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SETTINGS

by Gemita - 2019-12-14 07:30:23

Dear Pacer2019,

I'm still learning too and I will leave the detailed technical analysis to those able to give you a real opinion.  I will try to explain what I think I know !?

May I ask whether you are getting "irregular" heart rhythms ?  If you feel your pulse, is it an even beat you feel or runs of irregular beats.  Any irregular rhythm will cause difficulty (at least it does for me) when exercising.  If I try to push through during periods of irregular rhythms I become quite breathlessness, weak and experience chest pain.  

Your clinic should be able to tell you whether they have picked up anything significant.  I see under "Detection" lower left of your image that Atrial Tachycardia (AT) and Atrial Fibrillation (AF) and Ventricular Tachycardia (VT) are being monitored and that there will be arrhythmia intervention - see under " Features/Interventions" - if the parameters set for such intervention have been met.  I am not sure exactly what this means for you with regards to pacing during arrhythmias. 

Under Parameters I see you are in DDD mode (dual chamber pacing system).  I see you have Mode Switch On, so if they detect an arrhythmia in the upper chambers of your heart at a certain rate (? anything above 170 bpm), Mode Switch will come on and stop tracking what is happening in the atria and switch to pacing you solely in the ventricles, thus preventing unwanted fast arrhythmias in the atria from getting through the AV node to affect your ventricles.

The Amplitude, Pulse Width, Sensitivity, Polarity, PVARP are all beyond me Pacer2019, so hopefully someone can help you here.

I would recommend you download the Medtronic manual for your particular pacemaker model because it will explain a lot.  My Medtronic manual is almost 300 pages, but that is the sort of detail you need and you can look up so much and then discuss what the relevant bits mean for you.  

I cannot explain why you can't get enough "juice" as Swangirl has so well expressed, but an arrhythmia present at the time of any exercise will certainly cause me difficulties.  When my heart is beating in rhythm I am able to achieve so much more, so ask your clinic whether you are experiencing any irregular heart rhythms, particularly at speed, because that will adversely affect your ability to exercise.

Happy learning !

That's why the EP's get the big bucks

by Theknotguy - 2019-12-14 11:10:07

Being able to read the squiggly lines on the printouts, then determine what heart problems you have, then apply that knowledge is why the EP's get the big bucks.  I feel there are two things you aren't taking into consideration....

First, you have an ongoing heart problem.  That has to be taken care of and taking care of that may mean you don't go back to your pre-pacemaker heart responses.  There's the old joke about two doctors having a conversation.  First doctor says, "I've discovered a new treatment.  It's simple and effective." Second doctor says, "That's great! Can we see the patient?"  First doctor; "No, unfortunately the patient died."  So it doesn't do you any good if the doctor reduces or changes treatment and you die.  Having patients die doesn't look good for your heart doctor.  So they are reluctant to do things that may kill you.  And that may mean you don't go back to a pre-pacemaker lifestyle.

Second, it takes a while for the heart and body to adjust to all the new changes - and that takes time.   How long depends upon what problems you have and what it takes to fix it.  EP's have a tendency to get things started, then step back and wait.  Frustrating I know, but what is true for your condition today may not be true next week.  If the EP or cardiologist is changing things all the time they don't know what is working and what isn't.  So waiting is the game and patience is your part in it.  

I was very fortunate.  Threw a temper tantrum after something didn't work.  Nurse Kelly was my nurse.  "Look!", she said.  "You're a guy.  Guys like to fix things.  You're NOT going to be able to fix this.  You'll be a lot happier, live longer, and feel better if you learn how to live with what you have!"  So instead of (as the Brits say) whinging about not going back to pre-pacemaker settings, learn what you can do for the time being and go from there.  Yeah, I'd like to go back to my pre-pacemaker settings but that isn't going to happen.  And without the pacemaker I'd be dead and I like that option a lot less than what I've got.  

Bonus third thing to know.  Changes are on-going.  I'm six years out post pacemaker implant.  Changes in lifestyle and I end up doing more exercise.  I'm having problems running out of air.  Go in, talk with my EP and they make some changes in my pacemaker.  Now it's keeping up with my new lifestyle. Who would think you would need changes six years out.  But the previous treatment plus the pacemaker enabled me to get strong enough so I could do the increased exercise and would need the changes to the pacemaker.  My old heart would have done that automatically.  But the way my heart is now, that isn't going to happen and I have to rely on a machine.  And the machine may need adjustment from time to time.  

I was also fortunate a second time.  Health plan recommended I go for heart rehab.  Went to rehab and found out what I could and couldn't do.  Upper limits (at the time) and where I would max out.  Did I go back to pre-pacemaker living?  No, but I had a good idea of what I could and couldn't do and I started living with that.  And I'm leading a full life.  

Thanks

by Pacer2019 - 2019-12-14 16:34:31

For checking in and taking the time to share .  One thing I have learned is there are a lot of moving parts here - with the machine and with imdividual patients.  We all have our own definition of things.  I spent two hours combating on the court this morning and felt good. My heart still maxes out around 130.

Last week I had an echo cardiogram and had my carotid artery scanned ....Tuesday I'm having a nuclear ☢️ stress test .

im lookimg to check in on my artery situation with my cardiologist ...especially since this pacemaker caused me to meet my deductible ! It's all free from here on out or at least until 12/31. 
 

thanks again and keep up the exercise !