RV capture

Dr turned off RV capture, now feeling short of breath and dizzy and tightness in lower neck area. Says RV lead pacing in unipolar. Could turning off RV capture cause the symptoms I am having? When I was in the hospital rep changed from bipolar to unipolar and set capture threshold to 1.8@0.5. Couldmturning off the RV capture cause my symptoms? Any comments will be appreciated. I have a duel chamber biotronic pacemaker . I was in hospital for heart failure and first time afib! 

 


7 Comments

Call Doctor

by MinimeJer05 - 2021-09-14 14:23:36

I wish I could tell you if these changes are normal, but I don't have enough knowledge about this stuff just yet to shed any light. 
 

but I would totally call someone and at the very least, get some quick answers and reassurance. Might be nice to know it's fine but you should come in vs it's not fine and there's a problem. 
 

Jer

RV capture

by Jam - 2021-09-14 14:47:41

Yes have appt to talk to the doctor! Thanks for your comment.

RV capture and unipolar

by AgentX86 - 2021-09-14 19:33:13

If RV capture being turned off means that the RV lead isn't doing anything.  You're now being paced AAI, rather than DDD, probably.  I don't know your complete diagnosis but you say you had Bradycardia.  If this was from SSS only, the RV lead probably isn't doing anything anyway.  If you have heart block, I don't understand turning it off. 

Setting the RV to unipolar can cause issues with pacing muscles, as well as the heart. Again, I don't remember you whole history (it's a good idea to put this stuff in your BIO).  But, if your RV lead is turned off, whether it's set to bipolar or unipolar doesn't matter. It's off.

Do you happen to know what your pacing percentages were?  This question is sort of a back-door into figuring out why you have a pacemaker and why they'd turn off the RV lead.

RV capture and inipolar

by Jam - 2021-09-15 21:12:08

Only was pacing 2% on RV -100%on A.  I really do not understand this. This was from EP notes,  

Right Ventricular lead questions

by Gemita - 2021-09-16 05:34:49

Jam,

I can see you are still trying to get answers for your symptoms which is worrying and frustrating for you.  Many members have given good information over a period of time and I do hope this has helped you to understand more about your health condition and your pacemaker.  I also hope it is helping you to have a better relationship with your doctors, so that you can ask them directly some of the questions you are asking here (and better understand their answers).  From personal experience, I know this takes time. 

Your comment,  "Only was pacing 2% on RV -100% on A.  I really do not understand this. This was from EP notes", tells me that you were paced 100% in the right atrium and 2% in the right ventricle for the period recorded.  This would suggest to me that you have Sinus Node disease rather than Heart Block.  However 2% of the time you needed right ventricular support for whatever reason (perhaps due arrhythmia?) which may not sound much but it was needed.  Now you say your right ventricular lead capture has been turned off.   I would want to know why and whether the problem can be corrected or whether (1) a replacement right ventricular lead is needed, particularly in view of your difficult symptoms?  You were given a dual chamber pacemaker system in the first instance for a reason and I presume that reason still exists?  

I see you were in hospital for heart failure and AFib.  Both these conditions can of course cause the symptoms you describe (in addition to a faulty lead).  Are you on treatment for heart failure or AFib?  I have a dual lead pacemaker for Sinus node disease and pace 100% right atrium and approx 5% right ventricle but percentages can change rapidly depending on our pacemaker settings, our heart condition, our medication, on lifestyle factors and so on.

With Unipolar pacing there is more chance of pacing the diaphragm and other muscles which might account for your increased symptoms, although your right ventricular lead appears to have been switched off?  Question (2) Did they explain what exactly has happened to your right ventricular lead?  Question (3), is your atrial lead set Bipolar or is it set Unipolar to account for your worsening symptoms?  Both my atrial and ventricular leads are set Paced/Sensed Polarity:  Bipolar.

Right ventricular lead

by Jam - 2021-09-16 11:00:20

I had a pacemaker implanted for bradycardia and sick sinus syndrome Oct 2020. I have had numerous adjustments and have been hospitalized as well. During my hospital stay the.Biotronic   rep adjusted the pacemaker to unipolar. I was doing ok then had some episodes as I described previously.New EP turned off RV capture threshold now brief symptoms. Will see the EP tomorrow andI hope  no lead problemsSomfar the  leads haven't been a problem Thank you for your response as it gives me some idea as to what Questions  I need to ask the EP. Yesterday and today Inhave no symptoms. Will not cancel appt as could come back! 

Auto capture is a test

by PacedNRunning - 2021-09-21 02:18:44

Auto capture is just a test the device performs daily to make sure you have the right amount of energy to make the heart contract.  Turning that off does not turn off the lead. It will still work. Is there a reason it's unipolar and not bipolar? A majority of PM's today are bipolar.  Is there something wrong with the lead?  That would be the only reason to change it to unipolar. Doesn't sound like you lead that lead much so turning it off if there is a lead issue makes sense.  Make sure to ask for clarification 

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