Problems with Settings

I received my last pacemaker Boston Sci L321 Model  in January 2016.  I'm paced almost 96-98% of the time.  When I first received my this device, I had a problem with my heart racing when I rolled over in bed or moved my body a certain way.  Almost like the pacer was too sensitive to body movement.  Basically they turned the sensitivity on the device way down and for a long time, I kind of chalked up being tired and SOB when exercising and doing stairs as being out of shape. 

Now it's 2020 and I'm much more physically active and I was having problems with shortness of breath when doing anything that required a little oomph in heart rate. So, I went in to see my EP Dr. to see what could be done.  Found out my pacemaker was always beating at about 70 even when I was carrying things for a distance, walking briskly, working out...etc.    Two weeks ago my EP Doctor changed the settings to only slightly more sensitive to activity and the same thing is happening as happened when I first received my device in 2016.    I am much better with these new settings  when walking or exercising but now I'm having the same glitch of fast paced heart rate when I move my body a certain way or move quickly.  

Has anyone experienced this issue?    I'm a 58 year old female with my share of chronic health issues.  I work at a desk job and currently I'm full time WAH.    I have a can-do attitude and I'm not a complainer.   But I think something is wrong with my device.  I realize that this is probably not a life threatening issue, but when my heart starts to race because I've turned a certain way or bend over to pick something up, I realize that there is likely something wrong that's not going to be simple to fix.  And, when this happens, it's an uncomfortable feeling.   I also feel like the area over my pacer is uncomfortable.  Not really sore but like something is pulling. 

In any case, your heart shouldn't kick up from 70 to 130 or 140  bpm when you roll over in bed or bend to pull a weed.  I have felt similiarly when I've had issues with a laptop or car and and the service technician or IT Tech can't find anything wrong when they run the diagnostics....but it keeps on having issues. 

I've had three pacemakers since my first one in 2001.   This latest one, the Boston Scientific L321 has been recalled for other issues but not for this one.  I'm wondering if it's a bad model.   They don't have the greatest reputation with device quality control.   

Appreciate any feedback or suggestions.  I used to be on this board all the time 10-15 years ago but have not been here in a long while.   




happy medium

by Tracey_E - 2020-09-28 16:02:47

There should be a setting in between nothing and jump to 140 with the tiniest movement! Mine is super sensitive, my rate jumps up walking across the room, but I choose to have it that way because it's great at the gym. But I can' roll over in bed and not have a problem, and it doesn't go that fast. 

Has your doctor been responsive when you've told them what's going on? Have they done a stress test where they had you on the pacer computer so they can fine tune while you are active? I haven't heard of any recalls in a few years, most have been software updates, but something isn't right, either the device or the people adjusting it.

The device is working fine, but it's not correctly adjusted for *you*

by crustyg - 2020-09-28 19:23:58

Sounds like PMT to me (on the basis of not a lot of information except the very rapid increase in HR).  Accolade (your PM model) has a *ton* of ways to make sure that it doesn't drive your HR up too quickly unless you specifically wish this - dancers like this as they need to go from stationary to maxHR in a couple of seconds.  The downside is over-pacing (apart from the odd feelings that you have).  Usually folk want a respectable amount of time from LRL to maxHR - anywhere from 30s to 2min.  There's a setting in Accolade that can control this.

Either go back to your EP doc and explain what the problem is and see if you can get a tuning session organised as Tracey_E suggests, *or* (as a poor second best), PM me *all* of your current settings and I can work with you to try and suggest what should be changed.

If you don't have your PM records/settings then you need to politely and firmly ask for/demand them *all* at your next visit to the EP tech.

I checked the FDA medical device website just recently for BostonSci PM recalls and the last one was for the MV over-sensing issue in late 2017.  Sep 2108 they had a number of PMs affected by early battery failure but that didn't affect PM operation, just time-to-explant.


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But I think it will make me feel a lot better. My stamina to walk is already better, even right after surgery. They had me walk all around the floor before they would release me. I did so without being exhausted and winded the way I had been.