Pacemaker's not pacing me anymore?

So, for the last week and a half I've been getting very dizzy upon standing again. It's only been 3 weeks (as of yesterday) since my surgery, so I went in to see my doctor to day for a check. He wasn't at the hospital I normally go to, so it was my first time visiting this particular one this afternoon. At my last check on 8/26, it showed that I was being paced in my atrium 74% of the time with the lowest setting set to 50. That sounded about right because for the last 3 years, my HR has been consistent in the low 40's. Today when they checked they said everything looked perfect, my leads were good, etc. However, they said I'm being paced 0% of the time and the PM is just monitoring. The rep said that since my last check I haven't needed pacing at all and that my heart rate has ranged from 50-100 something in this last week and a half. I find this a smidge odd. That the minute I left my checkup on the 26th, my heart no longer needed pacing to stay above 50 and that the lowest my heart rate has gone in the last week and a half IS 50, which is exactly what the lowest setting is set to? Has anyone ever had this happen? My scheduled check at my normal hospital is on the 23rd, so I'm going to see what it says then, but it just seems very odd and coincidental that the lowest it'd go is exactly 50. Is it possible that the machine that was used today to do the interrogation was messed up in some capacity? The printer on it wasn't working right either, so who knows! Any info is appreciated. It's a Biotronik Evia pacemaker btw. Oh and also, a few times I've found my heart racing at 110-112 bpm without me doing anything but sitting in a parked car. I asked my doctor about it a week ago and he said it could be that the CLS is calibrating and it could also be due to it mistaking any sort of vibration (like from driving in a car) as my own movement and up my pulse. Butttttt, if that's the case, wouldn't it be showing as pacing me? And if it's really not pacing me, then what could the explanation be for it just randomly racing? I know settings are very technical and there's a lot of variables, but this is all driving me bonkers. Thanks in advance!

5 Comments

Sorry...

by ElizabethR - 2013-09-06 09:09:01

I meant my "native" heart rate has been 40 or so, before I had my pacemaker put in 3 weeks ago. They set they lowest limit to 50 and on the 26th it was checked and said I'm paced 74% in my atrium. But just today it said 0% pacing. However, my heart rate hasn't gone below 50. So they said from my last check, my hearts been at exactly 50 or above all on its own. But after 3 years of nothing but 40-44 (sometimes 38), I find that very hard to believe. So yeah, I think the machine is messed up. Hopefully everything is clarified when I go back on the 23rd.

odd

by Tracey_E - 2013-09-06 09:09:33

You are correct, something definitely doesn't add up.

If it's not supposed to let you get below 50, then 48 or 49 would be acceptable, but not 40. How are you counting 40? Many monitors aren't accurate with us so it's best to count manually.

Could they have meant that you pace VENTRICLE 0%? Atrial and ventricular pacing are two different numbers.

You are correct again, if rate response was sensing the car movement and raising your rate, then that would most definitely show up as atrial pacing.

Random racing can happen. Sometimes mine is exercise-induced, sometimes it's too much coffee, sometimes it just happens.

Make a list of questions in advance of your next appointment. It's easy to get flustered or distracted when you are there and walk out without the answers you want.

Not the machine

by PacerRep - 2013-09-07 02:09:52

Machine isn't going to be the issue here. I usually am pretty intuitive at guessing what's going on but you have me a little stumped here.

I'm with you, I highly doubt that you aren't pacing. Did the tech have to interrogate your pacemaker twice? What might have happened is he interrogated it..which clears the counters...and then reinterrogated it for whatever reason and it came up as 0% pacing and he just didn't recognize what happened?


Nobody goes from 74%pacing to 0% like that unless they shoot into A-fib or A-flutter the whole time. Just doesn't happen. I would guess the tech messed up the reading. The biotronik's are easy to do that on, he could have accidentally hit end session and it automatically reinterrogates with the wand still in place.

What's your upper limit set to? If it's 110 it could be the sensor needs to be recalibrated or it could be Pacemaker Mediated Tachycardia. But the device should have stored any PMT

I think you're right!

by ElizabethR - 2013-09-07 03:09:48

That could absolutely been what happened. I didn't even think of that. I know he moved the sensor over my PM twice. He put in on, it went "Bloop Bloop" and then a minute later moved it and have me hold it in place and it went "Bloop Bloop" again. And after the second time is when he finished all his stuff and called the rep over because it was at 0%. So I think you may be right! I'll know for sure on the 23rd when I go back to my usual hospital/tech. I'll definitely let you know! Thank you so much for responding. I was totally befuddled!

Lol

by PacerRep - 2013-09-08 01:09:54

My pleasure,the "bloop bloop" is the programmer reinterrogating.

best of luck to you

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