Interesting Case

• by dwelch
• 2017-06-12 20:28:11
• General Posting
• 1412 views
• 1 comments

Apparently I am an "interesting case" which in each use was followed by, you dont want to be an "interesting case".  What felt perhaps like PVCs from the description on this site they said were PMTs.  Would feel like it was skipping a beat then a big hard beat, when I was tired in the afternoon or evening was doing it almost every day.  Of course stopped the day I went in to talk about it. Take your car to the mechanic it doesnt break anymore. Was told my descriptions were straight out of the textbook, no big deal, but we will put a holter on you anyway.

I am a handful of weeks into pacer number five.  My first biventricular (all prior were dual chamber), but otherwise 30 years of pacing on two different brands, medtronic and st jude, this is a boston scientific.  So I know what strange feels like after 30 years.

Well doc said that since I never ever complain about anything and this is the first time, she took my charts home and studied every beat from the 24 hour monitor over the weekend.  And found something "very interesting", consulted with other docs to make sure she wasnt seeing things.  

Short answer, they claim my atrial lead is "perfectly placed" it is picking up cross talk from the RV lead, which it interprets as the body sending another beat causing another LV/RV beat and a feedback loop.  I am curious is it really that well placed (why wouldnt I see this in 30 years, their answer, different algorithms from different vendors) or is it because it is a 20-30 year old lead, different technology, grown in better, etc.  Who knows, unless someone here has a 20-30 year old lead that is also "perfectly placed", then maybe mine simply was.  

Another interesting part is the prior pacers would clip at 4-5mv on measuring the input, under that they could get a value, above that it clipped and was shown as above 4 or above 5, this boston sci can go up to 11 (insert Spinal Tap joke here), and mine were hitting 9, which they have never seen before...."interesting case"...

Also, something discussed constantly here with new pacer members, interrogations with nurses or techs or reps.  I have not dealt with reps (messing with my device) other than surgery day, but in this case they had the rep come in to make the adjustments.  In the past, the docs did it, but this office/practice that kinda makes sense, surgeon does this, EP does that, nurse/tech does interrogations, and this office has not that I can remember made any adjustments.  So that was an interesting side note.  Or maybe because I am an "interesting case".

So no real question here, just something interesting that happened after all of these years.