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How do technicians set defibulator
Can anyone out there who has a CRT-D explain a bit about what is paced. Is it the atrail and both ventricles? Also do the technicians set your pulse and high end heart rate so when you run or hike that your hr doesn't go over. I am not familiar with what is happening and need more info. Thanks. The Tec doesn't give out info and my EP said not to worry and isn't explaining much.
3 Comments
CRT-D
by Bill T - 2014-04-04 10:04:29
Hi Tanapuff, I have a CRT-D and I will try and give you my take of its operation. It kicks in one or both upper and lower chamber it their beat is lower than the CRT's set point. If the Rate Response is turned on it should increase your heart rate when you run or exercise if the heart's natural pacemakers do not keep up.
I have a complete AV Node ablation so my ventricles are paced 100%. Another important function of the CRT is that it insures that both the left and right ventricles are pumping at the same time. My EF was low in the low 30 when I was upgraded to the CRT-D and the cardiac resynchronization therapy has increased my EF back to or near normal range.
Hope this helps and best wishes with you internal computer (CRT)
Bill T in nw Ar
comments help
by tanapuff - 2014-04-04 11:04:38
Thanks both to Bill T and Theknotguy, l appreciate the information. I will get the tec reports today at my appointment. Your explanations helps. I too am going to do some serious fishing.
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Open and hidden
by Theknotguy - 2014-04-04 10:04:08
The information you request is both open to everyone and hidden. Open, in the sense you can get your PM report and read the information (most of it) you requested. Hidden, in the fact as to how it is done isn't shown anywhere unless you can somehow read the software that governs your PM. (The software is proprietary to your PM company so you won't be able to see it anyway. )
You can read on your PM report the tech has set (in my case) the high end pace to 130 bpm. How the PM actually determines that is handled by the PM software.
Even if your upper heart rate is set to 130 bpm it doesn't mean your heart can't go faster - it just means the PM won't pace any higher than 130 bpm. My PM is set to 130 and I went into an afib session where my rate went to 140. All the PM did was sit there and watch the high rate after I went above 130.
You can read on your PM report where the PM watches your heart beat. In my case, if the atrium beats now, the PM gives my heart 30 milliseconds to initiate the ventricle beat. If the ventricle beat doesn't start within that time frame the PM will initiate the beat. There is a resting time window, then if the heart doesn't initiate a new beat, the PM will go ahead and initiate a beat. Pretty complex programming when you think about it, especially since the PM has to adjust for different heart beat speeds. Mostly I just sit back and enjoy the fact I now have a regular heart beat.
From the tech and doctor side, all they have to do is to use their monitor system and plug in numbers. Max heart rate = (insert number here). Min heart rate = (insert number here). They don't really mess around with the programming although they can upload a new software update via the monitor if need be.
I have afib, and my PM, Medtronics, has an afib setting. It's called APP (Atrial Preference Pacing) and is supposed to counteract afib. My EP has indicated there isn't a definitive answer if APP really helps, but it doesn't hurt either. So after an afib session he turned on APP for me. I feel, in my case, it has helped. And APP is yet another piece of very complex programming. Can't tell you how it works, but I feel it does work.
If you haven't already done so, get a PM report at your next PM reading session. They have to, by law, give you a copy of your report if you request it. Most techs are aware of the legal issues and will give you your report without any grief.
The PM report is full of a lot of info - I can't understand all of mine, but it is really helpful in letting you know what is going on. Knowing what is going on is a really big help when you get some weird feelings. For example, I went into afib after they turned on APP and I got some really weird sensations between my heart and the PM. If I wouldn't have known APP was turned on, I might have reached the conclusion I was having a heart attack. Knowing it was the APP reduced my anxiety and helped me get out of afib a lot faster.
In the meantime, "God does not subtract from man's allotted time, those hours spent fishing." So I'd go out, start drowning worms, and enjoy the day knowing full well you have this wonderful piece of equipment that will help you enjoy life.
Theknotguy