Adjustments/tweeks

Hi All, Still new at this!! Had 1st Post-op visit. I informed MD that when i first stood up from a chair and walked a short distance I was tachy but it would settle down. He said the tech could tweek the PM to accomidate. I was at 60/130..now 60/120..I was tested in the office and it started pacing at 109 till we got to 80. Tried to walk today and HR got up to about 160 with shortness of breath. Anyone have any ideas? I have always walked, dont smoke, not overweight. What does it mean when they "set the PM down"? I think I want old settings back!!! MD said I had 10 different settings to play with....Thanks

5 Comments

settings

by Tracey_E - 2014-12-12 04:12:21

Why do you have it? I can't tell from your description what they might have changed, but if you don't feel better, don't hesitate to go back. They like to do changes in small increments so if something doesn't work, they can tell what it was and try something else. It's not uncommon to take several tries. They can take a guess at what will work, but we're all different so some of it is try it and see what works.

Twweks

by brian1951 - 2014-12-12 06:12:16

Hi Tracey, I have a PM due to Brady, 2nd degree AV block..Heart rate dropped to 30 and stayed there. Fainting issues, fatigue. I did go back today and they changed it back to the what I had. My visit in Feb they will have the Medtronic rep there.

Makes Sense

by brian1951 - 2014-12-13 01:12:13

Hi Tracey....Thank you for explaining rate response. I tried looking it up, but you explained it very well. My RR is still on. I don't have a difficult time getting my heart rate up..it does that very well. Any physical activity it goes up. I get out of a chair and my heart speeds up..hence the shortness of breath.,,but it settles back down. I'm not in AV block all the time..I think I have both types per my holter. maybe my own heart and PM are both doing the same thing. I dont think Im use to having a heart rate in the 70's and higher. They did speak to me about the RR but the MD didnt want to turn it off. They also talked about the "firing" rate. Thanks for your response. You have been most helpful. They did reset me from 120 to 130. I will discuss turning off the RR

rate response

by Tracey_E - 2014-12-13 04:12:49

I don't know why some are adamant about leaving rr on! With av block, the sinus node works just fine so there's no reason for it. RR is for people with sinus dysfunction. Definitely ask again about turning it off.

It will feel fast at first! Your atria was always going70+, but the ventricles weren't getting the message. My resting rate was high for about a year after, often in the 80's, then it settled down and now it's a more normal mid-60's.

If you are exercising and suddenly feel tired or dizzy, check your rate. If it's 130, ask to have that turned up higher. Mine is 170 so I can comfortably work out with my rate in the 150's + a cushion.

rate response

by Tracey_E - 2014-12-13 11:12:23

If you have av block, the biggest thing we need adjusted on settings is usually upper limit. Our atria works fine, we just need help keeping the ventricles in sync. They often set us at 120 or 130 which means if our atria gets higher than that, the pm isn't pacing the ventricles fast enough to keep up. So, making that number higher is usually all we need.

It sounds like they are messing with rate response. They often leave it on thinking it will be there if we need it, but it can compete with our natural sinus rate. Rate response is for when your sinus rate doesn't go up on exertion. The pm senses that we are moving and raises our rate for us. There are a number of sensitivity settings for this, how much movement it senses before it raises the rate. However, if you don't need help getting your rate up- and if you have av block you likely do not need help- then the best thing is to turn it off.

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