Pacemaker Check

Does anyone else feel rubbish after a PM check up? It's been a few hours but I can barely stay awake? 


Not normal Dinah . . .

by Gemita - 2021-06-10 05:00:52

unless they turned something off during testing and didn't turn it back on? How were you feeling before the check up.  If normal and then suddenly you felt differently following the check up, I suggest that they might have changed a setting.  I would ring them and explain your new sudden symptoms and ask what was changed?  Alternatively, you could ask to go back for another check or transmit a remote recording to them for analysis of your settings.  A lower heart rate setting for example would be seen as a possible cause, but you will need to go back for any settings adjustments, it cannot be done remotely.

Of course it could all be a pure co-incidence and you have developed a separate, sudden health condition causing these symptoms or it could be that you were very anxious going in for the check and worried that something was going to be changed.  Whatever the cause, you need to speak to your pacemaker team first for answers I think or you might want to give it a few days to see if you start to feel better.  

Post pacemaker check

by Theknotguy - 2021-06-10 07:38:08

My EP and I had this ongoing argument for years.  I suffer from a lot of afib and post pacemaker check I'd always go into an afib session.  My EP said it wasn't possible and I would always tell him to look at the graphs.  You could see it every time.   Both of us wouldn't back down from our respective positions.  

The EP's office finally got an in-house tech and we started getting the same style of testing on our pacemaker.  That's when I found out when the tech was testing the ventricle side of the pacemaker he (and other techs as well) were running up the ventricle side of the test really fast.  It felt like they were going from zero to over a hundred in just a couple of seconds.  Consequently I wouldn't feel good and would sometimes go into an afib session within 24 hours.  I started complaining and telling them to take it easy on the ventricle side. The tech agreed and for me he runs the ventricle side up slowly and does the minimum to verify the ventricle side is working properly.  

Now, when I go in for pacemaker testing I tell the techs to take it easy on the ventricle side.  I'll also tell them I can really feel it when it does happen and to take it easy.  In training a lot of the techs don't get any instruction about doing the separate part of the tests and aren't aware what they do can cause problems.  Unfortunately it's up to us to point that out. I haven't thrown any of the techs out of the room but I've been really fast to tell them to take it easy on the ventricle side. Most of them don't want to cause their patients any problems and are willing to go along although I've had a couple who didn't feel the need to listen. Consequently I've complained loud and long to the office staff.  

Sorry to go on for so long, but maybe you're having the same problems with your techs.  In your position I'd start asking and see if they can help you out.  If you feel bad post testing that means you'll start skipping testing when you really may need it and that isn't good either.  

Otherwise I hope you adjust well to your pacemaker.  


by crustyg - 2021-06-10 08:08:42

It can happen: for me, the Rate Response of my PM is everything.  It's easy to forget that on the BostonSci models that support MinuteVentilation as a feed into RR, any form of PM set - whether the config is changed or not - causes the MV to dump its calibration (so effectively turning off its contribution to RR => not enough increase in HR when I need it).  There are two ways for MV to recalib: automatically (which can take hours), or manually triggered by the PM tech - takes about 2min of sitting quietly, breathing gently and then it's done, all back to normal.

I learnt my lesson when I'd cycled into my EP-tech appt, forgot to ask them to initiate an MV-recalibration and had to cycle home with a miserable HR and useless legs.  Not fun.

But you don't have BostonSci.  I don't know enough about your Biotronik to know if something *similar* might happen to you.  The standard checks (slow pacing to assess any escape rhythm, drive HR up to check pacing output width at higher rates) should *not* leave you feeling terrible - unless your heart is in a very poor condition.


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