Metronic v. Boston Scientific

It all depends

by IAN MC - 2016-05-29 05:05:01

All pacemakers are brilliant at improving low heart rates . They will all put in extra heartbeats to improve your resting heart rate and to manage bradycardia. So for that basic function it doesn't matter what make you get.

That is the only feature which many people need from their pacemaker.

BUT if you are chronotropically incompetent i.e. your heart rate doesn't increase the way it should when you exercise then you need rate response and this is where different brands of PM are not equal.

The differences aren't about the PM's ability to put in extra
heartbeats on your 5 mile run , the differences are how the PM detects that you are exercising.

All Medtronic models rely on a single sensor which only detects upper body movement.

I am a runner and have a Medtronic. The rate response sensor is rubbish when I cycle , it helps when I run but I have lost most of my stamina and have to walk for a minute or so every couple of miles. The Medtronic sensor is not physiological , it is not like the real thing and it is not perfect for running.

It is interesting that I can play tennis without any problems, I guess that is because tennis is a far more stop-start exercise. Golf, absolutely no problem.

Some Boston Scientific models have dual sensors which detect upper body movement AND an increase in your breathing. I hope that our resident PM expert, golden_snitch, from Berlin chimes in because she runs and has tried all 3 types of sensor ( there is also the C.L.S sensor i.e. closed loop simulation , favoured by Biotronik which is not perfect either. ) She appears to prefer the dual sensors.

It is also worthwhile deciding if you want a PM which is MRI -compatible; if ever you needed a scan it would make it easier !

I have subsequently discovered that my E.P. does not clearly understand the differences between different makes of P.M. He has more or less admitted that he should have given me a PM with better sensors such as the Boston Scientific PM. because I am ( or was ) a keen runner.

Hope you make the right decision

Ian





 

Boston Scientific

by Grateful Heart - 2016-05-29 05:05:33

I have a BS with a dual sensor. I've had it for over 7 years so I guess it's considered an older model.....kinda like me.

I haven't ran in years and make a feeble attempt at walking :) but I do use a recumbent bike so lower body movement and my HR increases accordingly.

Like Ian said, golden_snitch can answer the comparisons.

Grateful Heart

another boston impant here

by techiej - 2016-05-29 09:05:55

Had mine put in this past December and it has 2 sensors - movement & respiration. While I am no where near being an athlete, having both has worked well for me whether exercising heavily, biking or walking. They had tuned the response rate (my natural one was not working well plus the brady) of both sensors over the first few visits.

Re the MRI compliant one, my EP talked to me about it and it came down to 1) the MRI one doesn't have as many adjustments/rate response options as others; 2) the battery life wasn't as long; 3) whether you have an MRI compliant one or not you would still need to visit an MRI facility that had experience with PM's and have the techs & Dr's on hand in case there was a problem.//just because it is MRI compliant doesn't mean they don't have to turn it down/protect it for the MRI.

I decided to not get the MRI one (even though I also have cancer) as there is a hospital in my area that can still do an MRI if needed.

Rate response

by golden_snitch - 2016-05-30 06:05:58

Hi!

Not much to add to what has already been said.

I wasn't a runner when I had the motion sensor/minute ventilation combination, but I did ride my bike, played some table tennis and basketball without any major problems. I'd definitely not go with a motion sensor only pacemaker (so, no Medtronic and St. Jude). CLS is tricky and, although it works quite well for me for daily life activities, there are many problems when I exercise. It's still better than motion sensor, though.

What you need to understand is that NONE of the rate response sensors is as good as a functioning sinus node. You always need to compromise a little.

For instance, the minute ventilation sensor responds to arm movement which has to do with the fact that is measures thoracic impedance, and that changes when you use your arm and especially chest muscles. So, I had it cause tachycardia at certain machines to train my chest muscles in the gym. Also, a minute ventilation sensor alone would give you only a very slow response, so it needs to be combined with a motion sensor (Boston Scientific and LivaNova/Sorin offer this).

From what I have been told the motion sensor works well for running, but not for many other sports. My experience is it worked when I ran, but there hardly was any heart rate variability; rate went up to max. programmed rate and stayed there, no matter how slow or fast I ran. The thing is that even if it works well for running, it doesn't for so many other sports, so you might feel many limitations. Like Ian, I found the motion sensor not to respond at all to cycling, for instance. And I talked to a few Medtronic guys who admitted that it's not a good sensor for active patients.

If I had the choice - which I don't any longer because I have epicardial leads now and those don't work with the minute ventilation sensor -, I'd always go with the motion/minute ventilation sensor combination. That also gives you lots of opportunities for fine tuning since you can adjust both sensors and their interaction. Might take a while to figure out the best settings for you, but I'm quite sure that this is the best option for you.

Good luck!

Thank you

by Heartfelt - 2016-05-31 07:05:18

Thanks so much for taking the time to respond.
I just don't know anymore. My EP will implant a Medtronic with dual leads and I'm just hoping fur the best. He told me I should never swim again because that particular repetitive upper body movement will accelerate wear and tear in the leads. (Running us ok, even light rowing.) He also told me that since I travel overseas frequently, Medtronic is the more adaptive device to that activity.

Heartfelt

by IAN MC - 2016-05-31 09:05:42

I'm not sure why you bothered asking us the question in the first place.

Your EP really is talking nonsense :-

Never swim again. --- Rubbish ! There are many people in the PM club who are keen swimmers

Medtronic is better in some way for frequent overseas travel -- total nonsense !!! Put your EP on the spot, ask him to justify that ridiculous statement. What on earth does " more adaptive device" mean ?

I'm sure you will lead a moreorless normal life with a Medtronic so don't worry about it .But you will realise it's limitations when you take part in certain sports such as running and cycling The limitations that we have described above are real, we are not making them up.

Medtronic may be the top- selling pacemaker in the world but your EP really is talking crap

Best of luck

Ian

Agree...

by golden_snitch - 2016-06-01 05:06:57

... with Ian, your EP talks absolute non-sense, I and also wonder why you asked, if this has obviously been decided already.

Clarification to Ian and golden

by Heartfelt - 2016-06-01 09:06:58

Apologies to you if you think I was disingenuous.
Nothing had been decided, and in fact I have three weeks to find another EP, or muster the courage to speak further with my current EP.
All the information I have gathered has been from this pacemaker site; I have tried my best to get informed by actual pacemaker patients as my only information has been from cardiologists telling me I need a pm or I'll die.
I noticed yesterday that I was the only person in the EP waiting room who was unaccompanied. What I need is to bring someone with me next time ---- someone who can ask the questions I obviously was not prepared to ask. As it was, I felt the EP was rushing me and speaking to me by rote.

Also confused by lack of consumer information

by 1975mg850t - 2016-06-04 15:26:55

I would say if you feel intimidated by any Dr, you should seek another.  You need to have full and open communication with them.

I feel this way a bit about the first EP I saw.  Better repoir with the second opinion doc.  I think I'll go with him for the implant.  Also he seems more willing to use different brand units.

I hope this doesn't result in a Hijack of your thread Heartfelt, but I am in a very similar situation ATM.  My first thread makes states my situatoin also, and maybe response should be there and not here.  https://www.pacemakerclub.com/message/29752/new-patient-which-brandmodel-pm-should-i-get

I have been diagnosed with Sick Sinus, as well as a 1st deg right a/v block.  I am told by 2 EP's thta I need a 2 lead PM.  One recommends and installs almost exclusively StJude.  The other doc reccommends I get one that is MRI compatible.

Primarily, I want to find the most reliable PM for battery life and with the best adaptive sensors/algorythms for adjusting to activity.  I am sorely disappointed with the lack of cosumer information that is available.  I too am looking for info sources and advice.

Thanks all.