I just got my 6 month

checkup and everything looks good. The best is that the estimated battery life is 13 years. I have a Medtronics Adapta ADDR01 pacemaker and was diagnosed with Stage 2 AV block. And there is where I have question and my doctor could not explain it. I am paced less than 0.1% in the ventricular and 4.8% in the Atrial. How can then I have AV block? Do I have Sick Sinus syndrome?

2 Comments

Sounds like it

by ElectricFrank - 2012-10-21 02:10:22

In fact you may not even have SSS. Atrial pacing can occur even in a healthy heart depending on the settings. All that has to occur is for your natural sinus rhythm to sufficiently different from the one set into the
Rate Response or Lower Limit to have it try to correct it for you.

In my case the Lower Limit is set to 55. During deep sleep my HR tries to go down to 54 so the pacer starts pacing the atrium to bring it up to 55. I wind up with very low atrial pacing percentages. My main problem is 100% AV Block so it shows 100% ventricular pacing.

Bottom line is that your heart may have healed from it's original condition and you don't need it. However, before running out and having it removed you might suggest that they tun it off for a while to see what happens. Give it a while. These problems have a habit of coming back and if you still have in implanted it's simple to turn it back on.

By the way they usually don't actually turn it off. They just set the conditions for pacing so they never happen.

frank

MVP

by golden_snitch - 2012-10-21 03:10:49

Hi!

The Medtronic Adapta has a special algoritm to reduce ventricular pacing in patients who do not have a complete heart block (or no heart block at all). I guess, since yours is a 2nd degree heart block, you did not have it all the time, but occasionally? Well, then the explanation is that the MVP algoritm (minimize ventricular pacing) in your pacemaker will not pace your ventricles in every single heart block that appears; that's the difference to a normal DDD pacer without this algoritm. Instead, your pacer will wait until it "sees" a certain number of heart blocks in a certain period of time, before it starts pacing the ventricles. So, your low pacing percentage is probably due to the fact that you mostly have single heart blocks, and very rarely have several in that period of time so that the pacer switches into DDD and paces the ventricles.

My pacer has an algoritm very similar to Medtronic's MVP. For second degree heart block, the algoritm in my pacer needs 3 heart blocks in 12 beats, before it switches to DDD and paces my ventricles. If I only have 2 blocks, the pacer will do nothing.

As for the atrial pacing percentage, I have nothing to add, Frank explained it very well.

Best
Inga

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