Voltage settings

I've had a PM for about six weeks now. Sometimes I can feel the pacing in my chest and diaphragm. My diaphragm was twitching but that isn't happening any more after some adjustments.  My Ra threshold voltage is .5V and Rv threshold is 1V but the settings are 2.5V for the Ra lead and 2V for the Rv. Is that usual and can that high safety factor be the cause of my sensing the pacing? Reading the report I never pace from the ventricle but pace 87% from the atrium since I started taking a beta blocker. Initially it was much lower. I'm really guessing on the meaning of those nimbers so please correct me if I'm wrong. No one voluntarily explains all those numbers so I feel like I'm reading tea leaves. 



by AgentX86 - 2022-11-08 23:52:34

Your RA seems to be quite high but your EP may have a reason for it.  A margin of 2x threshold seems to be more common. At six weeks, high numbers are unusual.  Your EP/cardiologist will probably have them lowered soon.

Pacing percentage is in the same zip code as irrelevant.  As you've seen, it can be manipulated six ways from Sunday.


by Springrich - 2022-11-09 00:10:25

Thank you for your reply. I thought it high but was told at the last visit that the PM system sets the voltage automatically at a safety factor of 1.25 and the tech said when she sets it she uses 2 times. But 2.5V seems five times if .5V is truely the minimum Voltage. I'll ask again about lowering the voltage so I don't sense the pacing. 


by AgentX86 - 2022-11-09 00:41:10

Sorry, I meant to say "At six weeks, high numbers are NOT unusual"


by PacedNRunning - 2022-11-09 06:03:20

They typically don't set it lower than 2.0v. So even if it can be 1.0 (0.5x2) m=1.0 they will set it no lower than 2.0v. So not sure why she did 2.5.  See if they can turn on daily auto threshold. That will make it set it lower. They set it high because they want a safety margin. The amount of stimulus it takes to cause the heart can change throughout the day. If they set it too low, it will fail to stimulate the heart and cause a pause. 


by Springrich - 2022-11-09 14:02:38

Thank you for the information. I will inquire about    going to 2V or using the auto setting.  I wish there was a manual that tells one all the details needed to be an intelligent patient but I'm glad there is this forum. 

I bought the book Nuts and Bolts of Pacemakers

by PacedNRunning - 2022-11-09 17:13:23

I bought the book Nuts and Bolts of Pacemakers by Tom Kenny. When my team had alot of difficulty programming my device for exercise, I decided to get a book and read to help.  This book is great because you can just flip the chapter you want to read about. 



I used to feel mine too

by Lavender - 2022-11-09 17:32:25

I used to feel my pacing a lot. Finally a tech changed the way the lead communication with the pacemaker(the can) itself works. They changed it from "ring three to the can to ring four to the can". Now I rarely feel it and when I do, it's a very faint sensation and only when lying down very still as I'm near asleep. 

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