"What a day a difference makes"

Hello all, wanted to share and ask a question about interrogations and their effect on PVC'S and A-FIB.. I went in for a routine check recently after a 10 month period and all seemed well. The report was normal but I felt strange as I left and for about a month (with travel) there were many more strings of both pvc's and pac's than I am used to. Just about the forth week i went into A-fib and went to my Doctor's office.  He was away on vacation so I met with Nurse who said I was still in a/f even though I was taking large doses of Atenolol and Flecainide.  I tried to see the pm techs but they did not feel it was needed..after being perstatnt I was interrogated.  Yes I was in afib but what is important is I felt relief as soon as the magnet was placed over the pm.  She would not give me the final report and said she did not make any changes.  Here is what stands out..( as i got my own copy a week later from records dept) In the 4 wks there were 3500 mode switches before i went into af and my ventricle pacing increased from 1% to 14% along with tthousands of pvc/pac strings.  Not had these problems in a long time and when I did they caused by improper settings.   The tech did made four changes ...

adl from 80 to 85...detection rate from 160 to 150 .. upper tracking rate from 150 to 130... upper sensing rate 150 to 140 ...PVAB from 180 to 130

Question ..Could the atenolol/flecainide cause false positives to create the need for the changes? Could there have been a "MAGNET REMOVAL" problem with the first interrogation i mentioned.  I believe that has to do with the length of the PVARP when removed.  Anyway, the af went away  after that interrogation but i have had small blips of it on two occasions since.  Keep in mind that all had been well until that magnet was removed the first time, and now I don't feel the comfort zone i was in for years.  Sorry for the long post but it was quite the day......

Thanking you all in advance,          -Philman

 

 

3 Comments

Feelings after interrogation of the pm...

by Rhythmstorm - 2017-06-09 09:04:55

I too have uneasy feelings, at times, after the interrogation as well as feeling it during the interrogation, which is to be expected during the interrogation. But the afterwards feeling for me is usually bursts of a rapid heart rate that, for me, lasts from 30 seconds to 2 or 3 minutes, with one exception, the rapid palpable rapid rate lasted for nearly an hour during my drive home, of about 45 miles, from the ep doctor. Otherwise, from time to time, I get these rapid hr of around 120 + when I go from a sitting to standing position or visa versa, bending or leaning over or even when I am sleeping and roll over form one side to the other and I feel it so strong that it wakes me up. Told my ep doctor and the interrogation tech about it and really seem to concern them so I don't know whether it is the pm or the medicine, Sotalol for the on/off ahrrythmia, I did not have this rapid hr problem before the pm implant. Of coarse the rapid rate does not show on the nightly transmissions because of the settings unless the rapid rate goes above 160. I don't like the feeling but apparently I will have to get used to it, if I can. Beginning to feel I wished I wouldn't have got the implant. But it has only been 5 weeks and maybe with the occasional interrogations and tweaking it will improve. Wishing you good luck with your pm activity...

Keep in contact and we will compare our experiances.......

Post ventricular atrial blanking ( PVAB)

by Selwyn - 2017-06-10 17:51:04

Shortening the time of the PVAB means that the AMS ( atrial mode switching) is more active in the event of a supraventricular tachycardia, as I understand this,  the longer the blanking period the less chance there is of the excessive atrial activity being sensed.

I don't know whether this information is helpful to you?

Selwyn

 

 

FEELINGS AND SETTINGS

by Philman - 2017-06-11 13:41:40


Thanks for the input Selwyn, i beleive you are correct.  It seems they want to establish more "episodes" with lower settings to prove a point. 

G-man thanks for the infomation,  it might worth while to have a holter monitor for some of the issues you are haveing...Ask your Doctor and maybe review the meds as a lower dose can sometimes help.  Patience, it will work out for you.

 

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