Biotronik CLS advice

Hi am new to this group.  Diagnosed with Chronotropic Incompetence being driven by my cancer treatment meds.  In bradycardia - 38 bpm at rest.  Recent treadmil test confirmed the CI with max of 90 bpm.  No AV block.  Getting the Biotronik CLS pacemaker (not sure of the model) since I have been told it will help me be less tired and respond the best during walking, gardening and cycling which are my main activities.  I have read a lot of great posts and have determined that some of the configurations and even pacemaker choices and very personal.  I am just trying to get ahead of the configuration curve - any advice for me to discuss with the docs before they put it in mid-June?  The only thing I see in the order is setting my resting heart rate to 70 bpm.  Thanks!


10 Comments

Why Biotronik?

by Doug H - 2023-05-30 14:30:26

I received a Biotronik and have had second thoughts on this manufacturer primarily because the hospital staff that installed the devices is surprisingly unfamiliar with Biotronik.  The device itself is fine (but others offer better features), and the doctor that installed it did a decent job (ie, no infection) - but I'm not an expert, so it's difficult to assess.  I would challenge your doctor, why Boitronik?  Why is it the best for you?  (Really, you want to know if the decision was made without any financial influence from the manufacturer.) 

Doug

Best Advice

by Penguin - 2023-05-30 14:33:04

The best advice I can give you is to talk to an 'owner' and discuss the good and bad points of the device you've been offered in the context of your diagnoses and needs....I'm sure one will be along soon :)

You probably already have this link to the company's website which explains some of the features of Biotronik devices and the models, but please find below just in case you don't. 

https://www.biotronik.com/en-gb/products 

CLS is probably the feature which is mentioned most often on this forum and it's worth reading the marketing information to understand it and then comparing it with patient experience which, as you point out will be personal.  From what I have read you are right to 'get ahead of the configuration curve' although you may find that a little confusing initially if you are new to pacing.   A Biotronik Rep for your area could also be useful perhaps as they could explain key features which may be useful to you if your EP hasn't already done so. 

Best Wishes

 

 

 

Thank you

by xcanuck57 - 2023-05-30 15:01:37

The medical team has been very thorough with my cardiac assessment  - lots of testing etc.  My cancer and meds complicates things a bit  but thankfully my heart is in good shape - just slow.  Their approach is "we are only doing this if it will have a postive benefit" and I am sure it will.  I have read about CLS as much as I can and you are correct I do not understand all of the "knobs" they can adjust beyond upper and lower limits.  Even then, there are folks flipping it out because not right for them and going to say...Boston Scientific.  My docs were pretty adamant with a "this is it" kind of posture on the Biotronik _ I guess I will just need to be on them about the "tuning".  Hopefully it is an easy process to dial in fast walking and cycling at a comfortable pace on flats!

Happy with the Biotronik

by Persephone - 2023-05-30 18:31:52

Hi xcanuck57 - I don't have any problems with the Biotronik device that was implanted but I don't know any different since it's the first one for me and I wasn't offered a choice. Similar exercise habits except don't road cycle, just stationary bike. It may be challenging to negotiate with your medical team on device brands, in my opinion, but depends maybe on what kind of time you can get with them. My only comment would be that 70 as a starting base rate may feel a lot different from what HR you've been accustomed to - not sure how long you've been in bradycardia - so could be some adaption period, but it sounds like your medical team is available to help you if adjustments are needed.

I hope it all goes well for you.

Dialing it in...does the Cardio dept know Biotronik?

by Doug H - 2023-05-30 20:35:08

I think this is key and it is a disappointment for me...your cardiologist needs to convenience you his department is familiar with adjusting Biotronik devices not just pacemakers in general - functionality may be the same but adjusting these is not. For a month after the installation, my device was a nightmare....racing heart, afib-like events, pounding heart. I was told this was normal. One night I called in almost pleading for help.  The nurse said she knew what the problem was.  I said great, can you fix it?  She said, no, I don't know Biotronik.  My response - well who does?  Her answer, Bob (name changed), he used to work at Biotronik.  This and other stories are seared into my mind.  I have no issues with the device...but do consider support, more so if you frequently travel internationally (no issues there yet but I do wonder if I ended up with device trouble in any non European country).  

Best wishes.  (FWIW the operation and recovery for me were outstanding.)

Biotronik - thanks for the info

by xcanuck57 - 2023-05-30 21:43:10

Thanks for the info.  You can read all of the literature and comments and then you have to put your faith (not too blindly) that the docs know what the right approach is.  I am a little concerned about the tuning  - but this is a large hospital and cardilogy team in Southern CA and these guy are nothing if not sharp!  My assumption is they are not giving me a Porsche and telling me after we only work on Chevys!  Those nuances like resting at 70 bpm and top-end rates will just need to get sorted out.  What I am looking for is relief from dragging around -- which is getting worse!!  Thanks to this site I come armed with way more questions!!

Yes, ask Doug H's question

by Persephone - 2023-05-30 22:11:26

Fully agree with Doug H. This question needs to be asked. I kind of feel like a graybeard (to use that expression even though I have no beard) because my cardiology clinic seemed to flounder a bit with the Biotronik and I had to self-advocate - which is familiar to many people who have been in medical treatment situations so I didn't find it too abnormal. The clinic stepped up quickly and brought in competent Biotronick mfr techs to work with them regularly in the clinic. That was over 5 years ago, so hopefully reflects a trend toward the medical teams learning about the Biotronik.

Mercedes

by Daedalus - 2023-05-31 01:12:00

Very happy with my Biotronik (Edora 8 DR-T) so far.  Works like a charm (set at 60/130; CLS off as it's not needed in my case).  My cardiologist also likes them and her comment about Biotronik was, "German engineering.....think Mercedes."   This is my first one, so obviously nothing to personally compare it to.  The two tech reps I've seen so far are well trained, knowledgeable, and communicate well.  If I'm still around come replacement time, I'll request another one. 

biotronik

by skigrl3 - 2023-05-31 06:40:51

Hi-

I have a Biotronik Edora DRT-8 and so far (1 yr later) no issues and I go for my annual check up on this friday. I am fortunate that my care is in a major renowned medical center and (so far anyways,haha) the care team seems like they know what they are talking about. Last time I went (about a month or 2 post op) they had the biotronik rep on site for my checkup I have no idea if the rep will be there when I go for my first annual on friday. Good luck, see if you will be getting a bedside monitor to take home, I think its more of a battery check than anything.

Why Biotronic

by AgentX86 - 2023-05-31 14:35:40

My best bet would be that it's just what your doctor/clinic/hospital uses.  Companies often give special deals, or kick-backs, or increased support to hospitals that use one manutacturer or another, exclusively.  This isn't really as sinister as it sounds. The service sometimes includes a factory trained and supported, on-site, PM tech. There may be paid training for PM techs on their devices.

Often the reason for the selection is simply monopoly or "lock-in". There isn't usually much of a difference.  CLS is one of the differences.

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