ICD Settings

Hi All,

New here. Got my ICD 3 days ago. Not sure if this is the place to ask about ICD settings, sorry if not. I've got myself a dual chamber Abbott Gallant DR and sometimes I feel a short electrical pulse in one of the leads. It doesn't hurt, it just sort of feel like a very slight vibration. Is that normal to feel ?

Here's my settings-

Lead Info

Atrial Lead:
High output stimulation did not result in diaphragm stimulationSensing: 2.8 mV Pacing Impedance: 510 ohms
Capture Threshold: 1 V
Pulse Width 0.5 ms
Right Ventricular Lead:
High output stimulation did not result in diaphragm stimulationSensing: 11.9 mV Pacing Impedance: 610 ohms
Capture Threshold: 0.5 V
Pulse Width: 0.5 ms
High Voltage Impedance: 57 ohms
Pacing mode: DDD Lower rate 40 bpm Upper rate 130 bpm
VT zone: Monitor only
VT detection rate 166 bpm
VT zone: On
VT2 detection rate 187 bpm
VT Therapies 1: ATP x 3
VT Therapies 2: 36J
VT Therapies 3: 40J x 3
VT zone: VF On
VF detection rate 222 bpm
VF Therapies 1 (joules): ATP x 1 VF Therapies 2 (joules): 36J
VF Therapies 3 (joules): 40J x 5




ICD Settings

by Gemita - 2021-10-08 07:33:10

Hello More Life,

Yes this is the place to ask about Settings for all types of pacemakers although this is a specialised area and many of us are still learning.  I certainly am, but I still try to help whenever I can.  Your ICD settings for your heart condition are of course best managed by your doctors and technicians who will know your detailed medical history best and who will “safely” provide you with the most appropriate settings for your needs.  If ever you feel something is not quite right, please speak to them in the first instance.   

Since your ICD was implanted only days ago, I would expect some teething problems and unusual sensations, including slight vibration.  Looking at your lead settings, I note that they tested your atrial and ventricular leads with high output stimulation which at the time did not result in diaphragm stimulation, although higher than normal output settings is often the cause for symptoms such as you describe. Initially I was told my lead settings would be turned up until leads were well embedded into heart tissue.  After an initial period at higher settings, these would be turned down to more comfortable levels when any symptoms of vibration, muscle twitching, pulsating should improve or slowly go away.  This was certainly the case for me.

If your current sensation causes you minimum symptoms, you may wish to wait until your first follow up before perhaps asking about a possible change in your Settings.  If however, you are very symptomatic from what you believe to be lead stimulation, I would have a word with your doctors when they might be prepared to adjust the lead settings to a more comfortable level for you.

I note your pacing mode is in DDD.  Your lower rate (base rate) at 40 bpm seems rather low to me, so you might ask whether this rate will be increased at some time in the future, particularly if you are getting any troublesome symptoms like breathlessness, fatigue.

thank you

by Alexander - 2021-10-10 04:04:47

I called my EP and they said everything was fine with my settings. Nothing out of the ordinary. I did get these numbers. Usage is at 1% at the upper chamber and 16% at the lower chamber. 

Good to know all is well

by Gemita - 2021-10-10 06:13:19

Thank you for the update and I am glad you have been reassured by your doctors.  I hope your vibration settles quickly.

I note your percentage usage is fairly low which means your heart is functioning a lot of the time without pacemaker support, although these figures can quickly change depending on your heart condition, pacing requirements or any changes to pacemaker settings.

I see you have got a new username (Alexander from More Life) but I am glad you kept your history for More Life, which is always helpful.   

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