Home Transmitter

I am a bit bummed.  After my pacemaker implant 3 years ago I received a Merlin at Home transmitter where reports were routinely sent in quarterly.  I felt very secure knowing I was monitored at night.  I am pacemaker dependent with complete heart block.  I moved and with Tracey's help here at the club, I requested my former Cardiologist release me to my new doctor whom I will see for the first time in a couple of weeks.  

I was just informed that this new doctor doesn't do the home monitoring thing.  I have been having some real issues with fatigue, especially after the rate response was turned on.  Just how important is this home monitoring?  I have been assured that I will have frequent pacer checks.  This doctor was highly recommended by my PCP.  Should I worry or just forget about it?  Also, I've heard others here talk about a watch type device that keeps track of things.  I'm 79 but surely open to anything available.  Thank you for your time.


8 Comments

Monitored at night?

by AgentX86 - 2022-07-27 12:03:06

I doubt that you were "monitored" at least with the common definition. Your pacemaker may have uploaded information every night, though for most it's only quarterly, but if there is an ongoing problem, nighly is possible.  It's not a real-time monitoring.

If complete heart block is your only issue there really isn't any need for frequent monitoring.  You're going to get the same answer.  If you really want to track your heart, the best solution is the six-lead Kerdia Mobile but it's not going to say much about CHB, particularly since you're being paced. 

If you had Afib or Aflutter, traking with a watch or Kardia might be useful,  Otherwise, it's probably overkill. Quarterly interrogations, either by Merlin or in-person, are likely good enough.

Home monitor

by Lavender - 2022-07-27 12:28:43

I know you're concerned. My monitor was important to me when I got my device. My cardiologist didn't turn it on the first month and I was miffed because I thought it would babysit me while I slept. I also thought she was delaying due to her having to pay the maintenance fees for it. I think now she knew it wasn't crucial for me. 
 

I think it's nice if they had apps for home monitoring on the cellphones. Not many products use the apps, though. 
 

Remember that the monitor is not a heart monitor. It collects information and relays it if there's something that shows up on the parameters preset by the doctor. Mine is a Latitude by Boston Scientific:

The LATITUDE Communicator checks your implant based on a schedule set by your doctor. The Communicator does not conduct continuous monitoring.

This data is sent to a secure website for your doctor to review.

LATITUDE does not reprogram or change any functions of your implant. Your implant still works even if your Communicator is not working.

The Communicator does NOT contact 911 during a health emergency. If you are not feeling well, call your healthcare provider or dial 911.

Maybe the new doc can reassure you as to why he doesn't use them. 

Monitor

by dorieg - 2022-07-27 12:52:11

I just had my pacer replaced after 10 years. I still see my electrophysiologist for check ups and monitoring. I have a cardiologist who I love but he doesn't do the monitor so I use both. 

I had been told mine would need replacement at my visit. Told me to expect it in a few months time. Two weeks later I got a call. I guess the monitor sent a warning to the doctor. I had it replaced three days later.

Monitor

by JaneJ - 2022-07-27 13:09:55

Depending on what is set on your monitor, it will send over if something like a major increase or decrease in impedance is detected or if your battery is critically low, or if you have some other red flags that may potentially be emergent.  They are pretty useful, as with complete heart block you want to make sure things are working correctly, or could be serious implications for you and your health.

nice but not necessary

by Tracey_E - 2022-07-27 16:22:04

Most offices like them because it means we don't have to come in as often. Odd that the new office would not want to use it, but it's not a big deal. Yes with CHB we are often dependent, but they don't suddenly stop working, even at the end of service. I'm on my 5th, and this is the first one I've had a home monitor. With the others, I went for quarterly checks. When it got to the end, I went monthly. 

It's good that your primary recommended this office, but I find it odd they'd eschew newer technology that makes all of our lives easier. Right now I'd say the recommendation balances the lack of wanting to use Merlin but keep your eyes open for other red flags.

home monitor

by skigrl3 - 2022-07-27 22:09:01

  I have a home monitor for my biotronik edora dual chamber. I am guessing its so I don't need to go in for checks. I got the pm in May, went for a 1 month checkup and don't have to go back for a year. I was told my monitor was a nightly monitor that checks to make sure the pm is doing its job. I had a cardiac loop prior so I was used to the nightly routine and hope they don't back off on that.

I can understand your disappointment

by Gemita - 2022-07-28 01:16:55

Benedeni,

If you have a look at the Poll we have running on monitoring, you will see a fair number of members do not have this benefit and I believe it is a benefit.  In my experience here in the UK, it is often only given on an as needed basis, for example, for an ICD patient who might need close monitoring to see whether a dangerous arrhythmia is being controlled. 

My own personal feeling is that while not essential for some of us, it is useful to have home monitoring because it saves time and resources and therefore costs in overall care, prevents unnecessary trips to see our team if we live far away or cannot get to our appointments because of adverse weather or due to mobility problems, particularly with the elderly.  Having a monitor to automatically or manually transmit data is progress after all, an add on to our pacemaker box of tools to use on an as needed basis if we get into trouble.

Can I make a suggestion Benedeni.  You could wait to see if you like your new doctor, if there is a rapport between you, if he is someone you want looking after you.  If not, you could find a doctor and practice where they encourage their patients to use home monitoring as part of your care. 

I have home monitoring here in the UK for arrhythmia monitoring;  my husband unfortunately does not but he has me to closely monitor him 

Monitor

by benedeni - 2022-07-28 09:45:10

Thanks to each of you for your input and knowledge re this monitoring.  Agent, you were so right in that I was, in all likelihood, not nightly monitored.  Gemita, our minds are thinking alike!  I will visit the new doctor and weigh pros and cons and if there is little rapport I shall look afield!  And Tracey, you are also so correct in regards to weighing the importance of recommended doc vs. the monitoring.  I do have occasional A-flutter but nothing like those of you who experience severe flutter or A-fib.  And Yes Lavender, we sorely need a better way of accurately tracking our own devices.  Surely in time...  Best to all and keep on pacing!

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