Info needed re: Medtronic PM

Hi Gang! After numerous ER visits 2010 to early 2012, I gave up on ablations (3 failed, 1 aborted) as a pathway to cure my paroxsymal A-Fib issue and gave the doc permission to implant a PM. He implanted a 3-lead Medtronic C4TR01 Consulta to deal with my mild Cardiomyopathy. Life's been much more pleasant since. I have the patient manual, but I haven't had a face to face talk with any EP or cardiologist about how this device actually works for me. Did I have a complete AV node ablation? Is my device pacing 100% of the time? What does the term "Mode switch" actually mean? etc., etc. I currently have remote downloads every 3 months along with a "device clinic" visit twice a year. A cardiologist (not an EP) receives the D/L report and everyone's response is "You're doing fine!" I'd like to get more specific info and I suppose I'll have to choose different Drs. within my health provider network. None of the current docs were involved when I opted for the P/M. Would Medtronic's patient services 800 number be my best bet?
--Dave--

2 Comments

CONSULTA

by Vinnie - 2014-11-09 08:11:33

Hi Dave; I have a CONSULTA --- C4TR01 pacemaker since June 2013. I don't know all the uses this pacemaker is used for but for me I have it because --- I have had my AV-NODE ablated ----- I have CHF. For me this pacemaker paces me 100% of the time and it can detect if my CHF gets any worse. If you go to the Medtronic website they will have some info there on the CONSULTA. Incidentally my CONSULT is a CRT-P which means it paces only --- no defibrillator. If you have a new doctor, once he take a EKG he can tell you more. Hope this helps.
Vinnie

Several options

by Theknotguy - 2014-11-09 12:11:03

Dave:

First thing I'd do is get your PM report when they read the PM. There is a lot of information on the report and your EP / cardiologist usually doesn't have time to go into details. I can't read everything on my report but I've always learned something.

Second, reading posts on this site has given me insight into what's on the PM report and I've gotten more information that way. I'm not sure if we have an EP on the forum but a couple members have given me information about my PM that is way beyond my non-engineering education. All have been helpful.

Third, I'd discuss Medtronic's APP (Atrial Preference Pacing) with your EP/ cardiologist. APP is a software setting that is supposed to mitigate afib sessions.

I have a Medtronic too and my EP turned on APP back in May of 2014. At the time, my EP said they weren't sure it would help, but it wouldn't hurt, and turned it on. Just got my November reading and my afib sessions are down.

Per the report, my afib sessions dropped from .3 per day to .1 per day. Percent of Atrial pacing went from 84% to 82%. Afib intervention went from 45% up to 54.9%. Beats showing afib went from 8.9 per day down to 1 per day. For the time periods recorded it shows 71 episodes where I went into afib and the PM kicked me back out of it.

Some of those numbers don't look like much, but I feel a heck of a lot better. Mental attitude is a whole lot better too. Seem to have more energy (which my PM report shows) and I don't have that black mental cloud hanging over me.

Medtronic's did a study and said (of course) people with APP were doing better than people without APP. That's from Medtronics but, based upon my experience, I'd have to agree.

It feels really strange when you go into afib and the APP kicks off for the first time. For me it feels like I have three heartbeats. However the afib sessions were less intense. Duration of my afib sessions seem a little bit longer but I go into afib anywhere from four hours at a stretch up to 24 hours at a time. Prior to APP I'd have to collapse in the recliner, take extra medication, and just sleep it off. Post APP I can take extra medication and spend a quiet day working on my computer.

Obviously I don't know if APP will be as helpful for you but, at least, you've got a positive report. And, having a potential positive therapy gives you some hope for changes in the future.

Discussed my afib with my EP. He indicated my grandparents swam in the wrong gene pool and my afib sessions are random. Since they don't know what triggers them, ablation is an option, but they'd rather hold off on that unless the frequency or intensity gets to the point where I can't function "normally" (whatever that means). With the decrease in afib sessions due to APP I'm pushing ablation off for a while longer.

Last point, APP wasn't instantaneous. While I was in the longer sessions of afib I felt the PM program was "learning" about my afib and was adjusting as it went along. First sessions in afib felt like the same old thing. Later sessions in afib seemed less intense. Had a quick afib session this AM and it stopped within a minute. (Could have been PVC's but I'll have to wait for my PM report.) So the APP gradually changed my afib sessions over a period of months. Just don't want you to think they'll turn it on and you'll be instantly cured.

Medtronics patient response area can be of some help at times. Other times it's either, "Contact your physician for specific details" or "We have no data on that situation." So it can go either way. On technical stuff they can go up to the engineering level which is way over my head. So it's always worth a check with them. Sometimes not getting an answer is worth as much as getting an answer.

Hope this report will be of some help for you.

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