First PM Check in Two Weeks

First, a word of THANKS to all of you who have made this web site a success. It provides a wellspring of information for us newbies.

Two weeks ago I had a Boston Scientific Altura 60 DDDR implanted -- with a low heart rate set at 70. I've notice some immediate improvements -- increased energy, restore strength, better circulation in hands and feet. Overall, I'm very satisfied with my PM and the improvements it has made.

In two weeks I go for my first PM check by a factory rep and have no idea what to expect, or what I need to tell him, or ask him. Do they tweak the PM without input from the patient? How much input do you have?

Today I went for a 1 1/2 mile walk -- which has mainly pleasant. During the walk I climbed a relatively steep ramp during which my heart rate went to 82-85 bpm with relatively good increase in breathing. Normally, I would have expected a heart rate of 95-100 or more with less heavy breathing.

Can the factory rep change my heart rate so it would go to 90-100? I would like to climb that ramp without getting out of breathe. How should I handle this with the factory rep.? What do I need to do to prepare for the PM check?

Thank you for your help.

PKite

4 Comments

PM Checkup

by SMITTY - 2012-10-01 10:10:06


Hello PKite,

The following is a comment I made for someone getting their first PM checkup. I wrote this comment in Mar '12 based my checkup experiences and if I were to write it today I would change nothing. Maybe it will give you an idea of what to expect.

A pacemaker checkup is somewhat like an EKG, except my PM checkups are done while I am sitting in a recliner.

I usually have to unbutton or remove my shirt so the technician can put 3 or 4 electrodes on my chest. Then they sit at a computer monitor/keyboard and put in various information on my PM. This may take from 5 to 10 minutes. A magnet is then placed over the PM. When the magnet is placed over the PM you may feel a change in your heart beat. This has never been uncomfortable for me, but it is a change in heart beat that is noticeable for a few seconds. Some have reported discomfort here. With the magnet in place the PM is operating in magnet mode which is where it must be to make any changes needed and to download information the PM has stored. This part may takes another 5 to 15 minutes. After which the magnet and electrodes are removed.

This is the time I'll ask questions as I avoid doing so while the technician is at the computer and may be making changes to my PM settings or reading the downloaded information. I want them to be able to give that part their undivided attention.

At the end they usually make a hard copy of the data obtained and any changes they have made. I always ask for a copy of that printout. Not that at I will understand much of what I see there, but it is a very good place for me to refer to for questions. Also, on my printouts any changes made in settings are marked by (>). I will take quick look at the print out as I can spot the (>) marks easily and since I know that indicates a change in some setting I'll ask what and why.

After that it is time leave. My total checkup time is usually less than 30 minutes.

Good luck,

Smitty

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by boxxed - 2012-10-01 10:10:09

It really comes down to physician preference and how much latitude/rapport the rep has with your doctor in allowing him to make changes as he sees fit. A rep a doctor has worked with for 10 years and are on very good terms may have significant latitude in making changes, because he knows what your physician wants and what the physician is okay with without checking with him.

Your first PM check he will test the leads. He most likely won't change anything. If this is your first device you are in an acute stage with your leads, that being, there is still a chance of you dislodging if you over-exert your left arm.

After several months during the next check the rep will start programming based around you. Lowering outputs to improve battery life while still adhering to a safety margin, tweaking rate response (which is what you should look into if you want your HR to bump up higher on exertion), etc.

Boston devices have a pretty good rate response. They are very programmable when it comes to tweaking how sensitive your activity sensors are and how aggressively it jacks up your HR when it senses activity. That's going to be a several check-long tweaking process. Overshoot the aggressiveness, and you may not be able to sleep because your heart is racing in bed. Completely go the other direction and you may feel exhausted and short of breath just walking around the house (depending on your indications for your device). So they'll manage and fine-tune that as that goes along.

If you have a good rep/tech, he will explain to you as you go along. I'm sure questions will sprout up during your check. Expect some potential very temporary periods of being uncomfortable during certain tests Some people don't notice the tests @ all, some people feel like the sky is falling when those tests are run. They're testing device function, whether it can sense appropriately and pace efficiently. That involves slowing down your heart rate and speeding up your heart rate until you skip a beat. If you have the right indications/diagnosis, you may really feel this.

Don't worry about this check, they won't change too much and it's quick and painless. And if any questions sprout up after the fact, this forum is a great resource for getting questions answered.

Good Luck!

Check Up's and Changes

by Many Blessings - 2012-10-01 11:10:50

My PM tech is great! She listens to everything I say. I sure hope you get one that listens to you. It makes a world of difference.

As for PM changes/adjustments, I've had some that made me feel a whole lot better, and I've had some that have knocked me on my butt and made me feel just horrible.

Just remember, if they do make a change and you feel worse, they can always change it back. Don't wait to see if you get used to it. Call them right away and tell them how you're feeling.

Since everyone responds differently to PM changes, your tech really can't say how you'll feel for sure. The stats may say it's the right change for you, but when you have the change done, it may make you feel worse. It can also make you feel a lot better!

Let your tech follow the treatment plan set up for you. Just make sure to speak up with any concerns you may have before, during, and afterwards. Again, if you feel better, let them know. If you feel worse, let them know and ask if they can change it back or try something else.

Best of luck to you!

Thanks Smitty, Boxxed, and Many Blessings

by PKite - 2012-10-02 09:10:22

Thanks Smitty, Boxxed, and Many Blessing

I appreciate your responses.

PKite

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