High threshOld

Just got a copy of the tech's report to my local dr. "Ventricular threshold is high but consistent @2.6v@0.4ms and 2.6V@1.0ms. Ventricular output set to 5.0V to maintain an adequate safety margin" safety margin for what, does anyone know? And any explanation for high threshold? Lead is apparently in a good place.
Thanks
Suroy

4 Comments

Thanks Inga

by Suroy - 2013-09-21 06:09:13

No heart attacks or surgeries so probably scar tissue then.
Thanks again
Suroy

Golden Snitch got it right

by PacerRep - 2013-09-21 10:09:01

Pretty much what she said. The question I have is...do you even use the ventricular wire? Many patients do not. We always set a 2X safety margin...yours is set a little higher than I typically would set it if you use the wire...but if your not using the wire it doesn't matter.

Another question is...has the threshold been gradually creeping up? or has it been stable at 2.6V for a long time?

Output & threshold

by golden_snitch - 2013-09-21 10:09:49

Hi!

The ventricular & atrial output are always programmed at least two times as high as the threshold to ensure that, should the threshold continue to increase, the heart is still stimulated effectively. So, if you're at a 2.6V threshold, setting the output to 5V is just right. It's a safety margin, as your tech states.

High threshold could be because of scar tissue around the tip of the pacemaker lead. If you have had some kind of heart surgery or suffered a heart attack, it could also be due to the scarring of the heart muscle itself. But usually it's because of scar tissue around the tip of the lead. 2.6V is not that bad, yet, I'd say, but one will have to keep an eye on this. And our battery will drain faster because your pacemaker now needs to stimulate using much more energy.

Best wishes
Inga

Yes...theoretically

by Suroy - 2013-09-22 04:09:29

I use the wire but not enough to be statistically significant apparently - see my post - "2 questions" from a week or so ago. I have 3rd degree heart block (intermittent). As far as I am aware the threshold has been the same since the implant 4 months ago, or at least since the one month post surgery check. Thanks for your insights and any further info PacerRep.

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