Sorin repyl dr

Hi. Just been for a PM checkup on my Sorin reply DR on Monday last. Due to tiredness and breathlessness the hospital have turned on the rate sensor in an effort to combat this, and have said it may cause increased episodes of Angina which I suffer from. My settings before this were dddr (which means nothing to me). Can any of the tech wizards out there tell me exactly what a "rate Sensor" on this model does and why it could possibly cause more Angina. Up to now it feels a little less stressful climbing stairs, but I did have one nasty episode of Angina yesterday which very nearly put me in hospital again, fortunately the GTN spray worked after two doses.
Any help would be appreciated.
Thanks in advance. Keep warm and vertical. clockman1
P.S. I also have a quad by-pass and stent if that makes any difference.

2 Comments

Great pacemaker!

by golden_snitch - 2014-06-13 01:06:47

Hi!

I have had a Sorin Reply DR for nearly six years, and I think it's safe to say that I know it pretty much inside out. I chose it carefully, so I did lots of research about it prior to my decision.

DDDR means that the rate response is on, that is what the "R" stands for. The three Ds stand for "dual" and refer to the chamber in which the pacemaker senses and stimulates (dual = atrium + ventricle), and to the mode it operates in (dual = triggered and inhibited). Inhibited means that, if your own rhythm works well, the pacemaker won't kick in; triggered means that if the pacemaker sees an atrial impulse (own rhythm), it will pace the ventricle.

If DDDR was your setting before, then you always had the rate response on. The Sorin Reply is one of the very few pacemakers who has a rate response that can work with a combination of two sensors: accelerometer (motion sensor) and minute ventilation (physiological sensor). The options you have is to switch both on (MV+G), or just one of these two (MV or G) . So, maybe that is what has been changed by your doctors.
You get the best response when you switch both on. That way, the limits and accelerometer alone has - it basically only responds to activities that involve upper body movement - are compensated by the minute ventilation sensor, which senses when you breath heavier and more often. When I was on accelerometer only, I had problems climbing stairs, because instead of my heart rate going up, nothing happened or it slowed down. With both sensors activated, I was much better.

So, with regards to the rate response, you have an excellent pacemaker that is much better than all the models that work with accelerometer only. I just don't get how a better rate response should cause angina. All the rate response does is to increase your heart rate according to your level of activity. I don't know, but maybe fast heart rates can trigger an angina episode? If so, then an improved, faster rate response could probably lead to more episodes of angina. But apart from this, I have no idea how rate response and angina can be linked. Sorry.

Hope this helps a bit. Best wishes!
Inga

Thanks Inga

by clockman1 - 2014-06-13 04:06:49

Hi Inga and thanks for your very informative answer. I was clueless about the rate response and your comments have made thing's a lot clearer. I am inclined now to think the Angina attack was just one of the normal run of the mill attacks I get, and not related to the rate response at all. I do seem to be not as breathless generally, apart from the Angina attack, and climbing stairs is not as hard as it was pre rate response change, so maybe things will settle down after I get used to the new settings. Thanks again for your help.
God Blesss.
clockman1 , in the sunny UK.

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