fast and slow rhythm control

Hi everyone, Have had a fast HR day and in researching online (rather than having a breakdown) many sites say that the rate responsive program will speed up or slow down the heart rate and make sure ventricles contract normally if atria are quivering as in atrial fib. If this is all true, then is it possible when I meet with my EPdoctor who did the implant, he might be able to make me able to function as before. Please God, let it be so. If not, please warn me ahead of time so I won't go on a crying jag in his office. This info just seems contrary to some comments I have seen here, With a grateful mind, body and soul.

4 Comments

Thanks Tracey with an E

by magenniskeith - 2013-03-11 02:03:46

Thank you for your response. The reason I keep thinking the afib/tachycardia is program related is because three months ago when I had implant, actually three months today, I was on 12.5mg atenolol. Slow rate and pauses were at night, unbeknownst to me. My only problem I was aware of was the fact that climbing hills was a very difficult process. Now I get the PM and my HR which was in the 60s 90% of the time is now in the 100s at rest and My atenolol has been increased to 75 mg. I just am not a big believer in coincidences but maybe I will have to become so. I guess I want the PM to do more than watch, huh. But since I had never heard of the programming you mentioned, maybe there will be something to help.

A-Fib control

by Roys - 2013-03-11 09:03:18

Hi
I have a Medtronic with EnRhythm pacing system, which has Overdrive Pacing (pmop) to manage recurrence of A-Fib, which means a pacing rate slightly higher than the intrinsic rate. It works for me.
Cheers Roy

?

by Tracey_E - 2013-03-11 10:03:58

I'm not sure exactly what you're asking.

Rate response works by sensing movement and it raises your hr for you if your heart doesn't do it on its own.

If the atria goes too fast, due to afib or just tachycardia, the pm can be programmed to put us in an artificial block so it paces the ventricles at half what the atria is doing. So if you are in afib and your hr is 200, it will pace at 100. This only works if your ventricles don't beat faster on their own. The pm can't do anything in that case but watch. The first way to treat afib is generally with medication, not pacing.

pacing

by Tracey_E - 2013-03-12 10:03:34

A lot of it depends on how you pace. Do you know what caused your slow rate? If you have an av block, that means the signal doesn't always get from the atria to the ventricle so before the pm you probably had a low pulse but the atria was going faster. That's what I have, before the pm my pulse was in the 40's, now it's never under 60, usually not under 70. So, if you have av block, I'd expect your heart to be faster now, and if you were in afib before, you probably didn't know it. Sometimes our one big problem masks another, fix the first and discover the second. We found I had two secondary problems that we never noticed when I was in block all the time. Annoying!

Ditto what Roy said. Sometimes they can program it to pace you out of afib but this sometimes means a higher resting rate.

There are some really nice videos on St Jude's website that show how the heart beats, what the most common problems are, and how the pm works
http://health.sjm.com/arrhythmia-answers/videos-and-animations

Last, it is very normal to take a few tries, or more than a few tries, to get the settings fine tuned. We're all different and respond differently. They like to make the changes in small increments- make a little change, see how it goes, then tweak it a little more or go in a different direction. It can take a while. Don't be shy about calling when you don't feel right. And, this is just me, but I question, question and question again when they want to change/add meds. I hate drugs! They all have side effects but so many drs are quick to toss out prescriptions for every little thing rather than take the time to think through other options.

Tracey

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