Backup pacemaker.

I don't have any idea about how pacemakers actually sense. I mean the mechanics that enable them to assess your required heart rate and proportion it to any increased physical demand.  I understand that it sense's through the leads and has an onboard computer but that's about it for now. I must research it a little more as nothing much is explained to you at first about it's potential in terms of adjustments related to lifestyle etc. As a layman l understand that when you exercise you get out of breath and so breath deeper and faster, logically your heart would need to beat faster to get the blood quicker to your organs to oxygenate them more efficiently etc. l don't know what factors the pacemaker can assess other than the hearts electrical activity. For instance, does it have the capability to detect oxygen saturation levels in the blood and make adjustments based on factors like this and are there any algorithms involved? At this stage l simply don't know, but considering that l have only had it a fortnight, it's still early day's for me. In life you obviously work with what you have and l now have something new to consider, and so once l know about it's full potential l intend to make the best possible use of it. 


6 Comments

Activity

by sgmfish - 2022-04-30 22:23:16

Most PMs have an accelerometer so that the PM can know if you are moving. Some PMs can do a little more than that I think, but movement is usually all. PMs can't detect O2 or CO2 levels and such. Your natual heart and brain can determine more aspects of your body's state and needs, so a PM is isn't as effective, but it's still pretty damned effective. Precisely how the PM responds to any body movement can be set via PM parameters (e.g, how fast it increases your heart rate, how long it waits until it responds, how quickly it ramps down again). The only complaint I've heard about is bicycle riders because they can exercise hard without their upper body moving much,so the accelerometer doesn't respond as it would if you were walking or running.

Do you need to know the details?

by LondonAndy - 2022-05-01 04:19:39

My bean-to-cup coffee machine makes coffee 17 different ways (who knew there were so many!), adjusting the coarseness of the grind to suit the brew, steaming the milk different ways to make either a caccucino, latte or cafe au lait. 

I don't know how that works either, but boy does it make a great coffee. Why worry about whaat a pacemaker does - the clever people who design these things have all the details, but for me they just work!

Why the EP gets paid

by Theknotguy - 2022-05-01 07:49:18

You have some great questions.  Answer is, that's why your EP gets paid the big bucks.  To get into the really deep details you'll have to start studying the same stuff your EP did to get his designation.  There are technical papers out there and they do go into pretty deep details, but for me, after the first one or two sentences it's just words on a page and noise when you read it out loud.

I did get into some of the technical stuff when my pacemaker failed to respond correctly to a situation a few years back.  But the programming features were way beyond what I was doing with my laptop computer.  And I couldn't understand the electronic side at all.  I just didn't have the technical background.  My EP and the pacemaker mfg rep got things set right quickly once they knew what the problem was.

As the other members indicated, we have the accelerometer that works, there are also rate response settings.  After that you can rely on your EP, the pacemaker techs, then the manufacturer reps.  All can make adjustments to help but to get into the technical details of how the pacemaker works are really complex.  Your pacemaker is a great piece of machinery and it does a great job.  I just got my second one and the new ones have some really snazzy stuff.  

Like I said, you can find technical papers out there if you're interested.  Otherwise, just sit back and enjoy the results.
 

What do you need to know?

by Gotrhythm - 2022-05-01 14:44:44

You're right. Patients are told very little about their pacemakers. I guess for those of us who aren't techies, it would be too, too overwhelming if we thought we actually had to know how our devices worked! And the truth is, pacemakers will work exactly the same whether we understand anything.

But I do think, imperfect as our understanding may be, a basic understanding of what the pacemaker is, what it does, and how it does what it does is of benefit when it comes to communicating with our EP and the tech staff.

I've tried it both ways. Assuming I could totally leave knowing up to them, and studying the subject until I at least knew the right words to call various pacemaker functions and could ask good questions. 

I know for a fact that if you show even rudimentary understanding, you get more respect. Doctors are more likely to listen, less likely to assume it's not worth trying to answer what you are asking.

I get the feeling from how you've worded your post that you are thinking about the pacemaker as if it is some tiny machine performing tasks. You said, "it senses through leads and has a computer onboard."

Let's clear that up right now. The pacemaker doesn't have a computer. It is a computer. The roundish thing in you chest containes a computer, an electrical impulse generator, and the battery to run it, that's all. There are no moving parts. The only thing it "does" is run programs--just like the PC you're using to communicate with us.  Algorhythms are fancy equations that the programs run. The only thing the pacemaker can sense is an electrical signal or things that can be converted into electrical signals.

There are some pacemakers that have 02 sensing capability. How the o2 saturation is converted into an electrical signal I do not know. We say that pacemakers sense "movement," but what they are really sensing is vibration (which is then converted into an electrical signal which the pacemaker signal can interpret.

The questions you are asking about the pacemaker sensing your need to have your heartrate increased when you are more active are questions about part of the pacemaker's programming. That's called rate response, or RR for short. Getting the RR settings right for you can make a big difference in how well your pacemaker supports your exercise and really all your activities of daily living.

I have discovered there is a Youtube video that will explain just about everything at just about any level of complexity. Simply type in Youtube pacemaker and your question. If it doesn't seem to be talking about what you wanted to know, try again wording your question a litle differently. Or just watch some of the others that will come up.

Watch the video over and over--as many times as you need to so you start to understand. Try different videos. Some are better than others.

 

pacing

by skigrl3 - 2022-05-21 20:40:39

I would have to agree that I was not given any info about pacing. I have a fit bit so I can monitor my pulse a bit. I think my pm has kicked in. few times since its insertion a week ago thurs, but that's based on just how I feel. I almost wish the loop recorder were still there,,,

pacing

by skigrl3 - 2022-05-21 20:40:39

I would have to agree that I was not given any info about pacing. I have a fit bit so I can monitor my pulse a bit. I think my pm has kicked in. few times since its insertion a week ago thurs, but that's based on just how I feel. I almost wish the loop recorder were still there,,,

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