RDR

Was turned on last week after having yet another syncope episode. I asked for a copy of my report and was told NO- the cardiologist will get a copy. REALLY?? The way I understand it, when my HR drops fast the pm now works faster and then beats my heart at 100bpm for two minutes. I have felt this happen several times, but leaves me with a pounding headache.
So your all you experts out there, does this make sense? I would rather have a racing heart and a headache then pass out again, but somehow it just doesn't seem right?? Thanks for any advice...

Still no pity parties!! I am upright and beating....

2 Comments

Some info on Rate Response

by KAG - 2014-06-28 12:06:44

I'm assuming that what is causing your troubles is your PM and not something like BP or something else.

According to your bio your mode is set to DDDR and you have an ADVISA model. This is some info from my ADVISA DR MRI SURESCAN A2DR01 model paragraphs on Rate Response. Perhaps it will give you some topics and get you familiar with topics to discuss with your cardio. I don’t have RR On so I haven’t looked into it much. Get your report after all it is YOUR report.

Programmable rates –
The Lower Rate is the slowest rate at which pacing occurs in the absence of physical activity.
The Activities of Daily Living Rate (ADL Rate) is the approximate pacing rate during moderate exercise and provides a plateau which helps maintain a stable pacing rate during changes in moderate activity.
The Upper Sensor Rate is the upper limit for the pacing rate during vigorous exercise.

Automatic Rate Response – With automatic Rate Response, Rate Profile Optimization continues to adjust the rate curve by varying the set points. The rate curve is adjusted based on how the ADL Response and Exertion Response parameters are programmed. The ADL Response controls the first slope, which determines how aggressively the pacing rate increases from the Lower Rate to the ADL Rate. The Exertion Response controls the second slope, which determines how aggressively the pacing rate approaches the Upper Sensor Rate.

Rate Profile Optimization automatically adjusts the patient’s rate response between office visits. The goal of Rate Profile Optimization is to ensure that the rate response remains appropriate for the full range of patient activities. Each day, the device collects and stores daily and long-term averages of the percentage of time that the patient sensor indicated rate is at different pacing rates. The device then uses the ADL Response and Exertion Response parameters to define the percentage of time that the pacing rate stays in the ADL rate range and exertion rate range respectively. Based on daily comparisons, the device adjusts either the ADL Set point, the UR Set point, or both set points. By programming new settings for rates or Rate Profile Optimization, you are affecting the comparisons. Immediate changes occur. These changes project how rate response should change in the future based on stored sensor rate information and the selected Rate Profile Optimization settings. The device continues to adjust the rate response over time. The device adapts Rate Response more rapidly for the first 10 days after Rate Profile Optimization is first activated post-implant or after certain Rate Response parameters are manually reprogrammed (Lower Rate, ADL Rate, Upper Sensor Rate, ADL Response, or Exertion Response). The intent is to quickly match Rate Response to the operation prescribed by the parameter changes. Note: Because the device is automatically changing the setpoint values, if you manually program the setpoint values, Rate Profile Optimization is disabled.

Manual Rate Response (Rate Profile Optimization Programmed to Off) – With manual Rate Response, the rate curve is established during a patient session when the rates and set points are programmed. The rate curve remains constant until the parameters are reprogrammed.

So I’d find out if you have Automatic RR or Manual RR. If it’s auto RR then you need to give it time and keep moving to allow your PM to auto adjust itself. If it’s manual RR then the PM tech or your Dr needs to make the adjustments. Sometimes they'll use a treadmill.

Hope this isn't to much info but I am an engineer so to me more is better.
Kathy

Thanks

by boysmom - 2014-06-29 06:06:42

To both of you for the advice/information. I will get my report from my cardiologist. He has never had an issue giving me my reports so I will call tomorrow and get a copy. I will then know if automatic or manual RR is set. I have no cardiac issues, no BP issues, take meds for thyroid disease only so I am pretty sure my issues have to do with my pm. I will let you know what I find out!

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I am 100% pacemaker dependant and have been all my life. I try not to think about how a little metal box keeps me alive - it would drive me crazy. So I lead a very active life.