Biotronik Edora 8 DR-T implanted yesterday - questions!

Yesterday

by AgentX86 - 2023-06-15 00:59:08

Welcome to the club!

It seems that the default settings for rate response are at least close to what you need.  Your rate is competely controlled by your pacemaker, now, so you can't exceed the rate programmed into it.  You've just received your pacemaker so your cardiologist is being very conservative, for at least now.  Talk to him about raising it but he might not unless you're really capping out.  He can tell by a historgram programmed into the PM, showing how long you're spending in each rate range.  If you're pushing it, the rates can be increased but he may not want to do it unless you're having trouble with your current settings.

One thing to watch for is how fast your heart comes up to speed and how long it takes to wind down.  All of these things can be set and they will usually let you tell them how you want it set.  It's a trade-off between exercise response and inadvertent heart rate increased due to vibration (e.g. driving over bumpy roads).

There are many settings to optimize your quality of life.  Some will have to play with the settings more than others.  Couch potatoes don't need a lot of tuning.  Athletes may require a lot of more complicated tuning.

Ask for a higher maxHR

by crustyg - 2023-06-15 04:58:04

If, as seems likely, high HR for you is 100% PM dependent then at present your device won't drive you to anything about 130BPM.  Which is probably a bit low for you - 155-165BPM is probably more realistic.

It's very common for maxHR to be left quite low at implantation: the checkup at 4-6weeks post implantation is the ideal time to ask for something higher.

Tell your heart team what sort of activities you have built into your lifestyle and they may be able to adjust your device accordingly. Dance, swim, hill-walking, road-cycling all require different settings for a PM for anyone with CI.  I've had SSS+CI for quite a while now, 4years post implantation and it's only this year that we've got my settings perfect for swimming and group (peloton) road cycling.

Welcome and hopefully a few more answers

by Gemita - 2023-06-15 06:10:25

XCanuck57:  Yes, welcome and I am so glad your procedure went well.  I am sorry to hear that the reason for your implant was related to your cancer treatment, the effects of which perhaps may reduce over time?  I do hope so.  

If your own heart should ever recover and be able to reach or exceed 130 bpm, then your pacemaker wouldn’t do anything to prevent this if exercise induced, but if arrhythmia induced, then depending on what is set up, it might switch you to a non atrial tracking mode and drop your atrial rate right back and then you would feel it with exertion.

In the meantime, it is always helpful to keep in touch with your team, and do lots of fine tuning with treadmill testing as you slowly recover your strength and level of fitness. 

I see AgentX86 and crustyg have already provided good advice.  I would just like to add that in the presence of an arrhythmia, you will also need more in the way of fine tuning to get those settings optimised as I am discovering.  And arrhythmias following implant can be quite common while healing is taking place.  I wish you all the very best

Thanks for the response.!

by xcanuck57 - 2023-06-15 13:01:45

I received a note from my doc last night stating that he could move max rate up from 130.  He said that my theoretical max is 155 (I'm 66).  I have walked two days in a row now - pushed it harder on some hills this morning and hit 128 according to my Apple watch workout app. That is not the walk I usually do which has much steeper hills so I am just projecting that I would hit 130 easily on those....today.  Fitness is a factor in all of it since I have not been able to do much for months as my CI worsened.  AgentX86, you mentioned recovery times and, at least from my watch app, it showed a 26 bpm drop in 3 minutes but only 10 in 1 minute...I think the standard is 18 in a minute (?).  Gemita, thanks for your comments.  I am on two powerful Tyrosine Kinase Inhibitors (TKIs) for stage 4 lung cancer.  Never smoked...it is very rare cancer but lots of drugs in development.  There are a long list of side effects and many people experience bradycardia within 1-2 months.  Took two years for my HR to drop to around 38 bpm.  I may come off these drugs when my cancer progresses and move to chemo - hopefully a long way off!  In the meantime, the impact of this PM has been remarkable for me - life changing instant relief!

What a success story!

by Gemita - 2023-06-15 18:26:05

Dear XCanuck57,

I am absolutely amazed to read about your stage and particular form of cancer and to hear how well you are doing.  I think your cancer is going to have a real fight on its hands with a patient like you and I send my warmest wishes for your continued success.

I am delighted to hear what a difference your pacemaker has made to your life already.  You absolutely deserve this.  Please take your time building up your strength, but the fact that you want to push yourself more tells me that you are feeling well and that is a very very good sign.  Remember to “pace” yourself as much as possible, listen to your body and don’t do too much on any one day.  You have your whole life ahead of you to achieve your exercise goals.  What a wonderful success story so far.