first check omg!!!

Hi everyone well been for my check 3 days post op and all is well and working i was quiet shocked to say the least when i was told am been passed both top and bottom 50% of the time!!! i was told i would prob only use it occationally i must admite i feel more alert lol also i dont feel it when it kicks in as expected too so alls good in kimbo ticker land just need to recover from the surgery now.

have a good day everyone

kimbo

3 Comments

ps

by kimbo - 2013-03-04 09:03:03

the top part was paced about 47% the bottom 49%

Pacing percentage

by golden_snitch - 2013-03-04 09:03:06

Hi Kimbo!

You have intermittent second degree heart blocks, right? Would you know what kind of pacemaker you have (model, manufacturer)? That would be interesting to know, because all manufacturers have different modes to reduce ventricular pacing in patients with intermittent heart blocks - some are better, some are worse. Generally speaking, if you are programmed in DDD mode, the pacemaker will take care of every single heart block, even if that means pacing you out of every single skipped beat. In this mode the pacemaker will give the AV-node a certain period of time, the AV-delay, to do the job on its own, and if nothing happens, it will kick in. Sometimes, if the AV-delay is programmed too shortly, your pacer kicks in a lot, although the AV-node could do the job, if it would get just a tiny bit more time. So, that could be one explanation for why you are pacing so much.

This kicking in for every single heart block is not really necessary. Some pacemakers have a special mode-switch that has been designed to reduce ventricular pacing. When this mode switch is turned on, the pacemaker will always wait until it has detected a certain number of heart blocks in a certain period of time, before it starts pacing your ventricles. So, you'd probably still feel a skipped beat every now and then, but as soon as it's, for instance, every second or third beat, the pacemaker would switch modes and start pacing the ventricles for a while (usually around 100 beats, then it checks again, if there are still blocks). In Medtronic pacers this mode is called MVP = manage ventricular pacing. It's very effective in reducing ventricular pacing to a minimum. It's much better than being in DDD mode all the time with a programmed AV-delay. I have a similar mode switch, and when I had intermittent blocks, I was paced less than 10% of the time, often only around 2%. But when they programmed the pacer in DDD mode, so that it kicked in for every single block, I ended up with around 40% of ventricular pacing.

Also, if you have intermittent blocks, there is not really a reason why you need pacing in the upper chambers, the atria. What's your lower rate limit? If it's high, for example 70 or 80 bpm, this could lead to the pacemaker not letting the sinus node do the job, if the sinus node would provide you with a resting heart rate of around 60bpm. Now, 60 is fine, but since the pacemaker is set to kick in whenever the rate drops below 70 or 80, you'll end up being paced all the time, because the pacemaker "thinks" your sinus node is too slow. So, check your lower rate setting, and if it is more than 60bpm, then maybe that's why you are pacing so much in your atria.

Best wishes
Inga

wow!!

by kimbo - 2013-03-04 09:03:12

thanks Inga for the info lots to take in there iv got a medtronic adapta its in DDD mode resting rate 60 my cardio was adermant he wanted the settings leaving as they are as i was so symptomatic with this heart block and pausing plus the whenkibach mortz as well i must admit my head feels like a cloud has been lifted i always was spacey and foggy headed before and iv felt no skipping or pausing and no ectopics at all but it is early days.
am looking forward to getting back to normal very soon and back to the gym :).

thanks again

kimbo

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