Do pacemakers self-adjust?

I  had my first pacemaker put in 6 weeks ago for sinus node dysfunction. At my first follow-up visit after 2 weeks  the technician implied that it was too early to make any adjustments to rate response, and that the pacemaker (a Medtronic Advisa DR) would adjust itself over the first few months. Is this correct or have I misunderstood him? I am gradually feeling more energetic as the weeks go by, but I have not read anything suggesting that pacemakers can make self -adjustments. Thanks for your advice about this.

1 Comments

Diagnostic Self-Check ? / Rate Optimisation ??

by IAN MC - 2017-04-13 08:51:19

Your technician may have been referring to two things :-

i ) Most PMs are set to run a daily diagnostic check at the same time every day.. This mainly looks at the pacing voltage needed to make your heart beat so it checks the resistance ( impedance) of the leads by sending a higher voltage through them. As this can raise your heart-rate it can be annoying if it is set to happen at 3 in the morning. I did in fact have mine turned off for that reason.

I guess the only downside in having it turned off is that it may lead to a slightly shorter battery life if an unnecessarily high voltage is being used..

The daily check can actually make very small changes to the settings but major changes can only be done when you go for a check-up face-to-face with the technician.

ii ) Your tech may have been referring to the fact that the Medtronic Advisa has a self-optimisation feature which can tailor the rate response setting to match your lifestyle over time.I think it can make automatic adjustments to the rate response slope . Maybe someone far more knowledgeable than me will explain how that works.

I suggest that you live with your present RR settings for a little longer so that you have a good idea of how your heart-rate is responding to exercise .  From what you say it sounds OK so far.

Best of luck

Ian

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