EB

Say What????

by Moner - 2012-08-18 02:08:54

Hi TW,

Just a few weeks ago, someone posted a question regarding the type of training pacemaker tech/reps have, it drew a lot of responses. I thought it had great comments.

If I were you, I wouldn't let that technician any where my pacemaker ever again.

Good luck next time.

magnets

by Tracey_E - 2012-08-19 11:08:05

Sorry, but I had to laugh out loud at your tech's response, I can totally see my rep (who is excellent and I trust him completely) saying just that. I don't think they do it anymore, but when I got my first pm in 1993, they gave me a magnet to do just that if it ever locked up. I've never used it, not even sure where it is anymore. It does work, it puts it in test mode as long as you hold it there so theoretically it resets itself when you remove it. It may not fix it but it's not going to do any harm, it's simply a tool to try on the off chance it happens. It's so rare to have that type of malfunction, I'm pretty sure they don't even give out the magnets anymore.

magnets

by TW - 2012-08-20 10:08:34

Thanks TraceyE!

pacing at upper rate

by shockbox340 - 2012-08-22 11:08:32

TW,

It sounds like you were having what is called pacemaker mediated tachycardia, or PMT (assuming you have at least two wires in your device). Some (but not all) hearts have what is called retrograde conduction, where a paced beat in the ventricle conducts 'backwards' through the AV node and causes an atrial contraction. The problem occurs when that backwards conducted atrial beat is sensed by the pacemaker. It considers that the beginning of a heartbeat and then paces the ventricle after the programmed delay. This pace then conducts backwards again, and a repetitive loop is formed at or near the upper rate of the device.

Patients with retrograde conduction have to have the appropriate blanking period extended out long enough that the pacemaker ignores any of those backward conducted beats in the atrium immediately after a pace in the ventricle.

Ask your tech if he tested you for retrograde conduction.

Good luck!

asfasfsaf

by boxxed - 2012-09-01 12:09:51

If it is PMT, then a magnet is a viable solution given certain circumstances

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