Device check

What all do they do when you have a device check right after you have a pacemaker implant?  How long does it generally take? Do they speed your heart up and slow it down? I would just like to have some idea of what they do before I go in. Thanks for your reply .


First device check

by AgentX86 - 2020-03-26 00:42:39

Really, what they're looking for at the first check is to make sure everything is working well.  They'll measure the impedance of the leads to make sure they're implanted well and aren't broken.  Yes, they'll run the heart rate up and down to make sure everyting is good.  They'll probably run it all the way down to 30bpm to see where your heart takes over.  For people with a really low or no native pulse rate this can feel really strange.  I liken it to riding a very fast elevator and stopping to pick up more passengers.  It doesn't last long and the the technician should warn you that it's going to happen. 

If you have any issue, though it's probably too early to tell, with the way your feel or want more oonph during the day, they can tweak the settigns so that you feel good.



by Tracey_E - 2020-03-26 09:54:32

I also liken the feelingt to when an elevator comes to a stop. It's a little weird but not painful. Whole thing doesn't usually take more than a couple of minutes and we are seated the whole time. It's ok to ask them questions about what they are testing. I've found that when they realized I want to know, they get chatty. 

new to you

by dwelch - 2020-03-27 12:44:53

Understand that for those of us with pacers for a long time now, the test feel different than they will for you.  your "normal" 24 hours before was what it was, if they turn off or turn down the device that puts you in your normal.  for us years/decades later turning off or down is not our normal so feels very strange.  another feeling or way to describe one of them is like someone is sitting on your chest.  

they are needing to do a couple of things.  one is are the leads still in place, did they seat well, so there will be tests that isolate each lead to do this.  one lead pacers one test, two two tests three three tests minimum.   Then being new to you and your body, there are settings of the signals, pacers are much better than when I got my first one but there are still many tweakable settings.  If the signal is not strong enough your body wont respond, if the signal is too strong you can actually get a double beat.  Likewise on the sensor end if the sensor is too narrow it wont see your natural pacemaker if any attemting to run the show, if too wide it may see noise or feedback from the pacer itself.

As the leads settle in and scar tissue grows and the resistance changes the settings may need another tweak, the few week visit and the few month visit ideally they get at or close to your long term settings, maybe even the first setup is good.  That doesnt mean they dont make changes over time they do.  But in particular these first few interrogations are looking to see the leads are in place and working right, and the settings are right.

Again being your first one the reality is more likely that you will feel strange immediately after, heart rate may be accelerated or put in some window of min and max, ideally it is smoother, so that may cause you to feel different.  You might have issues sleeping not just from the recovery pain, but from a rate perspective.  the brief moment they do one of the tests that same day/next day will be the last moment of what you think of as normal, but very quickly your normal will change and by 6 months or a year, the test will feel weird like it does for the rest of us.

note there are tests for the leads, there is a slow down test look for your natural pacemaker, and there is a speed up test which perhaps is a lead test.  the slow down feels like someone sitting on your chest the speed up you might get a head rush may start breathing faster, these tests only run for seconds, the machine only has these set temporarily if you are able to see what the tech is doing (often for various reasons you cant see the screen) they are touching a virtual button on a screen only while pressed is the test engaged, when released you go back to normal.  now the pacer is back but your body and your mind think they are still going on...they are back to normal...which tests is done in which order varies, depends possibly on software, device, tech, procuedures set out by the practice, etc.  I have had them vary over the 30+ years with pacers.

some techs warn you before  a test, some dont

the overall test time is short, minutes.  putting the ekg wires on and getting the wand/mouse on a cord thing over the device and setup are the same more time than the test itself.  In the office I have had pratces where the nurse that asks your name and what meds you are on and such wires you up then you sit and wait for the tech trying not to pull the clips off.  then they do the test and then the doc comes in.  my first one the doc did all of it, hooked it up, did the tests, etc.  and various combinations in between then and now.

while we can describe how these tests feel, you will really have to just discover them yourself.  you are fine, they are putting the settings back.  at one or two a year it will take some time to get used to it, but we all go through it it is really no big deal.

last note as for your copy of the printout, it is your data after all not theirs.  can use to keep track of your settings as desired, to ask and answer questions at pacemakerclub and to ask questions to your doc/EP during the visit.

hope this helps

After my first visit to the pacemaker clinic.

by Trunkmonkey - 2020-04-04 23:31:52

First time posting anything here.   Likely not the last...I had my ICD installed just over two weeks ago and had my first pacemaker clinic visit yesterday being  on a Friday.  The tech changed my pacing to allow for a lag to see if my native signal would pick up the impulse to beat.  So there is a lag (blockage) between my aortic and ventricle  chambers.  (I'm no expert so sorry if this is wrong but you get the idea) since the visit I've felt worse.  I've felt like passing out and sluggish. Much like prior to having the ICD.  Is this normal? I've read some comments and it seems like there is some growing pains as to finding the best pacing.  Is this accurate? 

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