pace marker has not worked on two occasions

Hi All, This is my first posting on the pacemaker club web site and would like to say that it is great for newbies like myself.Had my Boston Scientific Ingenio since August 27th, things have been going except for on two occasions the pacemaker did not work I am seeing two cardiologist at the moment told him this story did not believe me until I showed him my print out from my bike ride with heart rate around 60 for most of it ( did not last long ) then showed the history from the last 4 weeks when I had a check with the technicians two weeks early and the pacemaker did not kick in for that week. I have done around 15 rides since the procedure with the longest 100km in which I felt fine. I am going in for another stress test soon with a technician from Boston Scientific to see what is going on. Sorry about this long explanation but is it possible for the pm not work when it should be. I have second degree A V block which manly effects me while I am exercising Tanks again Darre.

3 Comments

PM did not work

by Dasser - 2012-11-06 04:11:54

Thanks TraceyE for your reply,
Yes I have read that Monitors are not that accurate my garmin edge is not.I I took my pulse manually and with a application on my phone and they both showed the same reading. After a short period my heart rate went back up over 100 felt great and when I started riding again up some very small hills it went back down again to 60 so I called it a day to be on the safe side, I felt the same as I did before I had the implant in August as I stated It has only happened twice, it is very hard when you don't know what type of ride you will have before you leave home. I am 49 I was fine one day (doing big mountains ) and the next I developed heart block but that is how it works in life and the Doctors just say your heart is like a t.v. electrics work fine one day next day you try to turn it on but nothing, is that a good explanation from them thanks again Darren.

pacing

by Tracey_E - 2012-11-06 06:11:01

Ah! You didn't mention it went right back up again. Two things may have happened that I can think of.

If you exceeded your upper limit, your atria started going higher than the upper limit on the pm, the pm may have decided you are in afib and a safety mechanism kicked in and put you in an artificial 2:1 block. This means instead of pacing 120, it cut back to 60. That's a great feature if you have afib, it's annoying as heck if you're simply exercising and going fast on exertion. I had this happen, they turned the feature off. I've never had afib so we weren't too worried about that particular safety feature. The other thing they can do is raise the upper limit if you are routinely hitting it. Example, if you routinely stay around 150 when cycling, you want your max rate to be 160 or so, so you have a bit of a cushion. They should be able to tell if this is happening pretty quickly with the stress test.

The other thing that may happen is your heart suddenly drops on its own every once in a while. Mine has done this, too. I probably had this problem all along but we didn't know about it when I was in block all the time. With the block, the ventricular rate didn't go up and down with the atria anyway so we never noticed if the atrial rate sometimes dropped. They turned on a feature called rate drop response so if the atrial rate suddenly drops too fast, the pm kicks in with atrial beats to keep it steady.

Hope this helps! I'm a big fan of stress tests, get on the treadmill and let them watch what is happening. It's a lot faster than trial and error with the settings!

monitors

by Tracey_E - 2012-11-06 06:11:20

It's very rare for the pm to not pace when needed but not unheard of. When you think the pm malfunctioned, were you counting your pulse manually or using the monitor? Monitors are notorious for not being accurate when we're paced. They can pick up the pace spikes as extra beats and read too high, or the pm can interfere and cause it to read too low.

If you are in second degree block, that means you don't need to pace all the time so it's possible you were beating on your own. But if you were beating on your own, you'd be higher than 60 on a bike. Will be interesting to see what the stress test shows. Good luck.

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