Help

Received biotronik dual chamber pacemaker Dec 3 2019 because of complete heart block. When I'm laying in bed I feel good. When I  start moving  I'm out of breath going up and down basement steps, both feet are numb, bottom low lip and chin are numb and I'm lightheaded.  My pace was set at 60 with aggressive censoring, then they moved me to 70 with aggressive censoring , now back to 60 pace with basic censoring. Still having same issues. Has any else experienced these problems 


4 Comments

questions to ask

by Tracey_E - 2020-01-04 16:50:22

I'm no doctor but that sounds like settings for sinus issues, not av block. Ask them if rate response is turned on, and how much you are pacing atrial and ventricular. With av block we expect to pace ventricular as much as 100% of the time. Most of us don't pace atrial at all which means lower limit is more or less irrelevant. We need the pacer to keep the ventricles in sync with the atria, not to keep the atria from going too slowly. That's what the lower limit is for, how low the atria can get before it paces. 

Rate response is there for people with sinus issues, when their rate doesn't go up on its own on exertion the pacer steps in and raises it for them. With av block, our sinus node works just fine, we only need the pacer to make sure the ventricles keep up with the atria. That means we don't usually need rate response. Sometimes they leave it on anyway, thinking either we won't use it or it'll be there if we need it. However, it can sometimes compete with our natural rate. So, if rr is on and you are pacing atrial, ask them about turning rr off. 

Don't be shy about going back. It's not uncommon to take a few tries to get it tweaked just right. They send us home with a good guess and adjust from there. 

Censoring

by Gotrhythm - 2020-01-04 17:06:57

"Aggressive censoring" is a term I haven't heard before. I don't know what it means.

Aggressive censoring

by AgentX86 - 2020-01-04 20:13:10

I think that's where they give "Bambi" an 'X' rating because of violence.

Perhaps what's meant is "agressive sensing" and the problem is that 1Elephant is over-sensing. 

<https://www.medscape.com/answers/162245-111839/what-causes-pacemaker-oversensing>

What the pacemaker does

by Gotrhythm - 2020-01-07 14:52:40

I'm not a doctor and don't pretend to have more than the most basic understanding of settings, but I have to say, I don't see how anything about the pacemaker would cause numbness of the bottoms of your feet, or numbness of the lower lip. 

If you have complete heart block that means the upper chambers of your heart aren't talking to the lower chambers. Therefore they can't coordinate which part of your heart should contract first and which goes second. The pacemaker takes over the job of communication. It tells which part to contract when. 

It uses all kinds of fancy technology and advanced mathmatics way beyond my understanding, but in a nutshell, that's what it does. It tells which part of your heart to contract when. And that's all it does.

It doesn't do anything to your feet or your lips.

It's important to realize that not everything you feel is related to having a pacemaker.

 

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Yesterday was my first day mountain biking after my implant. I wiped out several times and everything is fine. There are sports after pacemakers!