Bionic

Last week got a Biotronik Eluna 8 DR-T for SND. In over night to check for issues. Took Tylenol first three days post implant. Every day seems better. Been out for several good walks including three miles 8 days post implant. Wife and friends say my color looks better. Incision is healing nicely. Minimal discomfort. Hope to get back to jogging after my 4 week checkup and PM tune up by the techs. Asked for the Biotronik because of the ra response algorithm CLS since I run hike and ski (69 yrs). Seemed like the best option. I'll post update as things progress. So far I am very pleased with the doc and the pm.

7 Comments

Thanks!

by Jackw - 2015-04-21 04:04:49

It seems that the Evia and Eluna are similar in functionality. I chose the Eluna because it is MRI tolerant.
I am still only 11 days from implant, so my activity is still limited. I have an appointment in the pacer clinic in early May to get the pm tuned up. I look forward to getting back to jogging in a few weeks now that our weather (in New England) has finally improved.
I'll keep try to keep track of the CLS responses. Your post is very helpful in giving me an idea of what to expect. I am 69 now, so 160 is probably a reasonable max rate for me. In any case, I'll be glad to get my rate over 110 which has been my recent max prior to implant.
Looking forward to giving the pacer a workout!

CLS

by golden_snitch - 2015-04-21 11:04:05

Hi!

I have a Biotronik Evia now, chose it for the same reason as you: CLS. Always enjoy hearing from other active patients with CLS switched on. There are not that many out there.

At the moment, I run 5K's about three times per week, and since the weather has finally got a nicer, I also try to ride my bike for at least half an hour twice a week (no racing or mountainbiking, though).

CLS is tricky. I have been through all rate response sensors, and I sometimes think that minute ventilation + accelerometer gave me a better, and more stable response. But can't have that any longer, because I have epicardial pacemaker leads now, and those don't work with minute ventilation sensors.

With CLS I have the problem that when I run, I always reach my upper sensor rate of 160. Takes sometimes less than a minute to get there, and then it just stays at 160. There is no variation. Or better, I sometimes see an optimization process, but usually it's only for three or four runs, and then I'm back at 160bpm non-stop.

Another problem, sometimes the rate suddenly drops while exercising, for instance from 160 to 120, and then it does not always go back up, no matter what I do.

On the other hand, for daily life activities, CLS automatically optimizes a bit too much, so that I sometimes go for brisk walks, but do not get above 100bpm. We had to change the CLS response from medium to high, because my heart rates were too low in everyday life, and my heart was starting to throw in extra beats.

Last but not least, CLS resets itself whenever you change any setting manually or perform a manual interrogation with threshold/sensitivity tests. According to Biotronik this is caused by a bug in the programmer device software. For me, every reset means that I'll have loads of inappropriate tachycardia for at least 2-3 days. I always try to move a lot during these days, and then the sensor settles down again.

Looking forward to reading about your experiences!

CLS

by golden_snitch - 2015-04-22 01:04:34

The Evia is MRI safe, too, at least in the EU. But doesn't really matter for me, because my leads aren't and because this whole MRI safety debate is, in my opinion, just money making. All pacemakers and leads manufactured after 2002 are MRI safe. Johns Hopkins and Mayo and some smaller clinics have done studies on MRIs in patients with "older" devices, and nothing happened. Medtronic even got leads approved for MRIs that had been on the market since 2005 already.

Have they activated your CLS, yet? I think, I read somewhere that you need to wait for a couple of weeks after implant because of the leads. In my case that was different, because the leads had already been in for years, so everything had already healed nicely. I got up hours after implant, and immediatly got a very aggressive response from CLS. Max rate whenever I just walked to the bathroom. But, as I said, it got better the more I moved, and the sensor settled down after a couple of days.

Wishing you a speedy recovery!

Question and observation

by Jackw - 2015-04-22 04:04:52

Does a Garmin wireless HR monitor interfere with PM. I tried it but got readings that did not make sense. The chest strap is below but close to the PM.

Obs: I did have a few minutes of a different feeling while does some light work in the yard. When I checked my pulse, it was like preimplant: two quick beats and a pause. Only lasted a few minutes. Made me think of golden snitch's comment about CLS holding rate too low for ordinary activity and her heart throwing in an extra beat. I'll report this to the tech when I go in to the pacer clinic
Wonder if anyone else has had this experience with a Biotronk pm.

Thanks

Jack

Re: CLS

by Jackw - 2015-04-22 07:04:35

Golden snitch:

The tech who came to do a check the morning after the implant said that CLS was turned on but If it is the response must be on low. I have not felt the kind of aggressive response you describe. I did have one episode a few days after where I thought I felt a few extra irregular beats but that settled down in an hour or two and I haven't felt anything since. The tech said my minimum rate was set at 50. That may be increased when I go to the clinic. The thinking was to bring my rate up gradually since I was running in the 40s resting rate, down to the 30s at night.

I went for a pretty brisk walk yesterday and felt good but I won't really be able to push CLS until I get back to jogging.

Thanks for your comments and insights.

Jack

Garmin

by golden_snitch - 2015-04-24 01:04:15

Hi Jack!

Interesting, I tried a Garmin monitor last summer - always used Polar before, never had issues with that, but now wanted a GPS monitor -, and the readings were totally incorrect. It even showed rates that I simply could not have, because they were around 40bpm, when my pacemaker was set at a minimum of 60. I tried this monitor for several runs, but it just didn't work.

So, I got myself a new Polar instead with a stride sensor (to measure pace, distance etc.) and chest strap, and had no more problems with incorrect readings ever since :-)

Garmin or Biotronik problem?

by Jackw - 2015-04-24 01:04:36

Golden Snitch:

I looked at other posts on this site and it seems that Garmin has problems for some people but not all. I wonder if it is Garmin's problem or a Biotronik issue. Unfortunately, the responders who said they did not have a problem with Garmin did not indicate what brand or type of implant they have. As a first guess, I would not think that the electromagnetic emissions would be a lot different from brand to brand. Essentially all PMs are a pulse generator with one or more leads that also become antennas. (Suppose I could go back and look at profiles to see if any are listed.) Mine is not a GPS model. They were very expensive.
Again, thanks for your post.

Jack

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