Data Storage

Hello Everyone, 

 

I have a medtronic pacemaker which is set up too the mycarelink app on my phone, this acts as remote monitoring. Over the past 7 months or so i have been having a few issues with non sustained vt. My doctors have told me that on the remote monitoring to detect VT it needs to be over 4 beats and 176 bpm. 

So what i am wondering is does this also count for the pacemaker interrogations at the hospital, or can they see every beat? As my thought is i could of had a few episodes that where, maybe, 7 beats or more, or less long, but only 175 bpm, and this would still need to be looked at. 

I hope the proper pacemaker interrogations can detect all types of beats, not just ones that are so fast. 

Thank you for your time and i hope someone knows something about this,  

Hayden 


3 Comments

Data storage

by Gemita - 2021-05-26 05:38:01

Hayden, hello, I also have a Medtronic MyCareLink monitor. 

Firstly remember you have non sustained Ventricular Tachycardia (NSVT), not sustained VT - a fast ventricular rhythm over 100 bpm, lasting at least 30 seconds.  If sustained VT is ever seen, this would be picked up and reported on, even at rates below 176 bpm, if it lasted longer than 30 seconds.  Instead, NSVT lasting only a few beats, at high heart rates is something completely different that many of us get in response to vigorous exercise or other stresses and can be normal. 

On your specific question:  "My doctors have told me that on the remote monitoring to detect VT, it needs to be over 4 beats and 176 bpm”.  Yes it would appear your settings ceiling parameter of 176 bpm and more than 4 beats duration has to be reached before the event is reported/recorded as a VT episode.  My upper heart rate is set slightly lower at 160 bpm.  Logs of significant (say in duration) fast heart rates are kept Hayden, although clearly short runs (a few beats) at higher rates can be normal for many as already mentioned. 

You then ask whether they can see every beat recorded over the period of monitoring during your in person hospital interrogation?  Clearly not everything will be recorded, only what is programmed to be recorded in your pacemaker, depending on the parameters set to record an event.  

Pacemaker data has to be managed efficiently since the pacemaker has a limited storage capacity.  Nonetheless, most of us are still able to transmit data to our clinic for their complete analysis whenever we are concerned about our symptoms.  In my experience they are usually able to confirm any significant arrhythmia present, duration and heart rate.  If transmission at the time is not possible, I keep a diary note of event and report this during clinic interrogation.  If significant, the arrhythmia will be recorded, so my advice is always to keep your own records too when you get symptoms Hayden.

On one occasion, surprisingly, they actually located a pacemaker recorded ECG of a multi focal atrial tachycardia episode as the cause for my symptoms and this was confirmed by the Medtronic technician.  Without my records, I might not have received this vital feedback, so well worth keeping diary notes.

Please be assured that your doctors will detect what is important.  If you are really concerned that your doctors may be missing runs of more than 4 beats at just below the cut off threshold of 176 bpm, then talk to them about your concerns to see whether your parameters for recording these events should be changed?

During an in hospital pacemaker interrogation your technicians will of course be able to detect what rhythm you are in, your heart rate and anything significant.  The pacemaker downloads will show the information requested by your doctors for a specific period (say annually) - that is, the full information that has met certain parameters set by your pacemaker technicians for the recording, storage and reporting of an event like VT and other arrhythmias, heart rate logs (lowest/highest), % pacing in right atrium, right ventricle), % time in an arrhythmia and so on.

I have tried to answer your questions as best I can but I am still learning too what is set up in my pacemaker.  Your doctors will know best what is set up in your pacemaker Hayden and it will be a slow learning process so be patient.  If you want to learn more about your pacemaker, you could also read your manual online for your model of pacemaker, or go to the Medtronic Academy Website to read up on specifics like "monitoring ventricular tachyarrhythmias".  You could also ask your clinic for some of your most essential pacemaker Summary settings sheets which will have a lot of information for you to digest.  Good luck Hayden

Pacemaker data storage

by Theknotguy - 2021-05-26 10:28:14

Hayden :

I'm not sure how much the Medtronic devices store on the device itself.  Some of that information is proprietary to Medtronic and they won't discuss it.  So your Medtronic pacemaker probably already has the information you want.  Usually your EP and the techs don't need to go past the previous interrogation.  The doctor's office techs can punch the do-not-need button and the previous information is not available to the doctor's office techs.  Usually not a big deal.  

My story.  Volunteering at a hospital.  Have a Medtronic pacemaker.  Back hallway is 954 feet long.  (Actually had someone measure it.)  I'd walk 900 feet and run out of air.  Always ran out of air at the 900 foot mark. Talked to my EP.  Did some tests.   Last test the cardiologist said it was the pacemaker and called in the Medtronic rep.  

The Medtronic tech shows up and starts asking questions.  Since my hours at the hospital were documented, I could tell the tech to the hour and almost to the minute when I had the SOB episodes.  He proceeds to pull up  all sorts of heartbeat graphs that I'd never seen before.  And, these graphs went past the do-not-need graphs the doctor's office techs had used.  He was able to go to the minute I had my SOB episodes and then determine what wasn't set correctly for me.   A few taps on the keyboard and I was set.  Just needed a change in rate response from something slightly different from the standard doctor's office tech settings.  

In answer to your question and my point being is that, yes they can see the individual heartbeat and yes, if need be they probably can go back to the time you had your events.  The doctor's office tech may be able to pull up that information without bothering the Medtronic's tech.  You, of course, will have to document the date and time of the events in question.  I also think your local tech can give your EP a printout of that information or your EP can call up that information himself. 

Hopefully this will help. 
 

Data storage

by AgentX86 - 2021-05-26 23:10:55

Only "significant" information is stored.  "Significant" is what your EP decides is significant.  The heartbeats themselves (EKG) aren't stored unless programmed to and there is very limited storage.  It's possible to coorelate symptoms with events because the time and type of even is recorded, if it's programmed to record that event.  There are some arrhythmias that can't be recorded at all.

There are all sorts of statistics rcorded, used primarily to "optimize" (e.g. heart rate histograms) but are also used for diagnostics (%AF, %PVCs, and such).

The bottom line is that PMs record some things, can record others if so programmed, and others it can't record at all.

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