Answer about Pacing %

Hi to all!! I took a long time to contact you again for healthy reasons...but now I am back. I have a question I never understood well, related with how much Pacing percentage I am doing. In my last Quick look report it says:
Pacing (%of total)
AS-VS 87.3%
AS-VP <0.1%
AP-VS 0.8%
AP-VP 11.9%
My PM was implanted (April 2001) because I have Sick-sinus-Syndrome. Can somebody explain me what those parameters mean? I know that Pacing % depends on the condition the patient is treated for and that the battery´s life depends also on it. My PM change is scheduled for October this year.
Thanks and best wishes!
Manuela

5 Comments

Pacing percentage

by golden_snitch - 2009-08-08 03:08:45

hi!

frank explained it well.

the only thing that seems a bit strange is that you have a sick-sinus-syndrome but are actually paced around 12% in the ventricle. do you have a heart block, too? because otherwise this would be unnecessary right ventricular pacing which is not good on the long-term. normally you would think that no pacer paces unneccessarily, but especially the older pacer models do not have specific algorhythms to prevent this from happening. most of the newer ones have, but the effectiveness differs a lot. you should ask your cardio about it and make sure that you get a pacer with a good algorhythm when you have the replacement.

best wishes
inga

Good thought

by ElectricFrank - 2009-08-08 11:08:29

I think they sometimes pace the ventricles even with SSS with the idea that the problem may progress to AV block.

just a thought,

frank

% pacing

by ElectricFrank - 2009-08-08 12:08:13

AP is Atrial pacing
VP is Ventricular pacing

So the only one that is significant is VP 11.9% which is the percent you are paced.

The AS-VS 87.3 means Atrial Sensed-Ventricle Senses which means the pacer is just checking for a need to pace.

hope this helps,

frank

yes,...

by golden_snitch - 2009-08-09 01:08:32

yes, that surely is the thought behind putting in a dual-lead when you have SSS. i actually started out with SSS, and didn't have a dual-lead and most doctors i saw said this should be done more. my problems didn't progress on their own, i now occasionally get heart blocks because i had a slow-pathway ablation in the av-node, and am on a heavy antiarrhyhmic drug which also causes more heart blocks. this is why i had the upgrade to dual-lead pacer.

as soon as you put in the dual-lead and switch the ventricular lead on, the risk of unnecessary right ventricular pacing is there. this "aggressive pacing" can lead to heart failure several studies have shown so it should be taken very serious. so, unless the manuela's pacer clearly shows that there are blocks or a holter shows that, there is absolutely no need to be paced in the ventricle. might be better just to switch the lead off until she gets heart blocks.

just my thoughts.

inga

Thanks for the % pacing answers

by Maguila - 2009-08-10 09:08:48

Thanks Frank and Inga for your thoughts and the comments you gave me. Of course it helped!

Just you to know me better: my symptoms started around age 36 - my heart rate was 35, I felt weak and dizzy all the time. It went lower and lower (20) until I was fainting. They made all the tests (ECG, ECO, tilt test, Holter) and the diagnose was I had bradycardia and also SSS.

I have a (DDDR) PM that helped until now to keep a regular beat -and it was really useful, if I may say it!
I am set at 50 bpm, after some changes. Nevertheless the main symptoms I felt are still there.

After the implant, my cardiologist told me I would need to be paced on the atria but also on the ventricle to compensate and to obtain a better response. We never talked about heart block, but after read your comments, I will ask him about it and clarify it better.
I will keep you informed.

Once again, thanks a lot for your answers.

Manuela

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